Parenting Aspergers Children and Teens: Part 1

Monday, August 16, 2010

Socialization Tips for Children and Teens with Aspergers

In order to improve their social skills, children and teens with Aspergers need to learn and focus on socialization intellectually. What may come naturally for those without Aspergers or autism needs concentration by those with the condition. Here are some tips:

• Communicate with Pictures: To teach young children to be social, incorporate picture stories into their daily lives. This is important for difficult subjects such as sharing and communicating feelings. The stories should communicate how to handle the situation.

• Education Is Key: Education is an important part of Asperger socialization. Young children may be unable to grasp socialization skills initially, but as they get older, they can learn what gestures mean and how to interact with peers.

• Help Them Make Friends: In school and other social situations, those with Asperger syndrome will perform best with a parent's aid. Find a friend for the student at school that they know and can work with. The child may eventually learn from the friend how to interact.

• Professional Social Help: Work with a psychologist and counselor to teach and improve social skills. Some with this high form of autism can learn to be social. Therapies often teach Asperger patients to recognize potential problem situations. In addition, these professionals teach and practice strategies with patients so they can handle most situations.

• Rules of Social Language: Work with a speech pathologist that will evaluate and offer help for children with language. Even though the child may speak perfectly, learning social language is often necessary. Learning eye contact from a speech pathologist, for example, is an important skill.

Perhaps the best socialization tips for children with Aspergers come from practice. The only way for the child (or adult) to learn how to be social is to participate in numerous events and outings.

• Be involved in sports and extracurricular activities. Through practice, children and teens learn to be socially positive.
• During the teen years, dating is often difficult. Encourage teens to go out with friends and to date. It may take practice, but they will learn social skills with each outing.
• Encourage socialization from a young age by bringing other children into the home. With supervision, allow play dates to be teaching moments, too. A parent may say, "See how Billy has his hand outstretched? That means he wants to say hello with a handshake. Shake his hand."
• Reduce anxiety for your child whenever possible. Keep the rest of their life structured and organized as well as ensure that the environment is a positive and rewarding one for them. This allows them to focus on social interactions without concern about other difficulties.
• Utilize role-play at home prior to any type of excursion. Role-play allows the individual to image all of the various scenarios that could happen. Then, teach strategies for dealing with situations that are difficult.

Monday, August 2, 2010

Aspergers Tantrums

There is no doubt you, the parent of a youngster with Aspergers, have experienced the array of emotions from him/her (e.g., temper tantrums, loud outbursts, rages, etc). While, you may be inclined to believe that some of these rages are unfounded and come without reason, in kids with Aspergers, these rages and outbursts usually do come about with a strong foundation (at least in the mind of the child). If your youngster lives with Aspergers and experiences rages, temper tantrums, and outbursts on a regular basis, it is important that you understand how to manage and resolve these behaviors in order to restore some sense of normalcy to your life and to the life of your child.

Typically rages in Aspergers kids occur when he has experienced a maximum sensory overload and can no longer interpret the environment stimuli occurring around them. The rages and outbursts may occur because of miscommunication between your child and another child, or when your youngster is simply not able to interpret the communication occurring in their environment.

In most kids with Aspergers, rages occur because of frustration in their ability to interpret and communicate effectively, and in combination with the sensory overload of the activities around them. If you feel that your youngster is experiencing rages, tantrums, and outbursts due to environment stimulation complications, it is important to place him in an environment where you can, to some extent, control what happens in the environment. Progressively, over time you can increase the exposure that your youngster experiences in their environment as a way to slowly teach him how to manage and respond to the stimuli without experiencing feelings of rage.

When your youngster lives with Aspergers and has feelings of rage, it is important to understand some of the early warning signs that a temper tantrum is about to occur. In kids with Aspergers, biting of the lower lip or chewing on their play things is quite common when feeling distressed. In addition, he may begin to pick at his hands or fingers and show signs that he wants to rock in a chair. Some Aspergers kids, when feeling frustrated, may begin pacing, or even bolt-out of a room as a way to alleviate the frustration they feel when too much stimulation is present.

All of these early warning signs are important to signify that a rage is about to occur, and when you see these warning signs in your Aspergers child, not only should you defuse the situation, but also look around the environment to determine what could possibly be causing the rage to occur. Learning by experience, you can teach your youngster how to more effectively manage rage and feelings of frustration so as to create a more peaceful, tantrum-free, environment in which to live.

A parent’s behavior can influence a meltdown’s duration, so always check your response first:

1. Calm down
2. Priorities safety
3. Quiet down
4. Re-establish self-control in the child, then deal with the issue
5. Slow down

1. Calm Down. Take 3 slow, deep breaths, and rather than dreading the meltdown that’s about to take place, assure yourself that you’ve survived meltdowns 1000 times before and will do so this time too.

2. Priorities safety when your Aspergers youngster is having a meltdown. Understand that they can be extremely impulsive and irrational at this time. Don’t presume that the safety rules they know will be utilized while they’re melting down. Just because your Aspergers child knows not to go near the street when they are calm doesn’t mean they won’t run straight into 4 lanes of traffic when they are having a meltdown. If your Aspergers youngster starts melting down when you’re driving in the car, pull over and stop. If your child tends to “flee” when melting down, don’t chase them. This just adds more danger to the situation. Tail them at a safe distance (maintain visual contact) if necessary.

3. Quiet down. Keep your speaking voice quiet and your tone neutrally pleasant. Don’t speak unnecessarily. Less is best. Don’t be “baited” into an argument. (Often Aspergers kids seem to “want” to fight. They know how to “push your buttons”, so don’t be side-tracked from the meltdown issue).

4. Re-establish self-control in the youngster. When your Aspergers child is calm and has regained self-control, he will often be exhausted. Keep that in mind as you work through the meltdown issue. Reinforce to your youngster the appropriate way to express their needs/requests.

5. Slow down. Meltdown often occurs at the most inconvenient time e.g. rushing out the door to school. The extra pressure the fear of being late creates, adds to the stress of the situation. (Aspergers kids respond to referred mood and will pick up on your stress. This stress is then added to their own.) So forget the clock and focus on the situation. Make sure the significant people in your life know your priorities here. Let your boss know that your Aspergers youngster has meltdowns that have the capacity to bring life to a standstill, and you may be late. Let your child’s teacher know that if your youngster is late due to a meltdown that it’s unavoidable, and your child shouldn’t be reprimanded for it.

Remember that all behavior is a form of communication, so try to work out the ‘message’ your Aspergers youngster is trying to convey with their meltdown, rather than responding and reacting to the behavior displayed.

My Aspergers Child: Preventing Tantrums and Meltdowns in Aspergers Children

Tuesday, July 27, 2010

The Ten Commandments of Crisis Intervention

In today’s newsletter, we will take a look at The Ten Commandments of Crisis Intervention for your Aspergers child.

1. Allow the youngster, whenever possible, to make choices as you move through the crisis intervention steps; however, do not offer choices if they would compromise what you are trying to achieve.
2. Have a calm voice and demeanor, but convey firmness.
3. Help the youngster to see you as a problem solver. Let him know that you are aware of how difficult the situation is for him. Tell him your job is to help with this difficulty. Explain clearly that your help does not mean avoiding the situation or doing it for the youngster, but rather helping him to do it. E.g., "You have a problem and I am here to help you solve it."
4. Ignore or interrupt irrelevant comments. Respond with: "That doesn't make sense, I can't pay attention to that," or "That is off the topic, so I will have to ignore what you are saying," or "I can't help you with your problem while you are talking nonsense."
5. Make it clear to the youngster that you are in control; don't plead or make second requests.
6. Practice/rehearse what has been decided as the appropriate solution to the problem; this may involve completing an activity or sabotage, accepting a change, or restoring the environment after a meltdown.
7. Say what you mean and mean what you say at all times during the crisis.
8. Stay on topic during the crisis. The youngster may bring up extraneous or unrelated issues to try to justify his behavior.
9. Keep your goal in mind as you go through the crisis intervention steps: creating new rules for responding in the future.
10. A step isn't completed until the youngster has given you his verbal consent to the conditions of the step. Be prepared to repeat steps if additional meltdowns occur before moving on to the next step.

Short and sweet …but very effective.

How to Stop Meltdowns and Temper Tantrums in Aspergers Kids

Thursday, June 17, 2010

Aspergers and Aggression

Many parents, grandparents, and teachers today must deal with aggression in a youngster with Aspergers. I’m one of them. My grandson is 12, and he has both Aspergers and OCD. One of the random things we discovered when he was five was that “jumping” is a great way to help him relieve his extra stress and energy. A therapist put him on a mini-trampoline for a few minutes and for the first time in years he seemed to be calm. We went out and bought a mini-trampoline that afternoon!

It's been seven years since that miraculous discovery, and last year I bought my daughter and son-in-law a larger trampoline for all the kids to use. We still have the little one, which we use inside on bad weather days, but the kids all love the big one outdoors. We have a one-youngster-at-a-time rule, because we know how excited they can become.

The other thing we have used is a punching bag. I would use this option only if others aren't working, mainly because the punching activity is easily transferred to other things, including people. We have ours hung from a rafter in the basement where it's not obvious and the kids rarely remember we have it. We only mention it when they have gotten so upset about something that the need an extreme physical release.

