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How to Bond with Your Resistant Adolescent Client with HFA: Tips for Therapists

"I am a wife to a HFA husband, and a mother to 3 boys (2 of which are on the autism spectrum as well). I am also a therapist in private practice & I have finally been given a teen that I can't seem to reach. She is high functioning, however very flat affect (depressive sx) and all her comments in session are "I don't know" or she just doesn't answer. Is there any guidance you can give me so I can help her & build that rapport?"

There are a few unique considerations here, most of which I'm sure you are already aware of. And these considerations are specifically geared toward the early phase of counseling when trying to establish a bond with the client.

It has been my experience that people with an autism spectrum disorder dislike talking about themselves in general. However, they do enjoy talking about their special interests. Your client no doubt has a preferred activity. So initially, instead of directing questions to your client in an attempt to get her to talk about herself, identify her special interest and let the conversation revolve around that.

Once you have identified her main interest, spend a little bit of time researching that activity so that the two of you can exchange ideas about it. Here you are making statements about the special activity based on your new knowledge of it rather than asking questions. (Although a few related questions sprinkled here and there may be beneficial.)

Individuals with the disorder also are out of touch with how they feel. But they do like to talk about facts, especially those associated with their preferred activity. Thus, in the early going of therapy, it may be helpful to talk about facts associated with your client's special interest, and stay away from questions and comments about feelings.

I believe it is also important to match the eye contact style of the client. As I'm sure you know, individuals on the autism spectrum do not make a lot of eye contact because they do not glean information from facial cues and other body language. So if your client is looking down for example, you may want to look down at a notepad on your lap periodically, followed by a few seconds of actual eye contact.

Also, people on the spectrum are easily over-stimulated by a series of questions, both emotionally and cognitively, which often results in a shutdown. This may explain why your client doesn't answer your questions or simply says, "I don't know."

Lastly, I would keep sessions short - no more than 15-20 minutes initially. This will help avoid over-stimulation and a subsequent shutdown. Also, the ideas above are strictly for the "bonding phase" of therapy, and can be used for 3-4 sessions before moving on to the more serious stuff.


Resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

COMMENTS & QUESTIONS [for Feb., 2018]



Do you need some assistance in parenting your Aspergers or HFA child? Click here to use Mark Hutten, M.A. as your personal parent coach.

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Hi Mark,

I recently came across the video version of this blog post from a few years back: http://www.myaspergerschild.com/2012/02/lying-or-wishful-thinking-which-one-is.html. Actually, my wife forwarded it to me. Her and I both had the exact same “oh shit” reaction to this.

I am writing to you today basically at a point of desperation with my 13 year old son Jack. He has HFA, diagnosed when he was 5. The blog post describes him exactly. Before I go further, I want to let you know that Jack is currently in a residential treatment center for kids with behavioral and psychological issues; he’s been there for about 2.5 months for suicidal ideations. Here’s the problem: What happens when your HFA child becomes an adolescent and starts lying about big things, like wanting to kill himself, being part of racist groups and saying he’s different religions. Are they lies, perceived realities, fantasies or attention seeking behaviors? Our struggle is that we believe this might all part of his autism, but because of the specific topics and gravity of his claims, there is no differentiation made in the psychiatric community between the former and delusions or psychosis. So he’s being treated with anti-psychotics… guess what, they’re not working. Just like when we tried ADHD drugs on him to help with his impulsivity and they didn’t work.

I’m not really sure what I’m looking to you for, maybe not so much advice, but wondering rather, if there are there any studies that you are aware of that describe this behavior with adolescents on the spectrum? If so, what are the recommended treatments and outcomes. Any experts? We are going down this path with the residential treatment center, psychiatrists, psychologists, therapists, the school district and our attorney and we are constantly asking ourselves if we’re fighting for the right thing. Let me know if you have any thoughts on this.

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I was reviewing your online program for parents regarding meltdowns for their Aspie kids.  I have a full-grown, 55 year old very big husband who has meltdowns that are not on-coming so much as flash.  One second he appears ok and in the next second, he's exploding in fury, white-faced, completely out of control and it's all aimed at me for something I cannot relate to at all.  I can not see any triggers and I would love to even if I were the cause because I could change what I say or do to prevent these.  It would be worth it.  I am nearly an empath but I can't see these coming.
I would love to create an environment where I can keep him calmer but since he seems pleasant almost all the time, I wonder how I can de-escalate what I don't see escalating?  Although I said he seems pleasant, he is also uncomfortable in his demeanor all day long too.  Really, I've tried to read him all these years but when he blows with a melt-down, I have to freeze, let him roar until he wears himself out ten to twenty minutes later, then slowly creep out of the room while he sits down in shock.  He remains in a shocky state for the rest of whatever day there is left. If I am stupid enough to talk to him hours later, he is rattle snake nasty, so I quicky go back to walking on egg-shells, don't talk and don't go near him. 
He's rocky for another day or two, then super-nice for the next few weeks.  It completely knocks the wind out of his sails.  He had a brilliant counselor who insisted on medicating him for this twice, but he point blank refused.  He refuses all medication that others recommended including a psychiatrist.  Because of these meltdowns I have drawn a line in the sand for nutritional changes which he accepts about 85% of the time.  So far so good.  He has these meltdowns one or two times a year.  Sometimes we skip a year.
Do you think your program for parents and children can help adults?  Do you think it can help an adult whose meltdowns have no ramp-up?  I'm holding my breath in our case because the nutritional solutions seem to be having a good effect.  He struggles less with anger issues now. He has Oppositional Defiance Disorder which makes things worse, but it's not rampant or I wouldn't be able to live with him.  It's mild, but it's there.  So do you think your program is applicable in our case?
Thank you for your time.

