How Important is a Diagnosis?

If you suspect that your child has ASD level 1 (Asperger's), even if he or she is an adult, should they seek a formal diagnosis?

Answer: It depends!

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


Making Your Child's Bedroom More Conducive To Sleep

“Our 5 y.o. boy has been diagnosed with autism (high functioning). Any suggestions on how to make his bedroom more favorable for sleeping? We have been told by the therapist that he may be over-stimulated by the digital gadgets, toys, games, etc., in his room – and that these items are distracting him from falling asleep. This is a plausible theory, because he will get out of bed late into the night to play around. Also, he is easily aroused by the slightest noises through the night.”

It is important that the bed and the bedroom are associated with sleep and are not associated with activity. When young people with High-Functioning Autism or Asperger’s have sleep problems, it is highly recommended that their bed and bedroom activity be limited to sleep only. Also, it's important to make sure that extreme changes in temperature are avoided during the night.

Increasing light is associated with decreases in the release of the neuro-chemical melatonin, which triggers sleep onset. Thus, it is important to get the sunlight flowing in the child’s room as soon as possible in the morning. Conversely, darkening the room at night is critical. When a child’s fear of the dark is an issue, behavioral psychotherapy may be necessary. I also recommend moving the clock so that the child is not watching the time while lying in bed.

Here are a few additional suggestions that will help facilitate a good night’s rest:
  • Cool colors (those from the left side of the color wheel) are thought to provide a sense of calm. Choose one of these for your child’s bedroom, and avoid bright, loud colors that are more exciting than soothing.
  • If your child needs a little light to sleep comfortably, consider adding a couple of nightlights or a dimmer switch rather than having him sleep with a lamp on all the time.
  • Loud pipes might be keeping your child awake when one person makes a bathroom visit in the middle of the night. Look for the cause of any clanging and banging, particularly in a bathroom that may be adjacent to his bedroom.
  • Make sure doors and windows are solid and secure, with no drafts or rattles. 
  • Make sure that rooms adjacent to your child’s bedroom are not home to stereos, televisions or other noisy electronics. Most modern homes don't have completely soundproofed walls, and the bleed-through noise may be keeping him awake.
  • Organize closets and keep your child’s clothing and other personal items in their places. A chaotic, messy room is stressful to the mind. 
  • Select light-blocking window treatments. Even though the sun isn't out, plenty of light can sneak into the bedroom from outside, disrupting your child’s sleep patterns. 
  • Use an air purifier or humidifier to keep air quality at its best. Allergens and excessively dry air can interrupt a child’s sleep and make waking up unpleasant, too. Also, many machines create a white noise that drowns out other distracting sounds, which is often very appealing to children on the autism spectrum.
  • One mother suggests the following: "We also used either a sound machine (played nature sounds) or a CD with relaxing instrumental music to help our son get to sleep or stay asleep. That seemed to help reduce waking up from other people moving around after he went to bed." 

As a side note, many parents report that Melatonin (a hormone secreted by the pineal gland which has been shown to regulate sleep patterns) has been highly beneficial in helping their child with sleep difficulties.  For kids on the autism spectrum, the patterns of melatonin secretion may be irregular, so it is not that they don't produce it, but that they don't produce it at the right times of day. 


Medical Treatment for the Symptoms of High-Functioning Autism

“What medications are used to treat the symptoms of high functioning autism? Which ones have the best track record? And, what are the side effects of these medications?”

There are several medications used to treat the symptoms associated with High-Functioning Autism (HFA) and Asperger’s (AS). Medications may be considered for problematic behaviors in these children and teens, for example:
  • aggression
  • anxiety
  • compulsions
  • depression
  • destructive behavior, or other disruptive behaviors
  • hyperactivity
  • inattention
  • irritability
  • mood lability
  • obsessions
  • perseveration
  • repetitive behaviors
  • self-injurious behavior
  • sleep disturbance
  • stereotypic movements

After medical causes and environmental factors have been ruled out, a trial of medication may be considered if the behavioral symptoms cause significant impairment in functioning and are responsive to behavioral interventions. In some cases, the diagnosis of a comorbid disorder (e.g., major depression, bipolar disorder, anxiety disorder, etc.) can be made reasonably, and the child can be treated with medications.

Modifications of diagnostic criteria may be necessary to account for clinical presentations of psychiatric conditions in children with developmental disabilities, and certain tools (e.g., behavior checklists, structured interviews) may be helpful. In other cases, therapists opt to target specific problematic behaviors or symptom-clusters in the absence of a clear comorbid psychiatric diagnosis.

Approximately 45% of kids and teens (and up to 75% of grown-ups) with HFA and AS are treated with psychotropic medication. Older age, lower adaptive skills and social competence, and higher levels of problematic behavior are associated with the likelihood of medication use.