Monday, June 14, 2010

Aspergers: Bad News – Good News

The impact of the diagnosis of Aspergers on a family is no doubt partly related to the manner in which the individual was diagnosed. Families who recognize early on that there is something seriously wrong with their youngster and are given a diagnosis of autism spectrum disorder (and only later learn their youngster has Aspergers) will experience many of the reactions families with autistic kids have. Many families, whose kids progress far enough to no longer warrant an autism diagnosis, experience considerable relief and pride in their youngster’s accomplishments. At the same time, they still struggle with complex feelings related to their youngster's Aspergers diagnosis. If the diagnosis is made in a parent or other relative when a youngster in the family receives the diagnosis, a different constellation of feelings is often set into motion. In these families, the adult must grapple not only with the diagnosis of a disability in the youngster, but with coming to terms with his own disability as well.

It is hard to overestimate the impact the diagnosis of Aspergers has on a family. For many moms and dads, this pain is so searing that even years later, the memory automatically causes tears. All moms and dads wish for healthy kids and this diagnosis shatters that hope irrevocably; never mind the fantasy of "perfect" kids, it shatters the premise that one has a normal youngster.

There is generally a kind of anxiety surrounding the birth of a baby that the youngster be healthy and many of these kids early on seemed to be fine. To learn that one does not have the normal little girl or boy one thought one had is an especially painful blow.

Compounding the impact of the diagnosis of Aspergers is the fact that Aspergers, unlike some other handicaps, affects multiple and diverse aspects of functioning. There may be impairments of cognition, motor skills, language, behavior, and certainly social and emotional interaction. Aspergers affects the way in which kids respond to and relate to their moms and dads. This is most dramatic in those autistic kids who act as if people do not exist. There is nothing more chilling than the gaze of a youngster who appears not to see. Such difficulties tend to make moms and dads feel helpless and as if they don’t matter. Most families become preoccupied with Aspergers and see it as the central feature of their lives. According to one father, "There isn't an hour that goes by that I don't think about it." Another parent said, "Will I ever be happy again?"

Now for the good news…

When contemplating disorders such as Aspergers, there is a tendency to focus on negative aspects, such as difficulty in reading social cues. But many of those with Aspergers have positive traits as well, which has led some people to question whether it should be viewed as a difference rather than a disorder.

• Extreme Endurance—Some of those with Aspergers have great endurance when engaging in activities they like, which may translate into a talent for certain athletic pursuits, despite an inclination to be clumsy. Some Aspergers children have talents for swimming, rowing, running, bodybuilding, or other activities that require sustained physical effort. They tend to prefer individual sports to team sports, as there are no social demands and they can exercise complete control over the activity. Those who develop an interest in sport or fitness are likely to work at it every day, often for long periods of time. This tendency to adhere unvaryingly to routines enables Aspergers children who have fitness interests to stay fit and healthy, manifesting an exercise ethic that ordinary people can only match with a heroic exertion of will power.

• Free of Prejudice—Aspergers children are very accepting of the quirks and idiosyncrasies of others. Most don’t discriminate against anyone based on race, gender, age, or any other surface criteria, but instead judge people based on their behavior. They don't usually recognize hierarchies, and so are unlikely to accord someone superior status simply because that person is wealthy or has attained a high position in an organization. Those with Aspergers can listen to people’s problems and provide a fresh perspective, offering pure assessments based on the information provided, untainted by the judgments that people often make regarding one another's social position or social skills. Others can relax and be themselves around an Aspergers child without fearing social censure.

• High Integrity—Aspergers children will not go along with the crowd if they know that something is wrong. Most stick to their positions, even in the face of intense social pressure, and their values aren't shaped by financial, social, or political influences. Most Aspergers children have a good work ethic and pay attention to detail. Conscientious, reliable, and honest, many Aspergers children make very good employees if able to control their pace and work within either a solitary or socially supportive environment. Aspergers children are persistent, and when they set their minds to something or make a promise, they can usually be trusted to follow through.

• Intelligent and Talented—Those with Aspergers often have above-average intelligence, and many have one or more highly developed talents. They are more likely than those of the general population to pursue a university education, and because many are drawn to technology, they tend to become proficient in the technological media required for lucrative employment in the Information Age. Enthusiasm and a propensity for obsessive research ensure that Aspergers children develop a broad and deep base of knowledge in subjects of interest. They loathe small talk and trivialities, preferring instead to talk about significant things that will enhance their knowledge base. Because they have exceptional memories, those with Aspergers can bring up a variety of interesting facts (though some of these facts will only be interesting to the Aspergers children themselves), as well as recalling fine details that others miss. They also bring a highly original perspective to problem solving, and their acute sensitivity may support creative talents as well.

• Trustworthy and Reliable—Most people with Aspergers are dependable and loyal. They don’t play games or force others to live up to demanding social expectations. Aspergers children have no hidden agendas and no interest in harming others or taking advantage of their weaknesses. They are not inclined to lie to, steal from, or attack the reputations of those around them. Aspergers children are not likely to be bullies, con artists, or social manipulators, and girls with Aspergers are less inclined to be fickle or bitchy than their neuro-typical counterparts. While some people with Aspergers may lash out when provoked, they are unlikely to launch unprovoked attacks, verbal or otherwise. Aspergers children like to spend time alone and are perfectly capable of entertaining themselves. While most like to have friends, their need for social contact is not usually as strong as that of ordinary people. Because they are not motivated by an intense social drive to spend time with anybody who happens to be available, they can be selective, choosing honest, genuine, dependable people who share their interests.

Tuesday, June 8, 2010

Activities for Aspergers Children

Kids with Aspergers like to focus on just one or two things that interest them to the exclusion of everything else. Fun games or activities that get them interacting with the larger world can help offset this tendency. Of course, every youngster plays differently, but here are some suggestions:

1. Brainstorm a list of activities your youngster enjoys doing. Include other things that he should do or needs to learn. For example, practicing his multiplication tables, reading a book, or cleaning his room. Include at least one thing to do that involves going out such as a trip to the library or local playground.

2. Choose books with some kind of interactive component. Pop-up books, books with colorful pictures or interesting textures can get him engaged while he learns new words.

3. Get siblings in on the act. They can suggest and be involved in the daily activities, and it probably wouldn't hurt for ones close in age to your Aspergers youngster to follow a similar schedule. Older siblings can periodically take on the responsibility of making sure the calendar is being followed and the activities are being done.

4. Go to the park. Exercise is a great way for Aspergers children to blow off steam. Playgrounds and jungle gyms provide a chance to improve motor skills, and she can have fun amusing herself on slides, merry-go-rounds and swings.

5. Hang the calendar in a place that is readily accessible and near a clock. Fill the calendar with daily activities. The activities should encompass the entire day from the time your youngster wakes up to the time she goes to sleep. Do not forget the mundane activities such as eating. If you do, she may assume that those things will not occur. As part of the activities, add several pages from the activity books for her to complete and specify each day's pages. Put activities she needs to do at the beginning with things she enjoys included later on in the list. That way, it can be considered a reward to do the fun things after the "chores".

Spend the first few days making sure that your youngster is following the events on the calendar. If he balks at doing the necessary things, explain that more time can be allotted for him to complete those things but that could cause the things he wants to do to drop off the calendar. Correct the activity pages after he completes them and have him fix errors. After he seems to have the routine down, you can leave for a few minutes, but check back frequently to make sure the things on the calendar are getting done. Do not assume he will follow your directions or the calendar without you there.

Modify the calendar during the first week and as necessary. Which activities required more time? What things just didn't work out the way you planned? Adjust times as needed. Aspergers kids work best when there is routine so do not change the calendar dramatically from one day to the next.

6. Keep puzzles around. Kids with Aspergers usually need to develop their spatial skills. Puzzles or models of any sort are a fun way to get the youngster working with his hands and thinking about how things fit together.

7. Look through the local newspaper or other local magazines for events going on in your area. Many events sponsored by churches are free, such as a weekly movie night. During the summer, many organizations set up activities with kids in mind. Pick one or two events that you would like to do with your youngster.

8. Play board games together. This provides social interaction, but does so in a structured way that Aspergers children tend to be more comfortable with. And, as with all kids, games help children learn to handle defeat.

9. Sing together. Studies have shown that music can have a powerful socializing effect on Aspergers kids; and, like everybody else, they have an easier time learning words when they are set to music.

10. Watch TV or movies together and talk about how the characters interact. You can point out the use of sarcasm in a sitcom, or explain why somebody cries in a drama. This can act as a kind of tutorial that will help your youngster pick up on social queues.

Friday, June 4, 2010

Aspergers Students and Behavior Management

Challenging behaviors are frequently the primary obstacle in supporting students with Aspergers. Effective behavioral support requires highly individualized practices that address the primary areas of difficulty in social understanding and interactions, pragmatic communication, managing anxiety, preferences for sameness and rules, and ritualistic behaviors. While the specific elements of a positive behavioral support program will vary from child to child, the following 8 steps go a long way in assuring that schools are working towards achieving the best outcomes on behalf of their students:

1. Collaborate! Educators, administrators, related service personnel and moms/dads should collaborate on a behavior support plan that is clear and easily implemented. Once developed, the plan should be monitored across settings, and regularly reviewed for its strengths and weaknesses. Inconsistencies in our expectations and behaviors will only heighten the challenges demonstrated by a child with Aspergers.

2. Design long-term prevention plans. In the midst of problematic behaviors, adopting a long-term approach to a child’s educational program may be difficult. However, plans for supporting a child over the long term should be outlined from the start. Many procedures and supports with the most relevance and utility for children with Aspergers (e.g., specific accommodations, peer supports, social skills, self-management strategies) must be developed progressively as the youngster moves through school. These are not crisis management strategies but the very things that can decrease crisis situations from arising.