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Dear Mr. Hutten,

I really appreciate the information you provide! So many resources make it seem like I should run for the hills. But I love my husband, and our family, and just want to find a way for him to be happy.

About seven years ago (shortly after we were married) the couples counselor my husband and I saw let us know she believed my husband was AS. He aggressively denied it and forbid us from going back to her. I hadn't pursued more information on it because we manage to make things work most of the time.

Fast forward to now. We have two beautiful little girls, and are (I believe) fantastically well. My husband, however, is very very unhappy. (And firmly blames me, though he cannot articulate what is wrong other than "we don't connect" which I truly have no clue what he is referring to (I would love to get advice, or find a therapist who at the very least can help me help my marriage.

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I'm a 47 year old man and for over three years I've been in a relationship with a woman who, almost from the beginning, I've suspected has Aspergers or is somewhere on the spectrum.  She is six years younger than myself, Professor of French Horn and seems to possess most of the traits associated with Aspergers and with many that, according to Dr. Tony Attwood and others, seem to be more specific to females.  Beyond these comments I'm not sure how to proceed.  We've been in traditional couples counseling with a woman who uses The Gottman Method but my emailed suggestions (it is not an emotionally secure environment with my girlfriend in the room) voicing my concerns to the counselor have fallen on deaf ears.  Worse, there has been gaslighting by the counselor (reporting about things my girlfriend has said brings prompts from the counselor "you THINK thats what she said" or "THINK that's what you heard".  The traits that Aspie children, especially Aspie girls have, that my girlfriend had and still has are shrugged off.  Instead, since she believes that her husband (they were married for 17 years, divorced almost five years ago) was unfaithful and stole from her (money placed in their joint account by his parents to help pay for renovations to a property "flip" that they were investors in) and the counselor dismisses any traits that appeared prior to "the betrayal" as irrelevant.   My voiced concerns are akin to a little boy telling. Normal tit for tat rivalry and conflict in relationship.  My girlfriend's meltdowns are just signs that she's "just emotional" per the counselor.

    I'm at risk of dumping all of my frustration out in a flood here.  I'm in the Kalamazoo area in Michigan and I don't know what to do.  I don't want to stay and don't want to leave.  I've used several of the evaluation questionnaires that seem legitimate and she comes out at eighty percent likelihood or higher.  I've talked about my research into Aspergers and Aspergers in women.  But no light goes on with her.   I need to be connected with someone knowledgeable about Aspergers, Aspergers in women, in NT-AS diverse relationship and especially who can ask me insightful questions. 

Instead she's recently begun telling be that I'm contextually challenged socially.  Most recently this came up after I became a little animated and was singing along during a gospel flavored song at a recent vocal jazz concert.  She believes the appropriate way to show respect is to sit quietly and formally.  Anything else will embarass her and distract from the performer.  Many in the audience were reacting the way I was including a very well respected choral director that I've known for years.  My girlfriend is Professor of Horn (French Horn) is devoted to chamber music, longs for the sort of formality seen on Downton Abbey, admits that she can't relate to music other than classical and some 80s and 90s pop like George Michael and Duran Duran.  Other music is too loose and she can't follow it.  I performed in a similar vocal jazz ensemble including one of the pieces they performed conducted by that director I mentioned.  My behavior, in that situation was contextually appropriate.  This concert that we were attending featured two student ensembles at the university at which she is on faculty.  Her department director was in attendence.  Which is actually what she interprets as my being out of step contextually.  Her context was one of her own self consciousness at being seen in that situation with a real human.

    Okay.  I'm dumping.  What do I do? Sometime I feel like I need to bring an Aspergers expert into the counseling room.  Have one live with us for a month incognito? But she's good at mimicking and showing well.  What she calls "performing" so they don't find out she's "a fraud".  She feels she has to "perform" when in the backyard gardening.  (One of two and a half obsessive interests.  Gardening, Horn/Female horn players and Female classical composers.) I'm concerned about the parts that are heavily narcissistic and the parts that seem to mimic what I've read in descriptions of Borderline PD (extreme fear of abandonment among others) 

     I need some help making sense of all this.  How to communicate what I'm experiencing with out sounding disordered.  I've talked to a therapist but he takes a similar feminist line as the couples counselor.  (the couples counselor identifies him as a "supervisor" of her.  She is a Masters, he Ed. D.) As a man I'm not to judge a woman.  I'm depressed and having difficulty holding onto mindfulness practices and healthy belief in myself.