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


Selective serotonin-reuptake inhibitors (SSRIs), antipsychotic agents, stimulants, and α-adrenergic agonist antihypertensive agents are the most commonly prescribed classes of medications for kids on the autism spectrum. Double-blind, placebo-controlled studies have demonstrated the effectiveness of the SSRIs fluoxetine and fluvoxamine in the treatment of repetitive and other problematic behaviors in young people with HFA and AS. Studies of these and other SSRIs have shown improvements in target symptoms, for example:
  • aggression
  • anxiety
  • aspects of social interaction and language
  • depressive symptoms
  • difficulty with transitions
  • irritability
  • meltdowns
  • repetitive behaviors
  • shutdowns
  • tantrums

Potential side-effects of SSRIs include – but are not limited to – the following: 
  • abdominal discomfort
  • agitation
  • apathy
  • behavioral activation
  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • fatigue
  • headache
  • hypomania or mania
  • nausea
  • sexual dysfunction
  • sleep difficulties
  • suicidal ideation


Risperidone has become the first medication for the symptomatic treatment of irritability, aggressive behavior, deliberate self-injury, and tantrums in kids and teens with HFA and AS. Controlled studies have confirmed the short-term effectiveness of risperidone for these disruptive behaviors.

Potential side-effects include – but are not limited to – the following:
  • excessive appetite
  • constipation
  • dry mouth
  • dyslipidemia
  • extrapyramidal symptoms
  • hematologic abnormalities
  • hyperprolactinemia
  • insulin resistance
  • neuroleptic malignant syndrome
  • QTc prolongation
  • sedation
  • seizures
  • tardive dyskinesia
  • urinary retention
  • weight gain


Recent studies of methylphenidate have demonstrated improvement in hyperactivity, impulsivity, and inattention in kids with HFA and AS. Methylphenidate is effective in some of these young people, but the response rate is lower than that in kids with ADHD, adverse effects are more frequent, and it is unclear whether the results can be generalized to other stimulants.

Potential side-effects of stimulant medications include – but are not limited to – the following:
  • abdominal discomfort
  • appetite reduction
  • delayed sleep onset
  • exacerbation of tics
  • increased anxiety
  • increased blood pressure
  • increased heart rate
  • inhibition of growth
  • irritability
  • jitteriness
  • repetitive behaviors

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


Studies have documented modest benefits of clonidine in reducing hyperarousal symptoms (e.g., hyperactivity, irritability, outbursts, impulsivity, and repetitive behaviors) in young people on the autism spectrum.

Potential side-effects include – but are not limited to – the following:
  • constipation
  • decreased blood pressure
  • dizziness
  • drowsiness
  • dry mouth
  • irritability
  • sedation


Studies have suggested that atomoxetine may be effective for ADHD–like symptoms in kids and teens on the spectrum. Appetite suppression, dizziness, fatigue, liver injury, mood swings, nausea, and suicidal ideation are among the potential side-effects of atomoxetine.


Studies suggest that sleep disorders affect 50 to 70 million individuals in the U.S. Sleep disorders exist whenever a lower quality of sleep results in impaired functioning or extreme lethargy. Difficulties initiating and maintaining sleep are very common in young people on the spectrum, affecting about 15-25% of this population.

A large study revealed several of melatonin’s sleep-enhancing benefits. Reviewing 15 studies of sleep in healthy individuals, researchers noted that melatonin significantly reduced sleep latency (i.e., the amount of time needed to fall asleep), while boosting sleep efficiency (i.e., the percentage of time in bed spent asleep) and increasing total sleep duration. Studies demonstrate an important characteristic of melatonin: the hormone exerts its hypnotic (i.e., sleep-inducing) and sedative (i.e., anxiety-relieving) effects, regardless of dosage time.

Produced by the pineal gland, melatonin is a noteworthy hormone that works both as a sleep aid and a potent antioxidant/immune booster. Also, melatonin is a natural sleeping pill that shifts the body clock into the desired direction. When taken between 3:00 and 6:00 PM, melatonin tricks the body into thinking that dusk comes sooner. Thus, AS and HFA kids become sleepy earlier, helping them fall asleep at 10:00 or 11:00 PM, rather than tossing and turning all night.

Potential side-effects include – but are not limited to – the following:
  • abdominal discomfort
  • confusion
  • daytime sleepiness 
  • dizziness 
  • headaches
  • irritability
  • mild anxiety
  • short-lasting feelings of depression

In addition, melatonin supplements can interact with other medications, including:  
  • birth control pills
  • blood-thinning medications (i.e., anticoagulants) 
  • diabetes medications
  • medications that suppress the immune system (i.e., immunosuppressants)

It will be important for future research to address the need for more rigorous evaluation of safety and effectiveness of medication for kids and teens on the spectrum. When medications are used, baseline data regarding behaviors and somatic complaints should be collected, informed consent should be obtained, potential benefits and side-effects should be explained, and potential strategies for dealing with treatment failure or partial response should be reviewed. Also, it is important to have some quantifiable means of assessing the effectiveness of the medication and to obtain input from a variety of sources (e.g., moms and dads, educators, therapists, etc).

Consistent use of validated, treatment-sensitive rating scales and medication side-effect scales is necessary. A wide variety of outcome measures have been used in research studies and in clinical practice to measure problematic behavior treatment effects (e.g., Nisonger Child Behavior Rating Form, Clinical Global Impression Scale, and Aberrant Behavior Checklist).