3. Discuss how children with Aspergers fit into typical school-wide discipline practices and procedures. A major issue is fitting children into typical disciplinary practices. Many children with Aspergers become highly anxious by loss of privileges, time outs or reprimands, and often cannot regroup following their application. Another issue is school-wide discipline procedures. Schools which focus on suspension and expulsion as their primary approach, rather than on teaching social skills, conflict resolution and negotiation and on building community learning, are typically less effective.

4. Make teaching alternative skills an integral part of your program. Children with Aspergers should be taught acceptable behaviors that replace problematic behavior and that serve the same purpose as the challenging behavior. For example, a young youngster with Aspergers may have trouble entering into a kick ball game and instead inserts himself into the game, thereby offending the other players and risking exclusion. Instead, the youngster can be coached on how and when to enter into the game. Never assume that a child knows appropriate social behaviors. While these children are quite gifted in many ways, they will need to be taught social and pragmatic communication skills as methodically as academic skills. Self-management strategies also are important skills to teach. Self-management teaches people to discriminate their own target behavior and record the occurrence or absence of that target behavior. Self-management assists children in achieving greater levels of independent functioning across many settings and situations. Instead of teaching situation specific behaviors, self-management teaches a more general skill that can be applied in an unlimited number of settings. The procedure has particular relevance and immediate utility for children with Aspergers who can be taught, for example, how to practice relaxation or how to find a place to regroup when upset.

5. Think prevention. Too often the focus of a behavior management program is on discipline procedures that focus exclusively on eliminating problematic behavior. Programs like this do not focus on long-term behavioral change. An effective program should expand beyond consequence strategies (e.g., time out, loss of privileges) and focus on preventing the occurrence of problem behavior by teaching socially acceptable alternatives and creating positive learning environments.

6. Use antecedent and setting event strategies. Antecedents are events that happen immediately before the problematic behavior. Setting events are situations or conditions that can enhance the possibility that a child may engage in a problematic behavior. For example, if a child is ill, tired or hungry, he may be less tolerant of schedule changes. By understanding settings events that can set the stage for problematic behaviors, changes can be made on those days when a child may not be performing at his best to prevent or reduce the likelihood of difficult situations and set the stage for learning more adaptive skills over time. In schools, many antecedents may spark behavioral incidents. For example, many children with Aspergers have difficulty with noisy, crowded environments. Therefore, the newly arrived high school freshman who becomes physically aggressive in the hallway during passing periods may need to leave class a minute or two early to avoid the congestion which provokes this behavior. Over time, the child may learn to negotiate the hallways simply by being more accustomed to the situation, or by being given specific instruction or support.

Key issues to address when discussing these types of strategies are:

• Will the strategy need to be permanent, or is it a temporary “fix” which allows the child (with support) to increase skills needed to manage the situation in the future?
• What can be done to modify the situation if the situation cannot be eliminated entirely?
• What can be done to eliminate the problem situation (e.g., the offending condition)?

7. Understand the characteristics of Aspergers that may influence a child’s ability to learn and function in the school environment. It is important to understand the idiosyncratic nature of Aspergers and to consider problematic behaviors in light of characteristics associated with this disability. Following are some general characteristics:

• Academic difficulties: restricted problem solving skills, literal thinking, deficiencies with abstract reasoning.
• Behavior serves a function, is related to context, and is a form of communication.
• Emotional vulnerability: low self-esteem, easily overwhelmed, poor coping with stressors, self-critical.
• Impairment in social interactions: difficulty understanding the “rules” of interaction, poor comprehension of jokes and metaphor, pedantic speaking style.
• Inattention: poor organizational skills, easily distracted, focused on irrelevant stimuli, difficulty learning in group contexts.
• Insistence on sameness: easily overwhelmed by minimal changes in routines, sensitive to environmental stressors, preference for rituals.
• Poor motor coordination: slow clerical speed, clumsy gait, unsuccessful in games involving motor skills.
• Restricted range of social competence: preoccupation with singular topics, asking repetitive questions, obsessively collecting items.

8. Know that effective behavioral support is contingent on understanding the child, the context in which he/she operates, and the reason(s) for behavior. In order to effectively adopt a functional behavioral assessment approach, several assumptions about behavior must be regarded as valid.

• Behavior has communicative value (if not specific intent). Students with Aspergers experience pragmatic communication difficulties; while they are able to use language quite effectively to discuss high interest topics, they may have tremendous difficulty expressing sadness, anger, frustration and other important messages. As a result, behavior may be the most effective means to communicate when words fail.

• Behavior is context related. Understanding how features of a setting impact an individual (either positively or negatively) has particular value for adopting preventive efforts and sets the stage for teaching alternative skills.

• Behavior is functional. In other words, it serves a purpose(s). The purpose or function of the behavior may be highly idiosyncratic and understood only from the perspective of the individual. Students with Aspergers generally do not have a behavioral intent to disrupt educational settings, but instead problematic behaviors may arise from other needs (self-protection in stressful situations).

• Effective behavioral change may require all involved to change their behavior.

Since behaviors are influenced by context and by the quality of relationships with others, professionals and family members should monitor their own behavior when working with children with Aspergers. Each time a teacher reprimands a child for misbehavior, an opportunity may be lost to reframe the moment in terms of the child’s need to develop alternative skills.

Thursday, May 27, 2010

John’s Story: An Adult with Newly Diagnosed “Aspergers”

I went to a psychiatrist recently for mild depression. I had met a woman earlier, who never believed in depression or that she had it, but she took drugs that were prescribed to her, and the effect was enormous--like night and day. She suggested that I looked into depression medication if there is a remote chance.

Since, for one or two months, I found myself with an unusually low level of energy, being unproductive and unable to get work done for reasons I could not explain, I decided to try it out. I could not even will myself to do the simplest things. I examined my diet, my level of exercise, and air quality of my house.

The psychiatrist (the MD, who prescribes medication) referred me to a psychologist (the PhD) for further testing. I saw on a note a phrase "Pervasive development disorder." Hmm, that doesn't sound good. I went through a battery of tests, to check my intelligence, my memory, my social skills and so on. I was asked to define words--ordinary and difficult and asked to pronounce some difficult words, too. The psychologist noted that at few times that I accomplished some puzzles faster than anyone has seen. Doing in 30 seconds, puzzles that ordinarily take a minimum of two minutes; I felt happy about that. But the final review would be different.

The psychiatrist took the test results and told me that I had Asperger's syndrome--a sort of high-functioning autism. Huh? The test results showed that I was highly intelligent. According to the psychologist, if I took an IQ tests, I would be declared at least superior which is consistent with my education and my background. But, that I have a complete disregard for social matters or anything else non-intellectual. I also miss social cues, and have peculiar mannerisms, such as my "rocking."

Hey, Bill Gates rocks too, but then he was also compared to an autistic child in a Time Magazine article. Bill Gates used to brag about his SAT scores (800 Math), and would ask a girl her SATs score at Harvard, it's been reported. I started seeing connections, my SAT scores were higher than any of my 400 high school classmates, not to mention any other senior in the past 3 years; and in today's scale would be a perfect 1600. (Since the early 90's ETS readjusted SAT scores by 100 pts.) With 1 question wrong, my 790 GMAT score was also the highest at the UCLA Anderson School of Business. What was crazy is that when I took the paper-based GMAT, I finished each section in a fraction of the 30-minute allotted time--10 minutes for the quantitative section and 15 for the verbal section.

But I have also been called socially retarded. That's funny, I got a great score on an emotional IQ tests, but that's probably because I know what the right answer. I don't do well in social situations, can't converse in a group of more than 2 people. I have to translate my thoughts from my head to my mouth, unlike most people, who speak directly what they think; so I can't keep pace with other people in a group conversation. But then again I have never had a girl friend until I was 27. And since the girl was from a different culture, she didn't know better. I think that's why she divorcing me, because she's has been more exposed to other people in the US and wants someone more emotional and "normal."

I wonder if Asperger's is a medical term for "nerdiness." Even if it isn't, I think there would be greatly disproportionate concentration of sufferers at Microsoft compared to the rest of the world. In China, my wife says, you would not find such people, because "nerdiness" is not respected at all and ensures future poverty, so the family socializes nerds out of the condition.

Fortunately, I am in good company. Some people think Bill Gates has Asperger Syndrome. Not to mention that supposedly other famous scientists like Albert Einstein and Isaac Newton. Unfortunately, Isaac Newton died a virgin.

Thursday, May 20, 2010

Aspergers Characteristics

To help you better understand Aspergers (AS), here is a list of a number of characteristics that most Aspergers individuals have in common, as described (anonymously) by several adults with Aspergers:

1. Alienation— Being required to function in the intensely social realm contributes to the alienation AS people feel. When the alienation commences differs person-to-person the higher functioning individuals probably feel this earlier than others. Not being able to relate on the wave length, not aware of social issues, correct ways of responding, preferring to delve deeply into a subject, not being admitted to social groups, ostracism, bullying, teasing have all contributed to the AS individuals understanding that we are from a different planet, cultural aliens at best shunned and actively excluded at the worst. To sum; the advice given by an AS person don’t worry about them worry about yourself. Some AS individuals have learned to act to use social coping strategies to mask their AS mannerisms thus AS is concealed, others become reclusive, however no one AS person will ever be exactly like another each responding differently to another.

