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

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Raising Kids on the Spectrum: Sensory Processing Difficulties, Behavioral Problems, and Parental Stress


A child's ability - or inability - to regulate sensation (i.e., the process of noticing, organizing, and integrating information from the environment and the body, and then processing and responding appropriately) significantly contributes to general behavior patterns. Problems with regulating sensory information (e.g., taste, sound, touch, smell, body movement, or body position) may lead to patterns of:
  • hypo-sensitivity or sensory-seeking behaviors (e.g., needing high levels of sensory input such as a loud noise, firm touch, repeatedly crashing into walls, banging toys in order to register the sensation, etc.)
  • hyper-sensitivity or sensory-avoidance (e.g., over-reacting to bright lights, loud noises, being held, etc.)
  • a mixed pattern of sensory-seeking and sensory-avoidance



Asperger's and High-Functioning Autistic kids with poor sensory regulation show a wide range of problems across several domains, including internalizing behavior problems, externalizing behavior problems, problems in many daily activities, and problems in emotional and attention regulation.

Here are some of the behavioral problems associated with sensory processing difficulties:
  • Academic problems: The youngster may have mild to severe learning disabilities, and problems with generalizing new concepts and skills.
  • Difficulties with self-regulation: The youngster may have difficulty with mood stability or maintaining an optimal level of arousal. She may be unable to calm herself down after an activity - or get herself going for an activity. Her arousal level may fluctuate minute-to-minute or day-to-day.
  • Difficulty with transitions: The youngster may throw a temper tantrum, be uncooperative, or experience heightened anxiety when stopping one activity and starting another. Also, he may have a difficult time leaving a particular place or going to the next task of the day (e.g., bath time, bed time, dinner, etc.).
  • Emotional problems: The youngster may have significant self-esteem issues, be overly-sensitive to criticism, transitions, or stressful situations. Also, she may have difficulty relating to others or understanding her own actions, motivation, or behavior.
  • Excessive energy level: The youngster may be unable to sit still, constantly on the run, or engage in risky behaviors.
  • Frequent hand switching: The youngster may not have a dominant hand for writing by age 5, may switch hands often while cutting or writing, or may throw a ball with both hands.
  • Impulsivity: The youngster may be unable to control impulses (e.g., to jump out of his seat) or his behavior. In addition, he may be aggressive or frequently "blurt" things out without thinking first.
  • Low energy level: The youngster may appear lethargic, uninterested in engaging in most activities, or be sedentary most of the day.
  • Low frustration tolerance: The youngster may become upset, yell or throw a temper tantrum at the slightest thing that does not go her way. She may give up on tasks easily if they are difficult for her.
  • Motor coordination problems: The youngster may appear clumsy, slouch, rest his head on his hands during desk work, exhibit awkward movements, or have frequent accidents.
  • Motor planning problems: The youngster may have difficulty with sports, riding a bike, doing jumping jacks, clapping, handwriting, balance, using eating utensils, or getting dressed.
  • Poor eye-hand coordination: The youngster may have sloppy handwriting, difficulty cutting or drawing a straight line, catching a ball, or tying shoes.
  • Resistance to the unfamiliar: The youngster may experience anxiety or refuse to meet new people, try new foods, participate in new activities, or sleep in a different environment.
  • Short attention span: The youngster may have difficulty concentrating on one activity or task for any length of time, and she be distracted by every sight, sound, smell, or movement she sees.
  • Social skills deficits: The youngster may have a difficult time relating to his peers and sharing. He may isolate, get aggressive, and be overpowering or bossy in order to help himself regulate and to control his sensory environment.
  • Uncooperative with activities of daily living: The youngster may have difficulty brushing his teeth, eating, participating in certain activities, getting dressed, going to bed, or taking a shower.

A child's sensory sensitivities will indeed affect his or her behavior and general temperament, but the reverse can also be true (i.e., the child's temperament may affect how well or poorly he/she deals with sensory sensitivities).