Click here for references…

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

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

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

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

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

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

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

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

Great Resources for the Management of Young People on the Autism Spectrum

Below is a list of resources for professionals who work with children and adolescents on the autism spectrum:

1.    Afzal N, Murch S, Thirrupathy K, Berger L, Fagbemi A, Heuschkel R. Constipation with acquired megarectum in children with autism.Pediatrics.2003;112 :939– 942
2.    Aman MG, Lam KS, Collier-Crespin A. Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio. J Autism Dev Disord.2003;33 :527– 534
3.    Aman MG, Novotny S, Samango-Sprouse C, et al. Outcome measures for clinical drug trials in autism. CNS Spectr.2004;9 :36– 47
4.    Aman MG. Management of hyperactivity and other acting-out problems in autism spectrum disorder. Semin Pediatr Neurol.2004;11 :225– 228
5.    American Academy of Pediatrics, Committee on Children With Disabilities. Auditory integration training and facilitated communication for autism. Pediatrics.1998;102 :431– 433
6.    American Academy of Pediatrics, Committee on Children With Disabilities. Counseling families who choose complementary and alternative medicine for their child with chronic illness or disability [published correction appears in Pediatrics. 2001;108:507].Pediatrics.2001;107 :598– 601
7.    American Academy of Pediatrics, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home.Pediatrics.2004;113(5 suppl) :1545– 1547
8.    American Academy of Pediatrics. Understanding Autism Spectrum Disorders [pamphlet]. Elk Grove Village, IL: American Academy of Pediatrics; 2005
9.    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Publishing; 2000
10.    American Speech-Language-Hearing Association, Ad Hoc Committee on Autism Spectrum Disorders. Principles for speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span. Available at:www.asha.org/NR/rdonlyres/D0370FEA-98EF-48EE-A9B6-952913FB131B/0/v3TR_autismLSpan.pdf. Accessed February 22,2007
11.    Amminger GP, Berger GE, Schafer MR, Klier C, Friedrich MH, Feucht M. Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebo-controlled pilot study. Biol Psychiatry.2007;61 :551– 553
12.    Anderson SR, Avery DL, DiPietro EK, Edwards GL, Christian WP. Intensive home-based intervention with autistic children. Educ Treat Child.1987;10 :352– 366
13.    Arnold LE, Aman MG, Cook AM, et al. Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial. J Am Acad Child Adolesc Psychiatry.2006;45 :1196– 1205
14.    Arnold LE, Vitiello B, McDougle C, et al. Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. J Am Acad Child Adolesc Psychiatry.2003;42:1443– 1450
15.    Autism and Developmental Disabilities Monitoring Network Surveillance Year 2002 Principal Investigators; Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders: Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. MMWR Surveill Summ.2007;56 :12– 28
16.    Bågenholm A, Gillberg C. Psychosocial effects on siblings of children with autism and mental retardation: a population-based study. J Ment Defic Res.1991;35 :291– 307
17.    Ballaban-Gil K, Tuchman R. Epilepsy and epileptiform EEG: association with autism and language disorders. Ment Retard Dev Disabil Res Rev.2000;6 :300– 308
18.    Baranek GT. Efficacy of sensory and motor interventions for children with autism. J Autism Dev Disord.2002;32 :397– 422
19.    Birnbrauer JS, Leach DJ. The Murdoch Early Intervention Program after 2 years. Behav Change.1993;10 :63– 74
20.    Black C, Kaye JA, Jick H. Relation of childhood gastrointestinal disorders to autism: nested case-control study using data from the UK General Practice Research Database. BMJ.2002;325 :419– 421
21.    Bolman WM, Richmond JA. A double-blind, placebo controlled pilot trial of low dose dimethylglycine in patients with autistic disorder. J Autism Dev Disord.1999;29 :191– 194
22.    Bondy A, Frost L. The picture exchange communication system. Focus Autistic Behav.1994;9 :1– 19
23.    Bondy A, Frost L. The picture exchange communication system. Semin Speech Lang.1998;19 :373– 388
24.    Bosch J, Van Dyke C, Smith SM, Poulton S. Role of medical conditions in the exacerbation of self-injurious behavior: an exploratory study. Ment Retard.1997;35 :124– 130
25.    Bostic JQ, Rho Y. Target-symptom psychopharmacology: between the forest and the trees. Child Adolesc Psychiatr Clin N Am.2006;15 :289– 302
26.    Bouma R, Schweitzer R. The impact of chronic childhood illness on family stress: a comparison between autism and cystic fibrosis. J Clin Psychol.1990;46 :722– 730
27.    Bowers L. An audit of referrals of children with autistic spectrum disorder to the dietetic service. J Hum Nutr Diet.2002;15 :141– 144