2. Anger and frustration— Anger in AS individuals needs to be understood as an over stimulation where a little or a lot will cause the same effects, and that many AS individuals irrespective of age have a one size fits all response. Anger management presents problems for some AS individuals. Their ability to see things in black and white results in tantrums when they don’t get their exact own way, or per chance they are used to getting their own way and now cannot. Anger expressed may be a childish way to cope the person needing to be trained early on what is socially appropriate. Still others have an extremely short fuse blow up then wonder what all the fuss is about, conversely some ASPERGERS bottle up anger and turn it inward and hit or bite themselves, never revealing once where the bother is. As many ASPERGERS individuals are perfectionists it is prudent to train the ASPERGERS person in how to cope with the mistake without the fuss anger whatever this may take time. The ASPERGERS person often is expected to grow out of this behavior but does not as they need to be helped out.

3. Aptitude— A number of ASPERGERS individuals show special abilities these would include, painting /drawing, logic /computer skills, able to load the brain with facts, detail specific, early reader, hyperlexia, mathematical abilities, engineering tendencies, logic and argument. While these in themselves are useful when nurtured the individual can achieve ha high level of competency in a chosen field, this could be in sciences e.g., chemistry, physics, geology or IT where computer work requires ability and learning rather than training alone. Others may excel in music performance, composition or teaching. A number of gifted individuals of high achievement are / were ASPERGERS this would include Grandin, Einstein, Wittgenstein, Gates, Mozart and Bella Bartok to list but a few. By supporting and promoting the ASPERGERS person’s skills early in life greater achievement is possible in that person’s life.

4. Communication difficulties— ASPERGERS individuals often experience great bother with communication of any sort. Sometimes some ASPERGERS individuals are unable to speak or do so much later, than nonspectrum individuals, i.e. after 3-5years of age. Problems are many fold -- it is difficult to communicate in linear thought and/or we fail to interpret nonverbal signals, or that what we communicate is out of kilter with the audience expectations. Also we are often extremely literal in our interpretation of others conversations, on many occasions we can become confused when ambiguous communication appears. Thus we may check that cats and dogs are raining down and announce they are not here yet, or understand there are two suns when someone talked about two sons.

5. Detail vs. the Big Picture— As ASPERGERS individuals are often skilled at noticing details problems invariably arise. The importance of the detail prevents the ASPERGERS person from understanding the bigger picture as the context of that detail is only a detail. The context often requires social understanding to be able to process the whole picture this would require theory of mind, flexibility, where in the whole the detail may fit and its size to the end result. ASPERGERS individuals not able to access their frontal cortex or prefrontal lobe efficiently if at all, they must transact their social transactions from the realm of memory being prevented from accessing instinct or social areas of the brain. Consequently some tasks are difficult; turn taking, hypothetical scenarios, and other’s points of view cause ASPERGERS individuals great difficulty, and bother in thought. Thus often the ASPERGERS person aims for closure unable to realize the real consequences outside the ASPERGERS mindset or time frame. Some as a result fall foul of the law not apprehending the full ramifications of their actions in the big picture.

6. Light— Too much light, the wrong sort of light i.e. blue light, movement, synesthesia where sound appears in the brain as light.

7. Loneliness— As ASPERGERS individuals lack social capacity or awareness even, they find that despite sincere efforts and hard work they are unable to; connect rationally, understand body language, obtain friendships, employment, trust and or relationships. Many ASPERGERS individuals can and do work hard to be employed, marry as well as having at least one friend however there are some who find themselves isolated or worse alienated. Isolation can be due to; exposure anxiety, over stimulation in the environment, teasing, inability to enjoy social experiences like sport, talking about social things or enjoying others company, but mostly it’s because we are not programmed as nonspectrum individuals are. The alienation may be due in part to an inability to organize simple everyday experiences, eating, dressing appropriately, catching public transport, waking up in time, many things others take for granted, but we find extremely difficult to enact successfully alone or with other individuals. The alienation may also be due to criticism and teasing which has lead to a very poor self-image. These above listed points in turn have discouraged the ASPERGERS to pursue relevant goals. As ASPERGERS individuals are dereistic goal centeredness is not what he/she are programmed or interested in, thus the ASPERGERS individuals finds themselves an island of self marooned in a sea of sociality.

8. Need For Routine— As a train or tram needs tracks so to do ASPERGERS individuals need routine and predictability. Change can cause ASPERGERS to become stressed and too much change can lead to meltdowns. Changes like a different teacher at school, a new routine, doing things in a different order are some of the more obvious more subtle might include putting pants on before the shirt, going to the toilet at someone else’s place, changing a bedroom curtain can contribute to stress.

9. Pain— Some ASPERGERS individuals are unable to detect pain - others do but have a high pain threshold. On the other hand some are more sensitized and respond to only very small pain incidents out of proportion to the incident, still others may respond to minor pain incidents but fail to do so in more severe events.

10. Poor Coordination and Motor Clumsiness— ASPERGERS individuals may have cerebellum developmental delays resulting in poor balance, poor hand to eye coordination, or poor spatial awareness. Some may have motor clumsiness that results in difficulties with sequencing a task correctly, catching a ball, handwriting, cleaning teeth, shoelace tying, and other such like activities. These bothers make the person appear uncoordinated prone to fall and stand out when the person tries to run with other individuals, simple ball handling skills appear almost impossible. Some of these bothers if untreated will remain for life, others learned slowly later. Poor coordination may result in avoidance of some or all activities by the ASPERGERS person as they aim for perfection not pleasure when completing some sports tasks.

11. Right and wrong— Many ASPERGERS individuals seem pre-programmed to detect right and wrong and often will bluntly announce what is wrong. Other times will note others short comings but not their own.

12. Sensory Sensitivities—As with other ASPERGERS bothers this problem area tends to manifest as a spectrum ranging from no sensitivity to extreme sensitivity. Although some ASPERGERS have under sensitized systems the majority are more highly sensitized to their environment than nonspectrum individuals. The most noticeable response to a stimulus would be light or sound. Briefly we have included aspects of the stimulus that causes bother.

13. Smell— As with food smells and fragrances affect different ASPERGERS in different ways. Some perfumes over power others do not, the response to the overpowering may be avoidance, anger, windup due to overload, or inability to cooperate with the person who has the perfume, ditto other odors and smells but a number of ASPERGERS individuals prefer some odors and try to smell them more regularly. Smell may trigger outbursts when the fragrance smell whatever is linked to an event thus when experience at a later date the same feelings or replay of the event takes place.

14. Social Relationship Problems— From my perspective, many ASPERGERS individuals try hard to be social when we become aware of that need but often much effort results in frustration and alienation. Essentially we are not programmed to be social and each type of interaction must be learned by rote and cannot be transacted by instinct, as everyone else is able to. At other times we have no idea of how to respond even being totally unaware that we should. Some friends tried hard to be friends I was totally unaware of their efforts, failing to apprehend nonverbal signals. At other times facial expressions or etiquette are at best a totally foreign language no matter who is enacting the dialog. Some of us dislike social contact due to exposure anxiety not wanting to be different but not knowing what to do. Even after fifty years practice social relationships are very difficult with non-ASPERGERS individuals. The development of peer relations contiguous with age development appears out of sync where a lack of reciprocity results in a lack of sharing, bringing or reciprocation. Some ASPERGERS individuals will however bond more successfully with adults than peers, similarly they may also develop friendships with children who are much younger than themselves, yet another group may try to connect with their cohort particularly at school often being me with a lack of success alienation teasing and so on, a more noticeable group has no contact with anyone and isolates to cope. Occasionally the later group has individuals in it that are prone to running off not aware of danger, fear, strangers, or different surroundings. A lack of social or emotional reciprocity often characterizes individuals with ASPERGERS and may cause nonspectrum individuals to think the ASPERGERS person is actively snubbing them rather it often is that the ASPERGERS person is unable to respond as they either don’t know how to, are not aware that this is the time to say something etc, or choose not to as they see no need. Many ASPERGERS find it hard to locate a gap in conversation and then be able to immediately respond.

15. Socially imaginative Play Deficits— Many ASPERGERS children are unable to play pretend games often indulging in repetitive behaviors, seriation, tearing up paper, rocking, ant tracking, and other actions. Symmetrical patterns, color grouping and repetitive activities are nearly always preferred to joining others in their activities. Some ASPERGERS children may be attracted to wheels and perseverate over activities that involve them, as a child the bike turned upside down was a most excellent toy for as long as I could be allowed to indulge I could ignore all. Preferring to play alone ASPERGERS children may play parallel to other children or perchance with others try to dominate the activity.

16. Sound— Too much sound, too much of one frequency of sound, and or the brain focusing on one sound and ignoring all other sounds i.e. a computer fan, cause ASPERGERS individuals great discomfort and distraction. Unable to filter extraneous sounds a mélange of sound overloads the ASPERGERS who often has bother discerning which they should be hearing or ignoring individual peaks of sensitivity aggravate an already troublesome condition.

17. Special Interests— ASD individuals often develop unusual interests some of whom will be suitable for employment; an interest in busses allowed my brother a bus-driving career. Other interests may not be so useful and when one inappropriate interest is extinguished another usually takes its place. Encouragement should be given early to foster suitable special interests so that the ASD person has something to be interested in which would allow teachers to utilize in an educational setting as well as preparing the person for employment. It may be useful to encourage the ASD person’s memory so that what has been loaded is useful but prepares the ASD on learning more rather than letting the world drift by.