Will you help me? Point me in a direction.  Support groups are a challenge with things so jumbled in my head about all of this. 

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Hallo Mark.
Nice for me to read your book, The comments of the N.T. women on your site are not so positive ....
I have a question: Do there exist translations in other languages (German of course) because my N.T. wife really doesn't speak a good english and of course she doesn't trust me when I tell her the best strategies living with me and my behaviour.
In fact it seemed for her the first 7 years of our relationship I would have been a little bit extraordinary, but normal.
Only the last years and specially the last year I didn't functionate/work as she liked.
You you see there a special point?
2007 we first me. Weekend-relationship until 2009
2009 - 2012 living together in al flat. Each of us working. Marriage end of 2012
2013 (Jan) birth of our daugther. Buying own house. + dog + some cats
2014 (Sept) birth of our second daughter
2016 (March) diagnosis of kanner-autism (our first daughter) and from July on she moved out and lives at her grandma (mum of my wife)
2016 (July) birth of our third daughter
2017 (Feb) my diagnosis ADHS. (Oct) diagnosis of Asperger autism.
my wife thinks I am not on autismus; I would only read books about ADHS and Asperger (yes, for my information) and would only copy the behaviour of the people to cheat her and let her work until she breaks down and do nothing or less at home "he is so ill".
Two psychologists I asked about this told me this would not work (cheating to do as if I were ill).
My wife thinks autism is something you have a lifetime. Might be true but I think I was able to compensate many many years (never went on parties or team-meetings) but after birth of our third daughter the possibility to compensate was no longer possible and hearingall the "I have to do all child-hood and other daddys play with their children ...." took me down.
Do you agree oder maybe there are other points?
Is it ok when I do a translation by my own?

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Hi Mark,

I am contacting you to see if you can provide us with any assistance or recommendations on where we can get assistance in deciding the next steps in helping our 15 year old son with High Functioning Autism and significant cognitive rigidity. 

Our son (Michael) was diagnosed with PPD-NOS at 2 years & 8 months old.  We have provided him with the best possible care through evaluation and treatment by experts in our home of Atlanta, Georgia.  Michael had extensive therapy (ST, OT, PT, equine therapy, swim therapy, sensory therapy, Floortime, ABA, play groups, social groups, and sensory therapy) from 2-7 years old.  By the age 7, his therapy intensity and frequency decreased and gradually progressed to neuro-typical activities such as playing sports and attending camps.  He responded extremely well to these interventions and attended public school in a neuro-typical classroom for academically gifted children.

Starting in 3rd grade, he started verbalizing for the first time his dislike of school.  By 5th grade, we began to see him falling behind socially and academically, and he was demonstrating significant OCD.  At that time he was seen by a psychiatrist and placed on Abilify, which seemed to help initially.  His 6th grade year (first year of middle school) was a nightmare.  He required 2-3 hours of assistance each night to get homework done with a tremendous amount of effort and arguing.  This work should haven take less than 30-60 minutes. 

After seeing multiple medical professionals for further neuro-psychological testing, evaluations, and recommendations, we decided to move him in 7th grade to a small private school for kids with language-based learning differences.  His 7th grade year was a complete turnaround. He starting enjoying school again and returned to playing sports that he had withdrawn from for years.  Unfortunately, in 8th grade, things went downhill again, and he started to struggle again in the same small private school.  He was having difficulty socially and emotionally.  He began to hate school again and not do his work that was way beneath his ability (his IQ is 121).  We took 60-90 minutes to attempt to get him out the door and to school in the morning.  The morning routine in our house was a nightmare. 

Once again, we sought help form the school and from local experts, including outpatient and in-home individual and family therapy as well as a 3-month in-home parent training class.  Michael was also being treated by a psychiatrist for evaluation and medication management for ASD, ADHD, and anxiety.  We continued psychotherapy throughout this time. 

During this same period (5th to 8th grade), Michael began being fixated on electronics, and by the 8th grade, he only wanted to play electronics.  He would refuse to stop playing and would argue and fight non-stop to get electronics.  He would physically block and resist anyone trying to remove his electronics.  It became a real addiction for him and was totally destroying our family with fighting every single day about electronics.  

Again, through evaluation and recommendations by local experts we decided that Michael would go to a wilderness program and then to a therapeutic boarding school (both are in Utah).  Michael spent 11 weeks at the wilderness camp and then went directly to a therapeutic boarding school/residential treatment center that we were referred to by an educational consultant   He has been at the therapeutic boarding school for 9 months.  As of this February, he will have been gone from our home for one year, but we haven't seen any significant improvement. 

We are at a loss about what to do and where to go for further treatment options. The main difficulty Michael is having is that he is very cognitively rigid, and no expert or facility has been able to help him or us with that.

If you can provide us with any consultation or recommendations about where we can get further evaluations and treatment we would really appreciate it. 