28.    Bregman JD, Zager D, Gerdtz J. Behavioral interventions. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken NJ: John Wiley & Sons;2005:897– 924
29.    Brereton AV, Tonge BJ, Einfeld SL. Psychopathology in children and adolescents with autism compared to young people with intellectual disability. J Autism Dev Disord.2006;36 :863– 870
30.    Brown MJ, Willis T, Omalu B, Leiker R. Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005.Pediatrics.2006;118(2) . Available at:www.pediatrics.org/cgi/content/full/118/2/e534
31.    Bruinsma Y, Koegel RL, Koegel LK. Joint attention and children with autism: a review of the literature. Ment Retard Dev Disabil Res Rev.2004;10 :169– 175
32.    Buchsbaum MS, Hollander E, Haznedar MM, et al. Effect of fluoxetine on regional cerebral metabolism in autistic spectrum disorders: a pilot study. Int J Neuropsychopharmacol.2001;4 :119– 125
33.    Buitelaar JK, van der Gaag RJ, van der Hoeven J. Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: results of an open-label study. J Clin Psychiatry.1998;59 :56– 59
34.    Campbell JM. Efficacy of behavioral interventions for reducing problem behavior in persons with autism: a quantitative synthesis of single-subject research. Res Dev Disabil.2003;24 :120– 138
35.    Canitano R, Luchetti A, Zappella M. Epilepsy, electroencephalographic abnormalities, and regression in children with autism. J Child Neurol.2005;20 :27– 31
36.    Cardinal DN, Hanson D, Wakeham J. Investigation of authorship in facilitated communication. Ment Retard.1996;34 :231– 242
37.    Challman TD, Voigt RG, Myers SM. Nonstandard therapies in developmental disabilities. In: Accardo PJ, ed. Capute & Accardo's Neurodevelopmental Disabilities in Infancy and Childhood: Vol I. Neurodevelopmental Diagnosis and Treatment. 3rd ed. Baltimore, MD: Paul H. Brookes; 2008:721– 743
38.    Cheng-Shannon J, McGough JJ, Pataki C, McCracken JT. Second-generation antipsychotic medications in children and adolescents. J Child Adolesc Psychopharmacol.2004;14 :372– 394
39.    Chez MG, Chang M, Krasne V, Coughlan C, Kominsky M, Schwartz A. Frequency of epileptiform EEG abnormalities in a sequential screening of autistic patients with no known clinical epilepsy from 1996 to 2005.Epilepsy Behav.2006;8 :267– 271
40.    Christison GW, Ivany K. Elimination diets in autism spectrum disorders: any wheat amidst the chaff? J Dev Behav Pediatr.2006;27(2 suppl) :S162– S171
41.    Christodulu KV, Durand VM. Reducing bedtime disturbance and night waking using positive bedtime routines and sleep restriction. Focus Autism Other Dev Disabl.2004;19 :130– 139
42.    Cohen H, Amerine-Dickens M, Smith T. Early intensive behavioral treatment: replication of the UCLA model in a community setting. J Dev Behav Pediatr.2006;27(2 suppl) :S145– S155
43.    Connor DF, Ozbayrak KR, Benjamin S, Ma Y, Fletcher KE. A pilot study of nadolol for overt aggression in developmentally delayed individuals. J Am Acad Child Adolesc Psychiatry.1997;36 :826– 834
44.    Cooley WC. Redefining primary pediatric care for children with special health care needs: the primary care medical home. Curr Opin Pediatr.2004;16 :689– 692
45.    Croen LA, Najjar DV, Ray GT, Lotspeich L, Bernal P. A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan.Pediatrics.2006;118(4) . Available at:www.pediatrics.org/cgi/content/full/118/4/e1203
46.    Dawson G, Osterling J. Early intervention in autism. In: Guralnick MJ, ed. The Effectiveness of Early Intervention: Second Generation Research. Baltimore, MD: Brookes; 1997:307– 326
47.    Dawson G, Watling R. Interventions to facilitate auditory, visual, and motor integration in autism: a review of the evidence. J Autism Dev Disord.2000;30 :415– 421
48.    DelGiudice-Asch G, Simon L, Schmeidler J, Cunningham-Rundles C, Hollander E. Brief report: a pilot open clinical trial of intravenous immunoglobulin in childhood autism. J Autism Dev Disord.1999;29 :157– 160
49.    DeLong R. Children with autistic spectrum disorder and a family history of affective disorder. Dev Med Child Neurol.1994;36 :674– 687
50.    DeMyer MK, Hingtgen JN, Jackson RK. Infantile autism reviewed: a decade of research. Schizophr Bull.1981;7 :388– 451
51.    Dolske MC, Spollen J, McKay S, Lancashire E, Tolbert L. A preliminary trial of ascorbic acid as supplemental therapy for autism. Prog Neuropsychopharmacol Biol Psychiatry.1993;17 :765– 774
52.    Dosreis S, Weiner CL, Johnson L, Newschaffer CJ. Autism spectrum disorder screening and management practices among general pediatric providers. J Dev Behav Pediatr.2006;27(2 suppl) :S88– S94
53.    Dumas JE, Wolf LC, Fisman SN, et al. Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development.Exceptionality.1991;2 :97– 110
54.    Eikeseth S, Smith T, Jahr E, Eldevik S. Intensive behavioral treatment at school for 4- to 7-year-old children with autism: a 1-year comparison controlled study. Behav Modif.2002;26 :49– 68
55.    Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherill L. The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. J Autism Dev Disord.2006;36 :413– 420