18. Taste— Some ASPERGERS individuals are able to detect certain chemicals or tastes to micro molar amounts whereas others totally lack taste discernment. When medication, for the ASPERGERS person, is administered via drink or food the ASPERGERS person is often able to detect the presence of medication via taste even in very small doses. Other individuals have extreme bother in consuming certain types of food for the taste they perceive overpowers them greatly. To cope, they often limit themselves to what they eat opting for bland or foods of a certain taste only at the expense of everything else.

19. Time— ASPERGERS individuals not only experience bother understanding time they often are unable to utilize time effectively. Organizational skills in some ASPERGERS individuals are nonexistent chaos characterizes interactions their lives and homes. Deadlines are ignored, as they may not be understood.

20. Touch— Often referred to as tactile sensitivity, Aspergers individuals are highly sensitive to certain fabrics; sometimes these cannot be tolerated i.e. wool, wearing shoes, hats sunscreen application and the like. Seams labels joins in the fabrics are also sources of often-intense irritation. Others cannot tolerate; hugs, light caress like touch that is perceived as painful, certain types of food in the mouth or even full stomachs.

21. Vibes— If an ASPERGERS person has sensitivities to light sound etc then the ASPERGERS person may have an ability to detect things in the spiritual realm, to certain areas or sites, individual’s houses, even certain individuals themselves. Instinctively able to sum up a person results in their perception taking place before the other person has even spoken to them.

22. Vulnerability— ASPERGERS individuals are often unable to protect themselves at school or in various social settings they find themselves in. In later life they are may be regarded as eccentric odd or different, some unable to work as supervisors but capable of high work output and ethics when in suitable employment. Some ASPERGERS individuals are extremely trusting -- others suspicious of all.

Monday, May 17, 2010

Preventing Problems Before They Occur

Anticipate and Prepare—

Sooner is better than later. Most people tend to wait until a problem arises and then attempt to deal with it through the use of a consequence. Consequences can be positive (gaining something) or negative (losing something). At times, consequences are discussed prior to an event, but usually in terms of a motivator: "If you do this, you will gain (lose) something else." More often we use consequences in the middle of a problem, such as, "If you don't stop that, you're going right to bed." Or, "You won't watch any TV if you don't leave your sister alone." Or, "You're in time-out right now. I've had it." All of these statements are made when the behavior is out of control. You have given many warnings and you are now acting out of frustration. However, none of these comments will lead to positive change in the short or long run.

With an Aspergers youngster it is far better to anticipate the occurrence of a behavior and then plan for it. Many problem behaviors are repetitious, especially in the same situation. Even when they don't occur every time, they may still be frequent enough to warrant this approach. A rule of thumb is if a behavior repeats itself at least half of the time, you need to prepare for it. For example, if homework, bedtime, or dinnertime have been frequent problems in the past, chances are very good they will continue to be so in the future.

Future vision is the ability of a person to know what is going to happen in an upcoming situation because of its constant reoccurrence. When you know what is going to happen, you can prepare your youngster for the event prior to its occurrence by discussing what usually occurs and what needs to occur. For example, going out to dinner is often a problem time. So talk with your youngster about what normally happens, how he acts, how you do, and then follow that up with a discussion and see if you can get a firm commitment from your youngster that he is going to follow these new behaviors. If he responds in a positive way, you have increased the likelihood that things will go better when you go out for dinner.

If you happen to miss the opportunity to prevent a problem, there is often a small "window of opportunity" in which you can still salvage the situation. In the example above, suppose you have forgotten to say something before you left for dinner. As events begin to unravel, you have a very brief period of time – sometimes only a minute or two – before you'll be in a messy situation. Seize this opportunity. It may be the last best one in that situation.

Using Environmental Controls—

To make interventions effective you need to create an environment in which your youngster feels comfortable, anxiety is decreased, and your youngster has an understanding of the events taking place around him. The environment needs to provide consistency, predictability, structure, routine, organization, logically explained rules, and clear rewards/consequences in response to these rules. When this is in place, your youngster will begin to feel competent. I am reminded of a child who had been expelled from his kindergarten class as the result of unmanageable behaviors – even with one-on-one support. After his first week in my class of eight Aspergers children, without any additional support, he said, "Hey, I like this new school. I know the way." A number of things must be in place to create "the Aspergers world."

Physical Environment

First, the physical environment must be consistent. In all locations you need to identify consistent areas where specific activities are completed, such as that homework is always completed at the desk in his bedroom or at the kitchen table. These areas/activities should also have consistent behavioral expectations, which are explained to your youngster, such as, "At my desk I do calm sitting." Calm sitting is modeled and practiced. You need to identify clear physical boundaries, such as a planned seating arrangement in school or a planned play area at home. Use consistent materials that are clearly marked and accessible, like toys that are within easy reach and stored in or right by the area they will be used in.

In addition, expectations, such as the rules, rewards, and consequences, should be visually available. Once again, these must be clearly described to your youngster. After this has been completed, use charts with stickers or stars to keep track of reward systems. Use the letters of your youngster's name placed on a chart to keep track of consequences. Throughout the day, if letters have been received, they can slowly be erased for positive responding. This provides a wonderful visual response for appropriate behaviors, and you can deliver this feedback, depending on your youngster's needs, every ten minutes, fifteen minutes . . . three hours – you decide what works best.

Interpersonal Environment

Second, your relationship with your youngster must also be consistent in both word and action. He must see you as a predictable person, a person in control, a calm person, and, finally, a person who keeps his word. Being "easy" or giving your youngster a "break" will hinder your effectiveness. You make rules and stick to them. You make requests and follow through; you don't make second requests, and you don't plead. Your interactions must be stable, allowing your youngster to anticipate how he will respond. He must see you as someone who can help him understand the world around him. The highest praise I can receive from a youngster is being thought of as his helper or problem solver – "Ask Mrs. Simpson, she knows how to help." "Mrs. Simpson is a problem solver." "Did you know Mrs. Simpson's job is to help me figure things out?" If you are only seen as a problem causer, your effectiveness will be minimal. You must be highly organized and pay attention to details as you create a structured environment for your youngster. However, you must be able to remain flexible within this structure. By doing so, you will provide the structure your youngster needs to learn to be flexible.


Third, reinforcers will need to be very individualized, as the Aspergers youngster or adolescent often does not respond to typical reinforcers. You must be well aware of what your youngster views as a reward. Incorporating obsessions into a reinforcement system is an appropriate way of offering a strong reinforcer and of also controlling access to an obsession. You need to make sure your youngster is aware of how the reward/consequence system works. Natural consequences can also be highly effective and will remove the "giving" or "denying" of the reward from you. An example of a natural consequence is: "If you finish your morning routine within a certain time limits you will have time to watch a favorite TV show before school. If you take too long, you will not be able to watch the show." Favored activities should follow less favored or challenging activities. A word of caution: reinforcers can also cause difficulties if they are used too frequently. Not only will they lose some of their potency, but struggles can arise over the giving or not giving of the reward.

Daily Routine

Fourth, at both home and in school, develop a daily routine so that your youngster knows what he is doing and when. Posting the schedule and reviewing it when your youngster becomes "stuck" can provide the necessary prompt to move on. In addition, compliance is not a struggle between you and your youngster, but rather simply a matter of following the schedule. The person views the schedule as a guide. As noted, a guide will always serve to decrease anxiety, which in turn decreases behavior issues. I have heard my children tell visitors who enter our classroom, "That's our schedule; don't erase it or we won't know what to do." This is said even by children with excellent memories, who from the first week of school could perfectly recite the daily schedule for each day of the week (again, during sabotage, a goal will be to decrease the importance of the schedule as the year progresses).

The important detail is to review the schedule. We have seen many situations where detailed schedules are written, but never regularly and carefully reviewed with the youngster. As you review the schedule, you not only lessen anxiety, but you also provide an opportunity to discuss appropriate responding. When you develop a schedule at home, you may number the items on it, such as 1, 2, 3, but try to avoid assigning times to each event or activity. It is often difficult to do things to the minute, and failure to do so can lead to further upset for an Aspergers youngster. You may also choose to establish a routine for only a small portion of the day, if you feel a day-long schedule would be too great a change for your youngster. For example, you might create a schedule for an activity, such as going to the mall, as an easier place to start. For an adolescent, rather than using a written schedule, you could use a desk calendar or day planner. Again, this accomplishes the goal of providing a visual guide. We will discuss the use of schedules in greater detail later on in this chapter.

The creation of this environment will take time and will require you to examine more details than you knew existed in any environment. Your reward, however, will be the miracle of watching your youngster leave his anxieties and problematic behaviors behind. You will see him begin to really trust you and take chances he never thought he could. You will witness his gradual and steady steps into a larger world.

Using Language

It's time to expand your ideas of how to use language and to explore how you can use it as a powerful tool to decrease anxiety and increase compliance. Remember to gain your youngster's attention before you begin to speak. You should be physically close to him (though not in his personal space) and, for the young youngster, on his eye level. Your language should convey meaning, provide the "road map" or "game plan," and enable your youngster to respond more appropriately. These kids don't have the road map we all have and take for granted, which allows us to maneuver in the world around us. Language used in a concrete, predictable manner becomes a way to teach alternative behaviors. For example, even after social skills training, saying to Cody, age nine, "Today after school, Mom is taking you to the playground to make and play with a new friend," doesn't provide enough information. He doesn't know what that means or what is expected of him. Instead, I would provide Cody with a "game plan."