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My 13yr old son was diagnosed with ADHD at 4 yrs old.  But, recently they did some more in depth testing and have changed his diagnosis from ADHD to ADD w/ anxiety and High Functioning Autism.  All the support systems here in Central Florida seem to be for children 2 to 12yrs old and then there is nothing after that.  So, it has been very hard for us trying to find things to help him out.  What I am asking you is if you know of a book, article, movie, anything that will help us explain to him what HFA is.

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Hi Mr. Hutten,

Thank you for the resources for neuro diverse couples. My husband is the aspie and I am the NT wife. We have been married for 12 years. It wasn't until this past year that my Aspie husband has accepted that he has HFA. We read your book and watched your videos. I am still struggling.

I don't know if it is too late. We are trying to find a therapist who works and has experience with HFA adults. I am strongly relating to the morning you speak of in a conference you presented. I feel like no matter what, there are things my Aspie husband cannot give. I have become emotionally attached to a friend. I don't want to leave the marriage because I don't want to hurt my Aspie husband or our children and he hasn't had much time to process and for is to work through this. However, when I connect with this friend, it is a constant reminder of what I will never have with my husband.

To save our marriage, I am trying to disconnect from this friendship/emotional affair but now I am morning this loss. I don't want to lose this though but I feel I have no choice.

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Thanks so much. We had to take our daughter to stay with friends on Sunday after a week of out of control behavior. We have been using non traditional techniques (and are eager to learn more from your program), but she became completely defiant and verbally and physically abusive. Constantly crossing the line and would not separate from us or respect our boundaries. I had to leave multiple times with our other kids.

I urgently need to find where in the ebook or audio-video it addresses crisis times. Once the line has been crossed and she is not responding to the strategies. We are looking for a list of protocol/boundaries/steps to take when prevention steps have ceased to work, even temporarily. I have calls into counselors (hasn’t worked in the past) to find someone who can give us this protocol so we can get her back home and feel like we have instant steps to take if it gets to this point. I’d rather use your program but don’t know if it will take days/hours to find this information (if it’s even there)

If you can direct me where to find this I would so appreciate. I’m sure you’re busy so I will try to figure it out of not.

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Good afternoon:)  my name is dawn foster from katy, texas. My son , Jacob was diagnosed with hf autism at age 6.  He is now 10 and finishing 5th grade.  He was given a recent cognitive testing and has a 128 IQ.  He does very well in school for most part, but there are concerns.  

It is time for coarse selections for middle school.   Wanted to put him in pre-ap classes.  Despite Jacob scoring 100% on his STAAR state test in mathematics,  teachers do not recommend him being placed in pre-ap due to increased melt downs in class this school year. He has melt downs they believe due to stress or anxiety.   Occasionally,  very rare has melt down in reading class.  Unfortunately,  I believe these meltdowns are due to issues on play ground and misguided grouping of students for certain assignments.   Jacob doesn't do well in groups and teachers claim lots of team or group work will be required in pre-ap course work.  Why should my son be dismissed from high academic opportunity because of his struggles with social skills and executive function skills?  Am I wrong?  He is bright.  He is never a behavior problem or disruptive to the point class stops.  He is given breaks and taken outside of class to calm down sometimes.  He tends to forget to get things into back pack for studying of tests.  This is what accommodations are for righr?  Am I cresting un necessary stress for my hf ASD child for 6th grade? 

Just feel our district is looking at this completely WRONG.
Your take?

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Hi
I have just sign up to your book. It’s great.
My child is 12 and has Aspergers. My husband is not his dad but has been in his life for 9-10 years. My son only goes to his dads once a month. My husband has a lot of care of my son as I’m a shift worker. He is a police officer. So he is quite stricter with my son. He really struggles with my son. As my son believes he is an adult and wants to be treated like one. My son tends to think he is the big man. So they clash a lot. My son constantly get negative attention from my husband. My number one problem is my son forgets to but things away after himself and forget the rules. Also he can not get ready on time for school. He forget to do something before he goes. We have tried being with him while he get ready but he just wants to argue the whole time. We have tried a list and reword he just won’t tick off. Should he be disciplined for forgetting to do things? Like forgetting to put food away or leaving  the seat up? Also you said in you book that the parents should be saying I love you before bed. I’m not there for a few nights a week due to my work. I have asked is my husband will say it and he doesn’t want to. Do you think this will be an issue?

I have asked my husband to read you iBook and hoping he will support me with this. I would love some more support and help. I feel so helpless to the point where I just want to shutdown. I have seen 3psychologist with my son. The first one put him on meds and second just said to make a list and the 3rd has told me she thinks I don’t need a psychologist that we need to have a family counseling session.

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Whenever I attempt to call a ‘time out’ to halt a heated argument and wait to talk to my teen after we have both calmed down, he continues to whine, complain, rephrase, and pursue the argument.  My straight faced, calm response of repeatedly ‘no’ or ‘time out’ doesn’t have any effect on him.  If I leave the room he will shout his protests continually through a closed door.  After five minutes or so, he may leave, but will immediately restart his argument if I emerge from my ‘time out’ space.  I cannot spend hours physically hiding and waiting for him to calm down.  With a toddler or young child, the whining or tantrum passes and is usually forgotten.  My teen will stop only while being ignored, then immediately restart the same argument anew.   At age 15 I can’t force him to go to a time out, and his relentlessness is a formidable barrier to most tactics we’ve tried.