56.    Eldevik S, Eikeseth S, Jahr E, Smith T. Effects of low-intensity behavioral treatment for children with autism and mental retardation. J Autism Dev Disord.2006;36 :211– 224
57.    Erickson CA, Stigler KA, Corkins MR, Posey DJ, Fitzgerald JF, McDougle CJ. Gastrointestinal factors in autistic disorder: a critical review. J Autism Dev Disord.2005;35 :713– 727
58.    Fankhauser MP, Karumanchi VC, German ML, Yates A, Karumanchi SD. A double-blind, placebo-controlled study of the efficacy of transdermal clonidine in autism. J Clin Psychiatry.1992;53 :77– 82
59.    Findling RL, Maxwell K, Scotese-Wojtila L, Huang J, Yamashita T, Wiznitzer M. High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study. J Autism Dev Disord.1997;27:467– 478
60.    Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics.2001;108(4) . Available at:www.pediatrics.org/cgi/content/full/108/4/e58
61.    Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics.2006;118(1) . Available at: www.pediatrics.org/cgi/content/full/118/1/e139
62.    FREE Full Text
63.    Giannotti F, Cortesi F, Cerquiglini A, Bernabei P. An open-label study of controlled-release melatonin in treatment of sleep disorders in children with autism. J Autism Dev Disord.2006;36 :741– 752
64.    Gold C, Wigram T, Elefant C. Music therapy in autistic spectrum disorder. Cochrane Database Syst Rev.2006;(2) :CD004381
65.    Gold N. Depression and social adjustment in siblings of boys with autism. J Autism Dev Disord.1993;23 :147– 163
66.    Goldstein H. Communication intervention for children with autism: a review of treatment efficacy. J Autism Dev Disord.2002;32 :373– 396
67.    Gray C, McAndrew S. My Social Stories Book. London, England: Jessica Kingsley; 2002
68.    Gray DE. Ten years on: a longitudinal study of families of children with autism. J Intellect Dev Disabil.2002;27 :215– 222
69.    Greenspan SI, Wieder S. Developmental patterns and outcomes in infants and children with disorders in relating and communicating: a chart review of 200 cases of children with autistic spectrum diagnoses. J Dev Learn Disord.1997;1 :87– 141
70.    Gupta S, Aggarwal S, Heads C. Dysregulated immune system in children with autism: beneficial effects of intravenous immune globulin on autistic characteristics. J Autism Dev Disord.1996;26 :439– 452
71.    Gupta VB. Complementary and alternative treatments for autism. In: Gupta VB, ed. Autistic Spectrum Disorders in Children (Pediatric Habilitation Series Volume 12). New York, NY: Marcel Dekker; 2004:239– 254
72.    Gutstein SE, Sheely RK. Relationship Development Intervention With Children, Adolescents, and Adults. New York, NY: Jessica Kingsley; 2002
73.    Handen BL, Johnson CR, Lubetsky M. Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder. J Autism Dev Disord.2000;30 :245– 255
74.    Handleman JS, Harris SL. Preschool Education Programs for Children With Autism. 2nd ed. Austin, TX: Pro-Ed; 2000
75.    Hardan AY, Jou RJ, Handen BL. A retrospective assessment of topiramate in children and adolescents with pervasive developmental disorders. J Child Adolesc Psychopharmacol.2004;14 :426– 432
76.    Harrington JW, Rosen L, Garnecho A, Patrick PA. Parental perceptions and use of complementary and alternative medicine practices for children with autistic spectrum disorders in private practice. J Dev Behav Pediatr.2006;27 :S156– S161
77.    Harris SL, Handleman JS, Jennett HK. Models of educational intervention for students with autism: home, center, and school-based programming. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons; 2005:1043– 1054
78.    Hollander E, Dolgoff-Kaspar R, Cartwright C, Rawitt R, Novotny S. An open trial of divalproex sodium in autism spectrum disorders. J Clin Psychiatry.2001;62 :530– 534
79.    Hollander E, Phillips A, Chaplin W, et al. A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology.2005;30 :582– 589
80.    Hollander E, Phillips AT, Yeh CC. Targeted treatments for symptom domains in child and adolescent autism. Lancet.2003;362 :732– 734
81.    Hollander E, Soorya L, Wasserman S, Esposito K, Chaplin W, Anagnostou E. Divalproex sodium vs. placebo in the treatment of repetitive behaviours in autism spectrum disorder. Int J Neuropsychopharmacol.2006;9 :209– 213
82.    Horner RH, Carr EG, Strain PS, Todd AW, Reed HK. Problem behavior interventions for young children with autism: a research synthesis. J Autism Dev Disord.2002;32 :423– 446
83.    Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children with autistic disorder. J Pediatr.1999;135 :559– 563
84.    Horvath K, Perman JA. Autism and gastrointestinal symptoms. Curr Gastroenterol Rep.2002;4 :251– 258
85.    Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H. A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Res Dev Disabil.2005;26 :359– 383
86.    Howlin P, Goode S, Hutton J, Rutter M. Adult outcome for children with autism. J Child Psychol Psychiatry.2004;45 :212– 229
87.    Howlin P. Outcomes in autism spectrum disorders. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons;2005:201– 220