Here are 9 temperaments that may be associated with either sensory-seeking behaviors or sensory-avoidance:

1. Sensory Limit: This is related to how sensitive your youngster is to physical stimuli (e.g., sounds, tastes, touch, temperature changes, etc.), and refers to the amount of stimulation needed to elicit a response (positive or negative) in him or her. For example:
  • Is your youngster a picky eater, or will he eat almost anything?
  • Does he startle easily to sounds?
  • Does he respond positively or negatively to the feel of clothing? 
  • Does your youngster react positively or negatively to particular sounds?

2. Predictability: This trait refers to the regularity of biological functions (e.g., appetite and sleep). For example, does your youngster get hungry or tired at predictable times, or is he or she unpredictable in terms of hunger and tiredness?

3. Perseverance: This is the length of time your youngster persists in activities in the face of difficulty. For example:
  • Is she able to wait to have her needs met?
  • Does she react strongly when interrupted in an activity? 
  • Does she persist in an activity when she is asked to stop?
  • Does your youngster continue to work on a puzzle when she has problems with it, or does she just move on to another activity?

4. Disposition: This is the tendency to react to things primarily in either a positive or negative way. For example:
  • Is your youngster generally serious?
  • Is he generally in a happy mood, or does he tend to focus on the negative aspects of life? 
  • Does your youngster see the glass as half full? 
  • Does she focus on the positive aspects of life?

5. Emotional Energy Level: This is the intensity of a response, whether positive or negative. For example:
  • Does your youngster get upset in a very strong and dramatic way, or does he just get quiet when upset?
  • Does he react strongly and loudly to everything - even relatively minor events - or do most things seem to roll off of his back?

6. Physical Energy Level: This refers to how active your youngster is in general. For example:
  • Is he always on the go, or does he prefer sedentary quiet activities?
  • Is your child content to sit and quietly watch? 
  • Does she have difficulty sitting still? 
  • Does your child seem to always wiggle, squirm or pace?

7. Attention Level: This is the degree of concentration and paying attention exhibited when your youngster is not particularly interested in an activity. This characteristic refers to the ease with which external stimuli hampers the ongoing behavior. For example:
  • Does he or she become sidetracked easily when attempting to follow routine or working on some activity?
  • Is your child easily distracted by sounds or sights?
  • Is your child easily soothed when upset by being offered an alternate activity?

8. Approach/Withdrawal: This refers to the youngster’s typical response to strangers or a new situation. For example, does she eagerly approach new situations or people, or does she seem hesitant and resistant when faced with new situations, people or things?

9. Flexibility: This is related to how easily the youngster adapts to changes and transitions (e.g., switching to a new activity). For example:
  • Does he take a long time to become comfortable in new situations?
  • Does he have difficulty with changes in routines, or with transitions from one activity to another?

Sensory processing difficulties in kids on the autism spectrum often have a significant impact on the parent-child relationship. A child experiencing these difficulties can react to his parents or his environment in ways that are unpredictable or seemingly irrational. For instance, a youngster who is overly-sensitive to stimuli can react negatively to the parent's voice or touch. As a result, the parent can be confused by the youngster’s reactions, which may result in the parent feeling a sense of incompetence in his or her parenting skills.

Moms and dads of kids with sensory processing difficulties report higher levels of parenting stress than parents of "typical" children. As sensory processing difficulties increase in severity, so does the level of parental stress.

Most parents that see a significant reduction in (a) sensory processing difficulties, (b) resultant behavioral issues, and (c) parental stress identify the sensory issues their child is experiencing fairly quickly – and treat it soon after identification (usually via occupational therapy).


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Managing Disruptive Behavior in Children with High-Functioning Autism and Asperger's

“We've been going in circles with our high functioning (autistic) 8 y.o. and his disruptive behavior – hitting, kicking, throwing things, just to name a few. We have tried all that we know to try. It's been difficult when he acts out, not respecting us or his siblings. It impacts the entire family! Do you have any ideas of how to handle disruptive behavior of this kind?”