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Hi Mark,

I understand the parents you usually work with.  We were those parents before we had teenagers and the game changed, and so did our parenting.  But I am asking you to consider this as an extreme case where your techniques have been implemented and the child is incorrigible.  That is where we are at.  What are our options?  Our daughter has been staying with family friends for over a week and has made it clear she does not want to come home because she does not want limits and consequences anymore.  She also has a complete distortion of reality and refuses to treat us with respect.

I wish I could convey to you that we have already transitioned from traditional parenting to coaching our daughter in this way for the past 6 months.  We have two teens older than her and one younger (yes, 4 teens). These techniques have strengthened our bond with our other teens.  But, with Amanda, the minute she doesn’t get something she wants, she sets in on making family life miserable for all.  We do the poker face, and don’t give in, but she never stops acting out.  During which, she’ll cause more issues (which turns into a vicious cycle of consequences, even if we delay for later).

After 2 weeks of her refusing our parenting (and refusing to even have a respectful conversation), we sent her the attached letter and then met with her on Monday night to talk.  We used your type of language – “We think x happened because y, etc.”  She is completely cold and spiteful, it doesn’t work.  She denies being angry, resentful, doing anything for our suggested reasons.  She says all she gets from our letter is how strict we are, and she would rather live on the street than come back to our house. 

She was disrespectful throughout (and I kept thinking we are supposed to leave when she does this, to set a boundary, but felt helpless because she can’t stay at our friends indefinitely).  We suppressed talking about all of the pain she has caused and her lack of accountability or willingness to make amends.  Instead, we let her talk and she won’t share her actual feelings – she is blind to the truth and shares constant warped reality.  She was insulting, degrading, and emotionally abusive and eventually we did have to cut it off and leave.

We told her we had come up with a list of ideas to modify her school and activities she’s interested in to help stimulate her and boost her self -esteem.  Also, she knows I also am supposed to take her and her sister to California to visit my Grandparents in 10 days.  (She said she doesn’t care about California now)  We told her if she chooses not to go she will have to pay back her plane ticket.  We told her that we would need her to come home and demonstrate several days of being respectful and obey our rules before I would consider taking her on multiple planes across the country.  Even if she agreed to that, if we’re not reconnected with her and her heart is not in the right place, we’re going to go right back to where we were.  So, we’re at a stale mate.

Anytime we try to reestablish trust and a bond she becomes disrespectful to the point of emotional abuse.  When she starts, we let her know we want to work through things with her but she’ll have to go to her room until she’s willing to be respectful.  She is nasty to anyone who passes when she’s in there, and eventually refuses to stay in her room. 

What led to her leaving was not only did she completely refuse limits and discipline, but she continually came out to pursue anyone she could find to emotionally abuse.  We homeschool and can’t get our work done because she will not accept if she doesn’t get her way, and will stop at nothing to make family life miserable for all.  I knew better than to try to physically move her to her room and risk a physical escalation.  We had to leave twice in one week.  At that point I told her I think I’m supposed to call the police and left with the other kids.  While we were trying to figure out our options, and regroup from a traumatic week, we had family friends agree to let her stay with them in the short term. 

We met with multiple counselors on options for what we should do (to protect our other children and keep peace and stability in our home, and what we can do if Amanda remains incorrigible).  They both told us that she must agree to follow our rules in order to come home, and if she becomes incorrigible, threatening, or abusive to call the police.  They said it might take her staying overnight (or longer) to realize that her actions have consequences and she can’t act like this in the real world.  It seems like a spring board for her to get into drugs, alcohol, sex, etc.  They say we are doing too much to prevent her from failing and she will eventually do those things if she is going to.  They also suggested a therapeutic boarding school but we have one income and 7 kids and we can’t possibly afford that.

I have considered having her live with my Grandparents for the rest of the school year.  She is nurturing and can feel good about helping them and it will be peaceful for all.  However, it is not teaching her how to handle her feelings or change her behavior.  But, we have learned that can’t do that either if she is not willing to cooperate.  At least she will be with people who love her in a Christian environment, rather than with others who are much worse off than her and will introduce her to such.

Forgive me for how long this is.  Our hearts are broken.  I can’t begin to tell you the lengths and therapies we have gone through to help our daughter.  The message we are getting is it’s time to let go if she really truly won’t cooperate.  Please reply or call if you can help in any way.

Thanks for all you’re doing to help parents and kids who are struggling.

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Thank you, Mark.  We took her to our friends’ house, she didn’t run away.   She would physically get in the car to come home if we insisted, but has made it clear she does not want to be home or have rules or consequences, and will not show respect.  We don’t want her to come home under those conditions!  I don’t think runaway charges are applicable, but we could file incorrigibility charges.  We will talk to my Grandparents first to see if that is an option.