When your youngster misinterprets a situation, your language can be used to reframe the situation, allowing your youngster to reinterpret it appropriately. This reframing can also be used when your youngster engages in inappropriate behaviors. Through your language, you provide alternative responses for the future. More important, your language can be used to introduce new ways of thinking or rethinking previously held beliefs.

An example of this would be the introduction of new foods into a youngster's repertoire. This was a goal for Joe, an eleven-year-old who would eat very few foods. More disturbing, the particular foods he ate made him seem unusual to his middle school peers (the same soup brought from home each day, cold noodles, etc.). In beginning to work with Joe, the idea of eating new foods was introduced by linking the eating of new foods with age-specific skills. The discussion began by asking him to recall different skills he had learned at different ages (crawl/walk/run, cry/sounds/words, drink from a bottle/sippy cup/regular cup, etc.). This led to the development of a new system to classify how a youngster changes: the preschool way, the elementary school way, the middle school way, the high school way. Trying, eating, and then incorporating new foods into his diet was put into this system with specific foods for each category. Items such as pizza, sandwiches, hot dogs, burgers – typical adolescent foods – were included in the middle school category. This language approach was paired with a step-by-step program to actually introduce the new foods. In addition, we helped Joe to view eating these new foods in a different way (we reframed his approach to new foods).

Friday, May 14, 2010

Aspergers Children and Anxiety

Children with Aspergers can experience a variety of mental health problems, notably anxiety and depression, but also impulsiveness and mood swings. They may be misdiagnosed as having a psychotic disorder, thus it is important for psychiatrists treating them to be knowledgeable about autism and Aspergers. Conventional drug treatment can be used to treat depression, anxiety and other disorders. Behavioral treatments and therapies can also be effective. However, any treatment must be careful tailored to suit an individual and overseen by a qualified practitioner.

In this post, we will look at anxiety:

Anxiety is a common problem in children with Aspergers. At puberty, many Aspergers children report that “fear” is their main emotion. Any change in school schedule, for example, can cause intense anxiety and the fear of a panic attack.

One study found that 84.1% of children with pervasive developmental disorder met the full criteria of at least one anxiety disorder (phobia, panic disorder, separation anxiety disorder, avoidant disorder, overanxious disorder, obsessive compulsive disorder). This does not necessarily go away as the child grows older.

Many young adults with Aspergers report intense feelings of anxiety, an anxiety that may reach a level where treatment is required. For some children, it is the treatment of their anxiety disorder that leads to a diagnosis of Aspergers.

Kids with Aspergers are particularly prone to anxiety disorders as a consequence of the social demands made upon them. Any social contact can generate anxiety as to how to start, maintain and end the activity and conversation. Changes to daily routine can exacerbate the anxiety, as can certain sensory experiences.

One way of coping with their anxiety levels is for children with Aspergers to retreat into their particular interest. Their level of preoccupation can be used a measure of their degree of anxiety – the more anxious the person, the more intense the interest. Anxiety can also increase the rigidity in thought processes and insistence upon routines, thus, the more anxious the child, the greater the expression of Aspergers.

One potentially good way of managing anxiety is to use behavioral techniques. For kids, this may involve teachers or parents looking out for recognized symptoms, such as rocking or hand-flapping, as an indication that the child is anxious. Adults and older kids can be taught to recognize these symptoms themselves, although some might need prompting. Specific events may also be known to trigger anxiety (e.g., a stranger entering the room). When certain events (internal or external) are recognized as a sign of imminent or increasing anxiety, action can be taken for example, relaxation, distraction or physical activity.

The choice of relaxation method depends very much on the child and many of the relaxation products available commercially can be adapted for use for kids with Aspergers. Young kids may respond to watching their favorite video. Older kids and adults may prefer to listen to calming music. There is much music on the market, both from specialist outfits and regular music stores, that is written specifically to bring about a feeling of tranquility. It is important the child does not have social demands, however slight, made upon him if he is to benefit. It is also important that he has access to a quiet room.

Other techniques include massage (this should be administered carefully to avoid sensory defensiveness), aromatherapy, deep breathing and using positive thoughts. I often suggest the use of photographs, postcards or pictures of a pleasant or familiar scene. These need to be small enough to be carried about and should be laminated in order to protect them. I also want to stress the need to practice whichever method of relaxation is chosen at frequent and regular intervals in order for it to be of any practical use when anxieties actually arise.

An alternative option, particularly if the child is very agitated, is to undertake a physical activity. Activities may include using the swing or trampoline, going for a long walk perhaps with the dog, or doing physical chores around the home.

Drug treatment may be effective for anxiety. Children may respond to Buspirone, Propranilol or Clonazepam, although I have found that St. Johns Wort, benzodiazepines and selective serotonin reuptake inhibitors (SSRI) antidepressants to be more effective. As with all drug treatments it may take time to find the correct drug and dosage for any particular person. Such treatment must only be conducted through a qualified medical practitioner.

Whatever method is chosen to reduce anxiety, it is crucial to identify the cause of the anxiety. This should be done by careful monitoring of the precedents to an increase in anxiety and the source of the anxiety tackled.

My Aspergers Child: Preventing Meltdowns

Monday, May 10, 2010

Depression and Aspergers

Individuals with Aspergers are particularly vulnerable to mental health problems such as anxiety and depression, especially in late adolescence and early adult life.

The inability of children with Aspergers to communicate feelings of disturbance, anxiety or distress can also mean that it is often very difficult to diagnose depressive or anxiety states, particularly for clinicians who have little knowledge or understanding of developmental disorders. Similarly, because of their impairment in non-verbal expression, they may not appear to be depressed. This can mean that it is not until the illness is well developed that it is recognized, with possible consequences such as total withdrawal, increased obsessive behavior, refusal to leave the home, go to work or college etc., and threatened, attempted or actual suicide.

Depression is common in individuals with Aspergers with about 1 in 15 individuals with the disorder experiencing such symptoms. Individuals with Aspergers leaving home and going to college frequently report feelings of depression. As one young person says, "I also had to deal with anger, frustration, and depression that I had been keeping inside since high school". One study found depression to be more common in children aged 10-12 years with high-functioning autism/Asperger syndrome than in the general population of children of the same age.

Depression in children with Aspergers may be related to a growing awareness of their disability or a sense of being different from their peer group and/or an inability to form relationships or take part in social activities successfully. Personal accounts by young people with Aspergers frequently refer to attempts to make friends but "I just did not know the rules of what you were or were not supposed to do".

Indeed, some children have even been accused of harassment in their attempts to socialize, something that can only add to their depression and anxiety; "I also did not know how to approach girls and ask them to go out with me. I would just walk up and talk to them, whether they wanted to talk to me or not. Some accused me of harassment, but I thought that was the way everybody did that."

The difficulties children with Asperger syndrome have with personal space can compound this sort of problem. For example, they may stand too close or too far from the person to whom they are speaking.

Childhood experiences such as bullying or abuse may also result in depression, as can a history of misdiagnosis. Another possibility is that the child is biologically predisposed to depression. However, there are, of course, many other factors that may trigger the depression and this list should not be taken as exhaustive.

Depression might show itself through an individual’s particular preoccupations and obsessions and care must be taken to ensure that the depression is not diagnosed as other mental disorders. It is important to assess the individual’s depression in the context of their Aspergers (i.e., their social disabilities and any gradual or sudden changes in behavior, sleep patterns, anger or withdrawal should always be taken seriously).

Symptoms of depression can be psychological (poor concentration/memory, thoughts of death or suicide, tearfulness); physical (slowing down or agitation, tiredness/lack of energy, sleep problems, disturbed appetite (weight loss or gain)); or affects of mood and motivation (e.g., low mood, loss of interest or pleasure, hopelessness, helplessness, worthlessness, withdrawal or bizarre beliefs, etc.).

Some children with Aspergers are unable to express appropriate and subtle emotions. They may, for example, laugh or giggle in circumstances where other people would show embarrassment, discomfort, pain or sadness. This unusual reaction, for example after bereavement, does not mean the child is being callous or is mentally ill. They need understanding and tolerance of their idiosyncratic way of expressing their grief.

In treating depression, medications used in general practice may be prescribed. It is important to realize, however, that such agents do not make an impact on the primary social impairments that underlie Aspergers. As with any treatment for depression, adjustments may have to be made to find the appropriate drug and dosage for that particular child. Side effects should also be monitored and effort made to ensure the benefits of the treatment outweigh the penalties. It is also important to identify the cause for the depression, and this may involve counseling, social skills training, or meeting up with individuals with similar interests and values.

My Aspergers Child

Friday, May 7, 2010

The Positive Side of Aspergers

Are there benefits to having Aspergers? You bet!

Norm Ledgin caused a stir with his book, Diagnosing Jefferson. The author claimed that the genius of America's third president was due to Aspergers, which could explain his 54-year obsession with building and rebuilding Monticello, his inability to control his spending, and his affair with a youngster/slave.

After this book became a best seller, the author wrote Aspergers and Self-Esteem: Insight and Hope through Famous Role Models, which claims that thirteen giants of history - Marie Curie, Albert Einstein, and Mozart among them-also had Aspergers.

Some individuals also believe that Shakespeare, Jane Austen, Charles Darwin, Galileo, Pablo Picasso, Benjamin Franklin, Margaret Mead and Aristotle had Aspergers.

Lately authors are adding Bill Gates to the list of famous people with Aspergers because of his lack of social skills, inability to make eye contact and tendency to rock back and forth coupled with his obsession with technology.