88.    Hrdlicka M, Komarek V, Propper L, et al. Not EEG abnormalities but epilepsy is associated with autistic regression and mental functioning in childhood autism. Eur Child Adolesc Psychiatry.2004;13 :209– 213
89.    Hyman SL, Levy SE. Introduction: novel therapies in developmental disabilities—hope, reason, and evidence. Ment Retard Dev Disabil Res Rev.2005;11 :107– 109
90.    Ingrassia A, Turk J. The use of clonidine for severe and intractable sleep problems in children with neurodevelopmental disorders: a case series. Eur Child Adolesc Psychiatry.2005;14 :34– 40
91.    Jacobson JW, Mulick JA, Schwartz AA. A history of facilitated communication: science, pseudoscience, and antiscience. Science Working Group on Facilitated Communication. Am Psychol.1995;50 :750– 765
92.    James SJ, Cutler P, Melnyks S, et al. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. Am J Clin Nutr.2004;80 :1611– 1617
93.    Jan JE, Freeman RD. Melatonin therapy for circadian rhythm sleep disorders in children with multiple disabilities: what have we learned in the last decade? Dev Med Child Neurol.2004;46 :776– 782
94.    Jaselskis CA, Cook EH, Fletcher E, Leventhal BL. Clonidine treatment of hyperactive and impulsive children with autistic disorder. J Clin Psychopharmacol.1992;12 :322– 327
95.    Johnson CP, Myers SM; American Academy of Pediatrics, Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics.2007;120 :1183– 1215
96.    Jou RJ, Handen BL, Hardan AY. Retrospective assessment of atomoxetine in children and adolescents with pervasive developmental disorders. J Child Adolesc Psychopharmacol.2005;15 :325– 330
97.    Kagan-Kushnir T, Roberts SW, Snead OC III. Screening electroencephalograms in autism spectrum disorders: evidence-based guideline. J Child Neurol.2005;20 :197– 206
98.    Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry.2006;47 :611– 620
99.    Kerbeshian J, Burd L, Fisher W. Lithium carbonate in the treatment of two patients with infantile autism and atypical bipolar symptomatology. J Clin Psychopharmacol.1987;7 :401– 405
100.    Kern JK, Miller VS, Cauller PL, Kendall PR, Mehta PJ, Dodd M. Effectiveness of N,N-dimethylglycine in autism and pervasive developmental disorder. J Child Neurol.2001;16 :169– 173
101.    Klin A, Volkmar FR. Treatment and intervention guidelines for individuals with Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS, eds. Asperger Syndrome. New York, NY: Guilford Press; 2000:340– 366
102.    Koegel LK. Interventions to facilitate communication in autism. J Autism Dev Disord.2000;30 :383– 391
103.    Konstantareas MM, Lunsky YJ. Sociosexual knowledge, experience, attitudes, and interests of individuals with autistic disorder and developmental delay. J Autism Dev Disord.1997;27 :397– 413
104.    Kowatch RA, DelBello MD. Pediatric bipolar disorder: emerging diagnostic and treatment approaches. Child Adolesc Psychiatr Clin N Am.2006;15 :73– 108
105.    Krasny L, Williams BJ, Provencal S, Ozonoff S. Social skills interventions for the autism spectrum: essential ingredients and a model curriculum.Child Adolesc Psychiatr Clin N Am.2003;12 :107– 122
106.    Kuddo T, Nelson KB. How common are gastrointestinal disorders in children with autism? Curr Opin Pediatr.2003;15 :339– 343
107.    Kulman G, Lissoni P, Rovelli F, Roselli MG, Brivio, Sequeri P. Evidence of pineal endocrine hypofunction in autistic children. Neuro Endocrinol Lett.2000;21 :31– 34
108.    La Camera RG, La Camera AC. Routine health care. In: Cohen DJ, Volkmar FR, eds. Handbook of Autism and Pervasive Developmental Disorders. 2nd ed. New York, NY: John Wiley & Sons; 1997:730– 740
109.    Langworthy-Lam KS, Aman MG, Van Bourgondien ME. Prevalence and patterns of use of psychoactive medicines in individuals with autism in the autism society of North Carolina. J Child Adolesc Psychopharmacol.2002;12 :311– 321
110.    Layton TL. Language training with autistic children using four different modes of presentation. J Commun Disord.1988;21 :333– 350
111.    Lee DO. Menstrually related self-injurious behavior in adolescents with autism. J Am Acad Child Adolesc Psychiatry.2004;43 :1193
112.    Levy SE, Hyman SL. Novel treatments for autistic spectrum disorders.Ment Retard Dev Disabil Res Rev.2005;11 :131– 142
113.    Levy SE, Mandell DS, Merhar S, Ittenbach RF, Pinto-Martin JA. Use of complementary and alternative medicine among children recently diagnosed with autistic spectrum disorder. J Dev Behav Pediatr.2003;24:418– 423
114.    Leyfer OT, Folstein SE, Bacalman S, et al. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord.2006;36 :849– 861
115.    Lightdale JR, Siegel B, Heyman MB. Gastrointestinal symptoms in autistic children. Clin Perspect Gastroenterol.2001;1 :56– 58
116.    Liptak GS, Orlando M, Yingling JT, et al. Satisfaction with primary health care received by families of children with developmental disabilities. J Pediatr Health Care.2006;20 :245– 252
117.    Liptak GS, Stuart T, Auinger P. Health care utilization and expenditures for children with autism: data from U.S. national samples. J Autism Dev Disord.2006;36 :871– 879