Amanda has been like this for years.  She’s constantly maintains she’s not resentful or angry – to us, counselor, juvenile officer.  Yet she lashes out constantly.  The only explanation she gives are 3rd world things (entitlement/dependency) – taking her phone away, not letting her go to a dance, etc.  Always consequences that we set ahead of time what will happen if she makes a certain choice.  (We’ve even included her in choosing the consequences ahead of time, which clearly didn’t help as she said she was only agreeing to get what she wanted)  She makes the choice, gets the consequence, and becomes resentful.  Not just for an hour or a day.  FOREVER.

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Dr. Hutten:
I am hoping that you can at least direct me to any resources that may be useful to my family. I have an adult child (age 32) who has been diagnosed with ASD.  He is very intelligent and high functioning.  My son would like to do something meaningful with his life and has expressed a desire to work with ASD individuals. He speaks their language and, therefore, is uniquely qualified to help. 
Although my son is very capable of obtaining a degree, the "hidden curriculum" embedded within our educational system (even 100% online programs) is intolerable for him to complete.   For example, the social aspects of most undergraduate courses (including 100% online programs) seem unbearable as well as pursuing a degree that will, still, not allow him to participate in society.  It is known that young adults with ASD and academic degrees are still finding it difficult to find employment equal to their intellectual gifts. As one mother of a college grad with ASD stated,  "If we continue to ignore young adults with ASD, there is going to be a whole lot of people on disability."
I started searching for a college curriculum without the "hidden curriculum"  that would enable our son to further his education and lead to a meaningful career (helping others) unique to his gifts.  
Can you offer any advice for someone with ASD who is highly intelligent but is finding it impossible to enter society (education/employment)? He would easily be able to complete a unique curriculum (self-study) but we are finding that these types of programs are often not accredited or do not include a degree program.
To be honest, most resources are developed by neurotypical persons; thus, the unique high functioning ASD needs are not met by the available resources.  My son is aware of this and feels that he is best equipped to be an advocate for other ASD individuals (he speaks their language).  Who best is equipped to advocate for ASD but someone who understands ASD on a personal level?  However, the problem is that, although he is very intelligent, there is not a curriculum that will enable him to complete a degree. I appreciate any suggestions or advice you can offer related to the following topics  or additional options you may offer:
•    Is there an accredited college program (even in another country) without the hidden curriculum?
•    Are there volunteer opportunities for our son to work with ASD students?  He will complete the required background checks, etc.
•    Can he be a consultant to any ASD research?

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I have a child with high functioning autism.
He has very low ability to deal with frustration.
He got upset with a teacher aid pushing him to get started on his work relentlessly without a break and he walked out of school.
He has a room to go to for calming himself but their was a girl in their that gets upset easily so he didn’t want to upset her.
The school suspended him 5 days.
I have taken his electronics for the time period except to do work but how do we stop this behavior?

I have told the school he needs a minute to make a good decision when given prompts and if it doesn’t do it then he needs to have a consequence.  He doesn’t deal well with pressure put on him to perform but he will normally come around if he understands the objective and the consequence.

Also, he doesn’t know how to stop annoying people to get attention.   He is 12.   He struggles with relationships due to this.
Any suggestions for myself or teachers to help him stop touching others or bugging them.
He is a very sweet and helpful child unless he is in a group of people, has to sit in class or isn’t getting enough attention.

I have tried so many things to help him.
Removing myself from the situation and giving him time to make a good decision has worked best so far but he is struggling at school and with peers.
Part of my problem is I don’t know what part is the autism that he can’t handle and how much is defiance which makes it hard to discipline.