“Aspies” are our visionaries, scientists, diplomats, inventors, chefs, artists, writers and musicians. They are the original thinkers and a driving force in our culture.

Hans Asperger, the German doctor who discovered the syndrome, would agree with Kennedy's assessment. He believed that "for success in science or art, a dash of autism is essential. The essential ingredient may be an ability to turn away from the everyday world, from the simply practical and to rethink a subject with originality so as to create in new ways with all abilities canalized into the one specialty."

Likewise, Dr. Temple Grandin, an adult with autism who became a successful engineer, academic and speaker, believes that her disorder is an asset. She once famously called NASA a sheltered workshop for individuals with autism and Aspergers. She believes that individuals with autistic spectrum disorders are the great innovators, and "if the world was left to you socialites, nothing would get done and we would still be in caves talking to each other." However, it is absolutely impossible to diagnose anyone posthumously or without having the person in the room. Clinicians can only diagnose Aspergers by observing behaviors.

Another problem in throwing individuals like Mozart and Benjamin Franklin into the Asperger population is that even if a person is in front of them, doctors have a hard time distinguishing between intellectual giftedness, Attention Deficit Disorder and Aspergers.

There has been little research into the personalities of intellectually gifted individuals, but the few that have been done show that they are often intense, restless, strong-willed, and sensitive to light and sound -- all qualities of Aspergers.

Individuals with very high IQs often question the status quo, resist direction, have long attention spans, undergo periods of intense work and effort, and like to organize things even as kids. Other individuals often perceive them as "different." All this is the same with those who have Aspergers.

The idea that every person with Aspergers is a potential genius can put undue pressure on a youngster with Aspergers. Luke Jackson, a thirteen-year-old author with Aspergers, complains that he is always watching television about high functioning autistic individuals who can do things like play the piano brilliantly without taking lessons, draw detailed renditions of buildings they had only seen once or add numbers in their heads like Rainman. "I find these television programs depressing," he says. "I got all the nerdiness and freakishness but none of the genius."

Many individuals who are experts in Aspergers such as Dr. Teresa Bolick, Dr. Tony Attwood, and Dierdre Lovecky write about the positive aspects of Aspergers without focusing on the idea of genius. Lovecky notes how people with Aspergers often have advanced vocabularies, recognize patterns others do not, and pursue ideas despite evidence to the contrary because they are not easily swayed by others' opinions. Their ability to focus on details and their inability to see the big picture means they can often come up with solutions to problems others overlook.

People with Aspergers are often willing to spend long hours in laboratories and in front of computer screens because they do not mind being alone. All this enables them to make tremendous contributions at work and school. Individuals often admire those who can work independently. Our society celebrates the individual who does what he thinks is right and goes his own way.

Because of their unusual reactions to stimuli such as light and sound, people with Aspergers see the world differently than most individuals. They are able to comprehend multiple levels of meanings of words and can be fabulous punsters. When told they had to "eat and run," one Aspergers individual said, "Oh, that's makes us carnivorous panty hose."

Many experts relate that people with Aspergers can make amazingly loyal friends. They are usually free from sexism or racism. They do not manipulate individuals but speak out frankly and honestly. They are sincere truth-tellers, whose naivety and trusting nature makes them incapable of backstabbing. As employees, they are completely dependable and follow the rules of the job. Their deficits are actually assets, as they are unfettered by convention or manners. People with Aspergers help us stay grounded by questioning why we do what we do, why we need to get married, and other basic societal assumptions.

Moms and dads who have successfully raised happy and productive kids with Aspergers often advise others to never give up or become discouraged. An Aspergers individual who receives good help and professional services can lead a good life. The goal does not have to be about genius but rather everyday love and sharing among family members. Success for a person with Aspergers can be going to work or school without many incidents. Success can be simply having improved social relationships until the time when everyone's life becomes better. Life then becomes a more cooperative adventure for everyone and all.

My Aspergers Child: Preventing Meltdowns

Tuesday, May 4, 2010

Aspergers Children: Difficulty Understanding the Rules of Society

Not Understanding How the World Works—

Your Aspergers youngster has a neuro-cognitive disorder that affects many areas of functioning. This includes a difficulty with the basic understanding of the rules of society, especially if they are not obvious. Life has many of these rules. Some are written, some are spoken, and some are learned through observation and intuition. Your youngster only knows what has been directly taught to him through books, movies, TV shows, the Internet, and explicit instructions. He is not able to sit in a room, observe what is happening, and understand social cues, implied directions, or how to "read between the lines," and as he is growing up, he does not learn how to do this. Instead, he learns facts. He does not "take in" what is happening around him that involves the rest of the world, only what directly impacts him.

Many of the conversations he has had have generally been about knowledge and facts, not about feelings, opinions, and interactions. As a result, he does not really know how the world works and what one is supposed to do in various situations. This can apply to even the smallest situations you might take for granted. Not knowing the unspoken rules of situations causes anxiety and upset. This leads to many of the behavioral issues that appear as the Asperger youngster tries to impose his own sense of order on a world he doesn't understand.

The Aspergers youngster creates his own set of rules for everyday functioning to keep things from changing and thereby minimize his anxiety. Sometimes, he just makes up the rules when it is convenient. Other times, he attempts to make them up by looking for patterns, rules, or the logic of a situation to make it less chaotic for him and more predictable and understandable. If there are no rules for an event or situation, he will create them from his own experiences based on what he has read, seen, or heard. He will often have a great deal of information to use in reaching his conclusions and forming his opinions and feelings. As a result, some of his conclusions are correct and some are wrong.

He will rarely consider someone else's point of view if he does not consider them to be an "expert." The fewer people he sees as experts, the more behavioral difficulty you will see. He might consider teachers and others to be experts, but his parents will rarely be seen as such. Therefore, he will argue with you about your opinions if different from his own. He thinks that his opinion is as good as yours, so he chooses his. This represents his rigid thinking. He finds it difficult to be flexible and consider alternate views, especially if he has already reached a conclusion. New ideas can be difficult to accept ("I'd rather do it the way I've always done it"). Being forced to think differently can cause a lot of anxiety.

You must never overestimate your Aspergers youngster's understanding of a situation because of his high intellectual ability or his other strengths. He is a boy who needs to figure out how the world works. He needs a road map and the set of instructions, one example at a time.

Reasons for Rigidity—

1. A misunderstanding or misinterpretation of another's action.
2. A violation of a rule or ritual – changing something from the way it is supposed to be. Someone is violating a rule and this is unacceptable to the youngster.
3. Anxiety about a current or upcoming event, no matter how trivial it might appear to you.
4. Immediate gratification of a need.
5. Lack of knowledge about how something is done. By not knowing how the world works with regard to specific situations and events, the youngster will act inappropriately instead.
6. Other internal issues, such as sensory, inattention (ADHD), oppositional tendency (ODD), or other psychiatric issues may also be causes of behavior.
7. The need to avoid or escape from a non-preferred activity, often something difficult or undesirable. Often, if your youngster cannot be perfect, she does not want to engage in an activity.
8. The need to control a situation.
9. The need to engage in or continue a preferred activity, usually an obsessive action or fantasy.
10. Transitioning from one activity to another. This is usually a problem because it may mean ending an activity before he is finished with it.

Note: Attention-getting is very rarely seen. It should not be considered as a reason for rigidity until all of the above reasons have been considered and eliminated.

Thursday, April 29, 2010

Preparing the School for Your Child with Aspergers

In today’s newsletter, we will examine how to prepare teachers for your Aspergers child so that they will all know how to deal with most of the Aspergers traits.

Teachers can be great allies in keeping your son/daughter with Aspergers safe and successful in school, but you'll need to make sure they have all the knowledge they need to help. Use these suggestions to create an information packet to bring educators up to speed.

Five Things Teachers Need to Know—

1. If there will be any sort of change in my son/daughter's classroom or routine, please notify me as far in advance as possible so that we can all work together in preparing her for it.
2. My son/daughter has difficulty with social cues, nonverbal communication, figurative language and eye contact, which are part of his neurological makeup -- he is not being deliberately rude or disrespectful.
3. My son/daughter is an individual, not a diagnosis; please be alert and receptive to the things that make her unique and special.
4. My son/daughter needs structure and routine in order to function. Please try to keep his world as predictable as possible.
5. Please keep the lines of communication open between our home and the school. My son/daughter needs all the adults in his life working together.

Please print the information below and provide a hard copy to your son/daughter’s teachers:

Aspergers Fact Sheet—


• Appears eccentric to other kids.
• Lacks conversational reciprocity, unless explicitly taught.
• Loner, but intensely wants to be included by other kids; wants to be sociable.
• May appear clumsy or have delayed motor development.
• Needs space. May be hypersensitive to light, touch, noise, or smell.
• No clinically-significant delays in language or cognition, unlike classic autism.
• Often frustrated by writing.
• Repetitive, narrow and unusual patterns of behavior and interests
• Severe difficulty with social interactions; socially naïve, inappropriate, awkward

Brain biology:

• A pervasive developmental disorder.
• Likely genetic factors being researched.
• Often accompanied by mood and anxiety-spectrum disorders.
• Possible overlap with Nonverbal Learning Disability.
• Processes faces as objects; reduced activation of fusiform gyrus.


• Consult autism organizations for comprehensive treatment information and school support, especially Division TEACCH of UNC Chapel Hill.
• Teach and practice (rehearse) rote strategies for recognizing and handling social situations. No medication.
• Treat accompanying mood and anxiety disorders. May include medication.