118.    Lord C, Schopler E. The role of age at assessment, developmental level, and test in the stability of intelligence scores in young autistic children. J Autism Dev Disord.1989;19 :483– 499
119.    Lorimer PA, Simpson RL, Myles BS, et al. The use of social stories as a preventative behavioral intervention in a home setting with a child with autism. J Posit Behav Interv.2002;4 :53– 60
120.    Lovaas OI, ed. Teaching Individuals With Developmental Delays: Basic Intervention Techniques. Austin, TX: Pro-Ed; 2003
121.    Lovaas OI. Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol.1987;55 :3– 9
122.    Mahoney G, McDonald J. Responsive Teaching: Parent-Mediated Developmental Intervention. Baltimore, MD: Paul H. Brookes; 2003
123.    Mahoney G, Perales F. Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: a comparative study. J Dev Behav Pediatr.2005;26 :77– 85
124.    Malow BA, McGrew SG, Harvey M, et al. Impact of treating sleep apnea in a child with autism spectrum disorder. Pediatr Neurol.2006;34 :325– 328
125.    Malow BA. Sleep disorders, epilepsy, and autism. Ment Retard Dev Disabil Res Rev.2004;10 :122– 125
126.    Mandell DS, Cao J, Ittenbach R, Pinto-Martin J. Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. J Autism Dev Disord.2006;36 :475– 485
127.    Marans WD, Rubin E, Laurent A. Addressing social communication skills in individuals with high-functioning autism and Asperger syndrome: critical priorities in educational programming. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons; 2005:977– 1002
128.    Marcus LM, Kunce LJ, Schopler E. Working with families. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons;2005:1055– 1086
129.    Marcus LM, Lansing M, Andrews CE, Schopler E. Improvement of teaching effectiveness in parents of autistic children. J Am Acad Child Psychiatry.1978;17 :625– 639
130.    Mastergeorge AM, Rogers SJ, Corbett BA, et al. Nonmedical interventions for autism spectrum disorders. In: Ozonoff S, Rogers SJ, Hendren RL, eds. Autism Spectrum Disorders: A Research Review for Practitioners. Washington, DC: American Psychiatric Publishing;2003:133– 160
131.    Matson JL, Benavidez DA, Compton LS, Paclawskyj T, Baglio C. Behavioral treatment of autistic persons: a review of research from 1980 to the present. Res Dev Disabil.1996;17 :433– 465
132.    McConnell S. Interventions to facilitate social interaction for young children with autism: review of available research and recommendations for educational intervention and future research. J Autism Dev Disord.2002;32 :351– 372
133.    McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. N Engl J Med.2002;347 :314– 321
134.    McDougle CJ, Naylor ST, Cohen DJ, Volkmar FR, Heninger GR, Price LH. A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry.1996;53 :1001– 1008
135.    McDougle CJ, Scahill L, Aman MG, et al. Risperidone for the core symptom domains of autism: results from the study by the Autism Network of the Research Units on Pediatric Psychopharmacology. Am J Psychiatry.2005;162 :1142– 1148
136.    McEachin JJ, Smith T, Lovaas OI. Long-term outcome for children with autism who received early intensive behavioral treatment. Am J Ment Retard.1993;97 :359– 372
137.    Mehta UC, Patel I, Castello FV. EEG sedation for children with autism. J Dev Behav Pediatr.2004;25 :102– 104
138.    Melmed RD, Schneider CK, Fabes RA, Philips J, Reichelt K. Metabolic markers and gastrointestinal symptoms in children with autism and related disorders [abstract]. J Pediatr Gastroenterol Nutr.2000;31(suppl 2):S31
139.    Meltzer LJ, Mindell JA. Nonpharmacologic treatments for pediatric sleeplessness. Pediatr Clin North Am.2004;51 :135– 151
140.    Mesibov GB, Shea V, Schopler E. The TEACCH Approach to Autism Spectrum Disorders. New York, NY: Kluwer Academic/Plenum; 2005
141.    Mesibov GB. Formal and informal measures on the effectiveness or the TEACCH programme. Autism.1997;1 :25– 35
142.    Millar DC, Light JC, Schlosser RW. The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. J Speech Lang Hear Res.2006;49 :248– 264
143.    Milward C, Ferriter M, Calver S, et al. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev.2004;(2):CD003498
144.    Molloy CA, Manning-Courtney P. Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders.Autism.2003;7 :165– 171
145.    Moore ML, Eichner SF, Jones JR. Treating functional impairment of autism with selective serotonin-reuptake inhibitors. Ann Pharmacother.2004;38 :1515– 1519
146.    Mostert MP. Facilitated communication since 1995: a review of published studies. J Autism Dev Disord.2001;31 :287– 313
147.    Mudford OC, Cross BA, Breen S, et al. Auditory integration training for children with autism: no behavioral benefits detected. Am J Ment Retard.2000;105 :118– 129
148.    Murphy N. Sexuality in children and adolescents with disabilities. Dev Med Child Neurol.2005;47 :640– 644
149.    Murphy NA, Elias ER; American Academy of Pediatrics, Council on Children With Disabilities. Sexuality of children and adolescents with developmental disabilities. Pediatrics.2006;118 :398– 403