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Mark Hutton,
Do you counsel families who cannot afford and do not have a psychologists diagnosis?
I realize this is a long shot but we are out of options.   We are a very small online-based Christian school working with families from all over British Columbia.  We specialize in creating and supporting learning programs that support individual student needs.  (Each student is on their very own program designed to meet both their learning needs and the Provinces educational requirements.)  Recently we had a grade 8 student transfer in for 2nd semester.  
His story in short...His dad was killed when  his mom was pregnant with him and she has been the only parent to he and his 2 older sisters.   His family doctor currently has him on medication for anxiety and depression. The dose was increased this week.  He has experienced bullying at school in grade 7 and "graduated" to a larger middle/high school for this year.  This boy had been leaving home and not ending up at school, just walking around and around the block.  He totally quit going to school in December.  The school had not offered testing or counselling since he is not a behaviour issue.   Both of his older sisters also experience anxiety and depression.  His mom is caring but stretched thin and needs support with effective parenting skills. (Grandma needs the ideas to come from "a doctor or someone who knows".  Because this student was local to me, I did an intake session with his mom, his grandma who is highly involved (and a fairly strong personality), and the boy.  We did the session at his grandma's home.  He is a very quiet, cooperative, good-looking kid. (not at all the kind to be picked on by his looks or mannerisms.)  He didn't speak unless asked a direct question and did not make eye contact until toward the end when I was summarizing "the plan" and said, "he will go to Grandma's to do his work...." At that point he looked up and looked right at me and quietly said, "I want to work at home."  When I asked him what he would be willing to do to make that happen, he responded.  We explored that a bit and I asked him if he would be willing to write that in a contract and sign it.  He said yes, so we did.  All present signed that document.   Later, he did not remember what was in it.
That week, I began to work with him.  I have a voice meeting with him once per week and he contacts me by Skype whenever he needs, no matter what time it is. (He often cannot sleep and recently has been choosing to do his schoolwork then so in the morning I have skype messages from 3 a.m.)  He knows that I will I respond when I am available.  He and I worked together to set up his resources and his first week's assignments.  He really struggled with understanding, new things, and new people.  I could see that he was trying but I could also tell that he needed someone to show him what to do rather than just explain it. His grandma was willing but his mom was more effective.  We have also been very consistent about enforcing his contract  (work at home with a Friday deadline on assignments, and if not get the work finished submitted by Sunday evening or work at grandmas the next day, and if he doesn't get work at grandmas to go back to brick-and-mortar school)  Now a month later, with lots of work on simply developing consistent connection, we have worked out a system and he is communicating and staying connected rather than retreating or disappearing.  He has myself and another online support person working with him. It took quite a few tries for him to meet with the second person that he had not met face to face. We are going slowly and from what we have seen so far, I expect that we will uncover areas of learning and/or processing difficulty.  He is a fairly bright guy.
However, we have a rising issue.  We have not identified what is at the root of his stress and it is driving him.  In the last month, he has called the teen suicide line twice.  This is a new behaviour.  Because he does not have addictions, the doctor asks his mom to stay home from work for a day.  (She is not in a position to miss a lot of work.)  He has had one public-service counsellor who, summed up, advised him to "straighten up, go to school, and try".  It had a negative effect.  Because this young man is not a behaviour issue, the social agencies put him on a waiting list for counselling. There is nothing available in his location until he is 16 and can go the the university counselling program (final year students take on cases for very reasonable fees of $15 per session). 
From our observations, we feel this boy needs support sooner than 2 years.   As a school we can support him for a limited number of counselling fees, depending on the amount.   You are not local, but you are available online and he has some of the traits of a student coping with Aspergers.  He is not diagnosed and  I am not at all making a diagnosis but am sharing my observations.  Is there any possibility that you could meet with him and his mom via Skype and determine if there is anything you could do to support them and/or identify areas you could give them direction in?   Is it worth putting him on a wait list (2-3 years) to get in to see the one local psychologist and hope for a diagnosis?  (The next nearest centre is a 10 hour drive from his town; an impractical suggestion for this situation) 

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Dear Mark,

Thanks for the precious resources.  My 7.5 year old HFA son is refusing to practice piano daily.  He has strong wills and would do anything to avoid practice the piano.  I tried the motivation and he seems no longer care about token points for any rewards.  I tried compromise, but he ends up only practicing one day a week.  He may promise to practice after watching a movie on TV, but does not follow his promise.  If I confront him, he becomes violent towards me, threatening to kill me.

If I don't bug him to practice the piano, he is happy and calm.  He's happy to complete his homework.

He has played piano for two years now and the piano teacher says it's good for his brain development.
I wonder if I should stop the piano, if it's always triggering the tantrum and does nothing for his social skills.  Or do you recommend sticking with it, but trying to work on motivating him?

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We have an unusual situation and are in dire need of advice.  We adopted twin boys from Russia in 1998.  Both had mild reactive attachment disorder for some years, among other issues, but we worked very hard, were very involved, did rocking therapy, etc, and overcame all obvious RAD behaviors by the time the boys were in high school.  Our boys just turned 21.  One is away, on his own, and doing fine emotionally.  The other went away to the east coast his first year of college to play lacrosse.  (Before college he was a good, sweet natured, kind, sensitive young man, who loved his mom best.  He had a very good relationship with both his father and myself.)  He had a very hard first college year, was bullied, probably quite severely... what else we do not know.  He came home a different person, different in almost every way, and is suffering what we believe to be adult reactive attachment disorder.  His behaviors seem to be RAD in nature, but are quite severe, like he has regressed to his orphanage status.  He has been home now for two years this coming May.  Since he has been home he has had additional traumas:  he totaled his car August 2016, and his best friend took his life 30 November, 2016.  He quit going to a local community college in December 2017 mid-quarter, and is home, working about 10 hours a week, and driving us absolutely crazy. 