One of the biggest obstacles a parent faces is managing disruptive behavior in the child with Asperger’s (AS) or High-Functioning Autism (HFA). Whether the child is refusing to eat what was prepared, or throwing tantrum on the way to school, the parent can find herself at a loss for an effective way to respond.

If you are at your wits end, the ABC method can provide a roadmap to a calmer, more reliable way to manage problematic behaviors. This method also offers a chance to help the AS or HFA child to gain the developmental skills he needs to regulate his own behavior.



The ABC Method of Behavior Management

To understand and respond successfully to misbehavior, parents have to think about what came before it – and what comes after it. Here are the 3 crucial features to any given behavior:
  • Antecedent: This is the preceding factor (or trigger) that makes a behavior more or less likely to occur. Learning and anticipating the antecedent is a very helpful tool in preventing problematic behavior.
  • Behavior: This, of course, is the specific action the parent is trying to discourage - or encourage - as the case may be.
  • Consequence: This refers to the result that logically and naturally follows a behavior. The consequence affects the likelihood of a behavior recurring, whether it’s positive or negative. Also, the more immediate the consequence, the more influential it is.

Identifying “target behaviors” is the first step in a good behavior-management plan. These behaviors need to be (a) specific (so both parent and child are clear on what is expected), (b) observable, and (c) measurable (so parent and child can agree whether or not the behavior happened). An example of poorly defined behavior is “acting-out,” or “being mean.” An example of well-defined behavior is “completing homework” (good) “pushing your sister” (bad).

Antecedents—

Antecedents come in many forms. Some are wonderful tools that assist the parent in managing misbehavior before it begins as well as bolstering appropriate behavior, while others facilitate misbehavior. Let’s look at each of these in turn…

Antecedents that bolster appropriate behavior:

1. Providing countdowns for transitions: As often as possible, the parent should prepare her AS or HFA child for an upcoming transition. For example, let the child know when there are 15 minutes remaining …then 10 minutes …then 5 before he must come to dinner or start his homework. Note: Making the transition at the stated time is just as important as issuing the countdown.

2. Making expectations clear: Parents will get better cooperation if they and their youngster are clear on what is expected. Its best to sit down with the child and present the information verbally – and then put it in writing and post it in a prominent location. Even the child “should know” what is expected, explaining expectations at the outset of a task will help avoid misunderstandings down the line.

3. Letting children have a choice: As the child grows up, it’s crucial she has a say in her own scheduling. Giving a structured choice can help her feel empowered and encourage her to become more self-regulating (e.g., “Do you want to pick up your dirty clothes before or after dinner?”).

4. Being aware of the situation: Parents need to consider and manage both emotional and environmental factors. For example, anxiety, hunger, fatigue, or distractions can all make it much more difficult for the youngster to effectively manage his behavior.

5. Adjusting the environment: Examples of adjusting the environment are (a) removing distractions such as video screens and toys when it’s time to do homework, (b) providing a snack, (c) establishing an organized space for the child to work, and (d) making sure to schedule some breaks.

Antecedents that facilitate misbehavior:

1. Initiating transitions without warnings: A transition is hard for a child with AS or HFA – especially in the middle of something he is enjoying. Providing a warning gives the youngster the opportunity to find a good stopping place for an activity and makes the transition less stressful.

2. Shouting instructions out from a distance: It’s helpful to give the child important instructions face-to-face. A parent’s request that is yelled from a distance is less likely to be understood and remembered.

3. Assuming expectations are comprehended: Parents should not assume that their child automatically knows what is expected of him. The expectation needs to be spelled out! Demands change from circumstance to circumstance, and when the youngster is unsure of what he is supposed to be doing, he’s more likely to engage in problematic behavior.

4. Giving too many instructions at once: If parents deliver a series of instructions or ask a lot of questions, it limits the likelihood that the child will hear, answer questions, remember the tasks, and do what she has been instructed to do.