Classroom applications:

• Capitalize on verbal strengths. Relate subjects to narrow interests.
• Compensate for writing difficulties (grapho-motor problems). Reduce quantity of written work. Teach keyboarding. Use oral evaluation.
• Delineate space so other students don’t intrude (e.g. mat or chalk outline on floor.)
• May have more difficult behavior in school than home. Parents are more predictable -- hence less anxiety-provoking -- than classmates.
• Often Verbal IQ much higher than Performance. Teachers typically overestimate academic ability, underestimate frustrations. Remember, 80% of communication is non-verbal!
• Protect from bullies or predatory students.
• Student may find some reading assignments and courses “pointless” if high in social content and low in practical or concrete application. Needs fiction with strong plot. May intensely dislike fiction, love nonfiction.
• Use social stories (simple, first-person accounts of appropriate social behavior.)
• Avoid unstructured or unsupervised social situations.
• Avoid crowding in lines, bleachers or hallways.
• Do not insist on eye contact. Encourage to look at other person’s forehead if eye contact is difficult.

Advice for parents/care givers

• Read first-person accounts to gain empathy.
• Prepare child for novel social situations well in advance. Rehearse.
• Recognize and reward small steps toward desired behaviors.
• Provide plenty of structure.
• May be soothed by whole-body pressure, squeezing into tight space (e.g. between bed and wall), or by rocking or spinning.
• Remember inflexibility often results from anxiety about unpredictable situations. Use social stories to clarify expectations, provide concrete guidelines.
• Get plenty of rest and respite.

Monday, April 26, 2010

Aspergers - How to Deal with Meltdowns

Meltdowns can result in the Aspergers child going out of control. He may cry, scream, cry and scream, kick, throw things, pound on walls, or engage in other inappropriate behavior. It’s very difficult to determine when, where or why a meltdown will occur. When you ask the child what the problem is, he may give an off the wall reply, such as “I have no green toys,” when he has hundreds of green toys in his room.

Never punish an Aspergers child for having a meltdown, which appears to be nothing more than an intense temper tantrum. Allow him a quiet time and once he is again in control, try to find out what the real problem is. It could be something that happened immediately before the meltdown, yesterday, or even last week. It’s very difficult to determine why a meltdown occurs unless the child learns to communicate his feelings.

Meltdowns often occur after a rough day at school, a disagreement with a sibling, a lost game, a sporting event or other activity. Be patient and supportive. Don’t shout. Let the child know that you support him and love him. It is not unusual for Aspergers children to meltdown upon arriving home from school. A school day is very structured and they try to be on their best behavior, so venting when they get home is quite natural.

For a person with Aspergers, just living in the day-to-day world can be incredibly taxing. They depend on predictability in a world that is often random. They are constantly surrounded by other people whose social and emotional reality they don’t truly understand. If you have ever visited a culture significantly different from your own, you may recall how tiring it can be when you don’t intuitively know social rules or the meaning of people’s gestures and actions, when figuring it all out is work. It is like that for people with Aspergers every single day. To make matters worse, they want to connect, but cannot often successfully do so, despite repeated attempts.

It is no wonder some of them are prone to meltdowns. In the case of children, tantrums or rage attacks often take place either just at school, where stresses are greatest, or just at home, where the child can let it all out. The fact that the child is good-natured most of the time makes such outbursts all the more bewildering. The child can seem to be a “Jekyll and Hyde.” In some cases, teachers and parents may be perplexed by each other’s conflicting descriptions of the child, with one seeing the child as untroubled and one seeing the child as raging. In other cases, the child has a hard time controlling his impulses across all settings.

Hans Asperger, after whom Aspergers is named, included conduct problems in his list of descriptors. Says one group of researchers:

“The most common reason for referral of Aspergers patients involved failure at school and associated behavioral problems including aggressiveness, noncompliance, and negativism, which were accounted for in terms of their deficits in social understanding and extreme pursuit of highly circumscribed interests. Asperger was particularly concerned about his patients’ poor social adjustment and how mercilessly they were bullied and teased by peers.”

Coping with stress, confusion, and frustration is an enormous challenge for individuals with Aspergers. One way their supporters can help is by noting the patterns or total stress load around meltdowns and intervening before a blow-up. Those with Aspergers may not be able to self-monitor well enough to know they are building up to an explosion. For example, students with Aspergers…

“…may not always know that they are near a stage of crisis. Quite often, they just ‘tune out’ or daydream or state in a monotone voice a seemingly benign phrase, such as ‘I don’t know what to do.’ Since no emotion is conveyed, these behaviors go unnoticed by teachers. Then at a later point in time, the student engages, seemingly without provocation, in a verbally or physically aggressive event, often called a rage attack, meltdown, or neurological storm. The student may begin to scream or kick over a desk. There seems to be no predictability to this behavior; it just occurs.”

These meltdowns are horribly upsetting for the child while they are in progress; afterwards, he may think that once he feels better, everybody feels better, not appreciating the lingering worry, upset, or strain teachers, fellow students, or family members may still be feeling.

Clearly, such explosiveness, which seems from the outside to come from nowhere, can get a person with Aspergers into considerable trouble: suspended, fired, arrested. Working to know what types of stressors build up to crisis, and then working to help the person with Aspergers recognize when it’s happening and how to defuse it, is an important goal.

When the meltdown is occurring, the best reaction is to ensure the safety of all concerned. Know that explosive behavior is not planned but instead is most often caused by subtle and perplexing triggers. When the behavior happens, everyone in its path feels pain, especially the child.

Stages of Explosive Behavior—

So, what exactly is explosive behavior? In my book Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders (Endow, 2009), explosive behavior is defined as having four distinct stages, followed by a clearly defined recovery period. In addition, the physiological fight/flight mechanism is triggered immediately prior to the explosion.

In this model, the four stages of explosive behavior are the same for all experiencing explosive behavior and are depicted by four train cars called Starting Out, Picking Up Steam, Point of No Return and Explosion. The idea is to try to prevent the train cars from hooking up because when they do we have a runaway train that ends in explosion.

Working backwards, the Explosion is the stage where the meltdown behavior is evident. Immediately prior to this is the Point of No Return, which is exactly what it implies—there is no going back from the meltdown because this stage is where the fight/flight response is triggered. The pupils dilate, and breathing and heart rates increase. Physiologically, our bodies respond as if our very lives are at stake, and we automatically behave accordingly: We fight for our lives. It is entirely impossible to reason with anyone in this survival mode. As soon as you see the child’s identified Point of No Return behavior you can know the Explosion is coming and need to do your best to quickly create and maintain a safe environment.

The place to impact explosive behavior is ahead of when it occurs. In the Starting Out phase, whispers of behaviors are evident. The Picking Up Steam phase is just that—the whispers become louder. Though you can learn to successfully intervene at these stages, the most effective way to manage explosive behavior is proactively, before the whispers even start.

Strategies to Prevent Meltdowns Before They Start—

An individual mix of three major supports and interventions is usually most effective in preventing the first stage of meltdown behavior from starting. These three major supports include proactive use of a sensory diet to maintain optimal sensory regulation, visual supports and managing emotions that are too big.

People with AS usually do not have sensory systems that automatically regulate; instead, they must discover how to keep themselves regulated. This is most often accomplished by employing a sensory diet. A sensory diet for a person with autism is like insulin for a person with diabetes. It is easy to understand that a person with diabetes has a pancreas that is unable to regulate insulin effectively. We can measure blood sugar and know the exact state of affairs, and from there figure out how much insulin the person needs.

• Managing Felt Emotions. A third area in which many with ASD need proactive support is in managing felt emotions. Most often, felt feelings are way too big for the situation. An example in my life is when I discover the grocery store is out of a specific item; I get a visceral reaction very similar to the horror I felt when first hearing about the 9/11 tragedy. I know cognitively the two events have no comparison and, yet, my visceral reaction is present and I need to consciously bring my too big feelings down to something more workable in the immediate situation. Managing felt emotions does not come automatically, but can be learned over time with systematic instruction and visual supports such as The Incredible 5-Point Scale.

• Sensory Diet. Unfortunately, medical science does not allow us to take a blood sample to measure sensory dysregulation. However, we can figure out and employ a sensory diet to prevent dysregulation, and just like insulin prevents serious consequences for a diabetic, a sensory diet prevents serious troubles for an individual with AS. As an adult with autism, I spend time every day on sensory integration activities in order to be able to function well in my everyday life. A sensory diet employed proactively goes a long way in preventing the Starting Out stage of explosive behavior from ever occurring.

• Visual Supports. Another crucial area of support to put in place proactively is that of visual supports. As an autistic, I can tell you the saying “A picture is worth a thousand words” is the monumental truth. Although each person with AS has a unique experience, processing written and spoken words is not considered by most of us to be our “first language.” For me, the meaning I get from spoken words can drop out entirely when I am under stress, my sensory system is dysregulated or my felt emotions are too big. Visual supports can be anything that shows rather than tells. Visual schedules are very commonly used successfully with many individuals with AS. Having a clear way to show beginnings and endings to the activities depicted on the visual schedule can support smooth transitions, thus keeping a meltdown at bay. For maximum effectiveness, visual supports need to be in place proactively rather than waiting until behavior unravels to pull them out.

The good news is that explosive behavior can be positively impacted. With proactive supports, explosive behavior can be outsmarted so individuals with ASD can move on to living purposeful and self-fulfilling lives.

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