Besides the extreme symptoms of reactive attachment disorder, there may be some PTSD (?).  He is violent, hateful, argumentative, cannot be touched, even brushed against in passing, is disorganized, and extremely angry.  He yells, curses, name calls, won't listen, won't respect the house rules, won't cooperate in any manner, and has to be in control of every situation, every conversation, every decision.  He is passively-aggressively needy then rejecting; he seeks attention when not appropriate or not convenient, such as not letting us go to bed, or waking us up in the night to talk; conversely when we ask to talk or discuss an issue, he will not cooperate and usually leaves the house.  He projects his behavior onto me (Mom), claiming I am alcoholic (for having a half glass of wine), crazy, stupid, have alzheimers, etc.; all of this is nonsense.  We have had the sheriff at the house once for his physical aggression.  I am afraid of him and tired of being hurt physically and emotionally.  At this time my husband and I are both emotionally exhausted, frustrated, angry, sad, just plain worn out.  We would like to kick him out, but believe that he really needs help instead of being alone on the street so to speak (plus we live in the Seattle area, where rent is outrageous).  Because we went through so much of this when they were kids, we believe this is a deep, complex situation that requires our help and support to get through.  He has also driven all his friends away, and has completely alienated his brother.

We have been unable to find help locally; he had one psyche evaluation and one physical evaluation both August 2016 after his car accident; both said he was fine, no issues.  We began counseling a couple weeks ago with someone who says he has adoption and RAD experience, but nothing has changed, in fact it is worse.  Our relationship with our son continues to deteriorate as his symptoms continue to increase.  

We are at a loss; we have no strategies.  When they were kids it was easier because we had more control; now he is bigger, stronger, and everything we have tried has failed.  Will your program work with adults with RAD?  Can give us any links or names of who to contact for help?

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My son is 19.  In HS he was straight A student but didnt have much of a social life - basically 1 friend he saw every couple of weeks.  He lives with his mom and I see him every other weekend.  He tried going to MSU (Michigan State University) and dropped out after 1 1/2 weeks.  The Next semester he tried a jr college and dropped out after 1 week.  He feels that he fails at everything he does and has told his brother he feels like he is just taking up space.  He as you can imagine has difficulty in social situations. He is currently in a musical (he loves to sing and has a great voice) and recently went to a karaoke night with the crew and had a great time.  His mother tells me he will sit and look out the window at her house for hours and has told her he doesnt have any joy in his life and hasn't for a long time. When he is with me he always seems like he has a good time but on oc
 casion his mom will call me and tell me he told her he didnt have a good time. He has recently started seeing a counselor twice a week - after he dropped out for the second time he realized he needed help.

He has an older brother (2 yrs older) who just graduated from OSU and is also a straight A student but has a wide network of friends.  When he was younger he hung out with his brothers friends when they came over.

Unfortunately he was not getting help when he was younger - no excuses he should have been. There are three main issues I would like to work on him with but not sure how to go about it..

1) How do I help him get his self confidence back?
2) How do I help him feel more comfortable in social situations?
3) How do I help him expand the foods he eats? Currently his diet consists of Fruits & French fries.

Not sure which one is the most important but I listed in the order I think would be the right way to address as if he gets his self confidence back the other 2 may start to take care of themselves.

~~~~~~~~~~~~~~~~

Hi Mark,

My son was diagnosed at the age of 4 being moderate on the autism spectrum.  After early intervention ABA and speech therapy he attended main stream primary school with the help of learning support.  At the moment his achievements in Maths are high, and his English results are basic to sound.  He has difficulties making and keeping friends, especially after his best friend (a girl) moved to another city this year.  I haven't told him about his diagnosis.  Is it a good idea to disclose this to the child?  If so, what age and how to disclose?
My second question is when choosing a high school for him, what are the main considerations we should take?  His current school provide accelerated Maths and supported English.  Is IEP something beneficial for high school?

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Can you help us?  My undiagnosed 17 year old grandson had sex when he was 6 weeks into his 16th birthday.  The girl was 12 going on 20 and pursued him. She kept saying she would kill herself if he wouldn't have sex with her. They met at a teen library function.  She had sex with others before him.  One boy was blackmailing her so she told her parents,  My grandson was sent to a residential facility 5.5 hours away for having sex with her twice.

Tommy is getting abused by the refugee boys who are in the unsecure facility with him...broke his glasses, ear drum, punched in the nose, poured cleaner all over his clothes, through a chair at him, jumped on his chest while he was sleeping.

He has been there 8 weeks and lost 50 pounds.  They don't provide any of the foods he will eat.  He is eating croutons for dinner. 

I hav written to approximately 5 lawyers and no one will take his case.  We have an "update" hearing March 6 in St. Joseph Michigan.  My daughter and I want to get him out of there and move him to my house 90 miles away in Schererville, Indiana.  I would get Legal Guardianship.  I CAN'T FIND ANYONE TO HELP US   
   
Help, i don't know where else to go.  I contacted the state representative, his assistant called the probation officer but she won't talk to anyone but the mom and in writing only. 

Mu grandson is not a punk ass thug.  Yes he had sex with a girl.  He is not a sexual preditor, has not had sex since then  which is a year and a half ago.  The longer he is at this facility the angrier he gets and the less likely he will complete the program in the original timeframe.  He is scared to be there.

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

Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

How to Prevent Meltdowns in Children on the Spectrum

Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

Parenting Defiant Teens on the Spectrum

Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

Older Teens and Young Adult Children with ASD Still Living At Home

Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

Parenting Children and Teens with High-Functioning Autism

Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...