Consequences—

Not all consequences are created equal. Some have the potential to do more harm than good, while others are an exceptional way to create structure and help AS and HFA children understand the difference between unacceptable and acceptable behaviors. As a mother or father, having a good understanding of how to consistently and intelligently employ consequences can make a huge difference in outcomes.

Consequences that bolster appropriate behavior:

1. Being clear and concrete when using time-outs: Parents should establish which behaviors will result in a time-out. When the AS or HFA youngster exhibits that behavior, the corresponding time-out needs to be relatively brief and immediately follow the misbehavior. If a time-out was delivered for not complying with a task, once it ends, the youngster needs to be instructed to complete the original task. In this way, he or she won’t begin to see time-outs as an escape method. During the time-out, parents should not talk to their youngster until he or she is ending the time-out. It should end once the youngster has been calm and quiet for a brief amount of time so that he or she learns to associate the end of time-out with this desired behavior.

2. Staying consistent: If parents arbitrarily issue time-outs when they are feeling aggravated, it will undermine the behavior-management system and make it harder for the youngster to connect behaviors to consequences.

3. Using active ignoring: Ignoring is used for minor misbehaviors and involves the deliberate withdrawal of attention when the youngster starts to misbehave. With this method, parents pick their battles carefully and save their energy for the larger issues that need to be addressed (e.g., verbal or physical aggression). As parents ignore, they wait for appropriate behavior to resume. Then they should give positive attention as soon as the desired behavior starts. By withholding attention until positive behavior is exhibited, parents are teaching their youngster what behavior gets acknowledged and praised.

4. Using positive attention for positive behaviors: When parents give their youngster positive reinforcement for behaving appropriately, it helps maintain that ongoing good behavior. Positive attention improves self-esteem and enhances the quality of the parent-child relationship. Positive attention to “brave behavior” can also help alleviate anxiety, as well as help the child become more receptive to instructions and limit-setting.

5. Using reward menus: A reward is a tangible way to give your youngster positive feedback for desired behaviors. It’s something that is earned, an acknowledgement that the child is doing something that’s difficult for him. A reward is most effective as a motivator when the youngster can choose from a variety of things (e.g., a special treat, extra time on the computer, etc.). This reduces the possibility of a reward losing its allure over time. Also, the reward needs to be linked to specific behaviors – and always delivered consistently.

Consequences that facilitate misbehavior:

1. Using positive consequences for negative behaviors: This reinforces the behavior you are trying to eliminate. For example, if your youngster procrastinates instead of putting on her shoes or pouring milk for her cereal, in frustration, you do it for her, you have just increased the likelihood that she will procrastinate again in the future.

2. Giving negative attention: Negative attention actually increases bad behavior over time (e.g., raising your voice, threatening to issue a consequence, etc.). Also, reacting to misbehavior with criticism or yelling negatively affects your youngster’s self-esteem. Kids value attention from their parents so much that any attention — negative or positive — is better than none.

3. Using disproportionate consequences: As a parent of a child on the autism spectrum, you understandably get perturbed from time to time. You may even have become so frustrated at a particular behavior that you said or did something that you felt guilty about later. This is normal and to be expected.  But, keep in mind that issuing a massive consequence – especially out of anger – that is not in proportion to the misbehavior is demoralizing for kids, and they may even give up trying to behave well.

4. Delaying consequences: Effective consequences are immediate. Every minute that passes after a behavior, your youngster is less likely to link his misbehavior to the consequence. As a result, you end up punishing for the sake of punishing, which makes it much less likely that the misbehavior will change.

Though kids with AS and HFA are found to have neurologically and developmental related symptoms over time, the primary problem is behavior. Moms and dads need an arsenal of coping methods to reduce the behavioral problems at home. By utilizing the suggestions listed above, such problems can be reduced to a more manageable - and livable - level.

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

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==> Parenting Children and Teens with High-Functioning Autism

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Articles in Alphabetical Order: 2017



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