150.    Myers SM, Challman TD. Psychopharmacology: an approach to management in autism and intellectual disabilities. In: Accardo PJ, ed.Capute & Accardo's Neurodevelopmental Disabilities in Infancy and Childhood: Vol I. Neurodevelopmental Diagnosis and Treatment. 3rd ed. Baltimore, MD: Paul H. Brookes; 2008:577– 614
151.    Myers SM. The status of pharmacotherapy for autism spectrum disorders. Expert Opin Pharmacother.2007;8 :1579– 1603
152.    Namerow LB, Thomas P, Bostic JQ, Prince J, Monuteaux MC. Use of citalopram in pervasive developmental disorders. J Dev Behav Pediatr.2003;24 :104– 108
153.    National Center for Complementary and Alternative Medicine. Expanding horizons of healthcare: five year strategic plan 2001–2005. Washington, DC: US Department of Health and Human Services; 2000
154.    National Research Council, Committee on Educational Interventions for Children with Autism. Educating Children With Autism. Lord C, McGee JP, eds. Washington, DC: National Academies Press; 2001
155.    Nickel R. Controversial therapies for young children with developmental disabilities. Infants Young Child.1996;8 :29– 40
156.    Nye C, Brice A. Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane Database Syst Rev.2005;(4) :CD003497
157.    Olley JG. Curriculum and classroom structure. In: Volkmar FR, Paul R, Klin A, Cohen D, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons; 2005:863– 881
158.    O'Neill R, Horner R, Albin R, et al. Functional Assessment and Program Development for Problem Behavior: A Practical Handbook. Pacific Grove, CA: Brookes/Cole Publishing; 1996
159.    Owens JA, Babcock D, Blumer J, et al. The use of pharmacotherapy in the treatment of pediatric insomnia in primary care: rational approaches—a consensus meeting summary. J Clin Sleep Med.2005;1 :49– 59
160.    Owley T, Walton L, Salt J, et al. An open-label trial of escitalopram in pervasive developmental disorders. J Am Acad Child Adolesc Psychiatry.2005;44 :343– 348
161.    Oyane NM, Bjorvatn B. Sleep disturbances in adolescents and young adults with autism and Asperger syndrome. Autism.2005;9 :83– 94
162.    Ozonoff S, Cathcart K. Effectiveness of a home program intervention for young children with autism. J Autism Dev Disord.1998;28 :25– 32
163.    Paavonen EJ, Nieminen-von Wendt T, Vanhala R, Aronen ET, von Wendt L. Effectiveness of melatonin in the treatment of sleep disturbances in children with Asperger disorder. J Child Adolesc Psychopharmacol.2003;13 :83– 95
164.    Patzold LM, Richdale AL, Tonge BJ. An investigation into sleep characteristics of children with autism and Asperger's disorder. J Paediatr Child Health.1998;34 :528– 533
165.    Paul R, Sutherland D. Enhancing early language in children with autism spectrum disorders. In: Volkmar FR, Paul R, Klin A, Cohen D, eds.Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons; 2005:946– 976
166.    Pavone P, Incorpora G, Fiumara A, Parano E, Trifiletti RR, Ruggieri M. Epilepsy is not a prominent feature of primary autism.Neuropediatrics.2004;35 :207– 210
167.    Perry, DW, Marston GM, Hinder SA. The phenomenology of depressive illness in people with a learning disability and autism. Autism.2001;5:265– 275
168.    Phillips L, Appleton RE. Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment. Dev Med Child Neurol.2004;46 :771– 775
169.    Pickett JA, Paculdo DR, Shavelle RM, Strauss DJ. 1998–2002 update on “Causes of Death in Autism. ” J Autism Dev Disord.2006;36 :287– 288
170.    Plioplys AV. Intravenous immunoglobulin treatment of children with autism. J Child Neurol.1998;13 :79– 82
171.    Polimeni MA, Richdale AL, Francis AJ. A survey of sleep problems in autism, Asperger's disorder and typically developing children. J Intellect Disabil Res.2005;49 :260– 268
172.    Posey DJ, Erickson CA, Stigler KA, McDougle CJ. The use of selective serotonin reuptake inhibitors in autism and related disorders. J Child Adolesc Psychopharmacol.2006;16 :181– 186
173.    Posey DJ, Guenin KD, Kohn AE, Swiezy NB, McDougle CJ. A naturalistic open-label study of mirtazapine in autistic and other pervasive developmental disorders. J Child Adolesc Psychopharmacol.2001;11:267– 277
174.    Posey DJ, McDougle CJ. The pharmacotherapy of target symptoms associated with autistic disorder and other pervasive developmental disorders. Harv Rev Psychiatry.2000;8 :45– 63
175.    Posey DJ, Puntney JI, Sasher TM, Kem DL, McDougle CJ. Guanfacine treatment of hyperactivity and inattention in pervasive developmental disorders: a retrospective analysis of 80 cases. J Child Adolesc Psychopharmacol.2004;14 :233– 241
176.    Posey DJ, Wiegand RE, Wilkerson J, Maynard M, Stigler KA, McDougle CJ. Open-label atomoxetine for attention-deficit/hyperactivity disorder symptoms associated with high-functioning pervasive developmental disorders. J Child Adolesc Psychopharmacol.2006;16 :599– 610
177.    Quintana H, Birmaher B, Stedge D, et al. Use of methylphenidate in the treatment of children with autistic disorder. J Autism Dev Disord.1995;25:283– 294
178.    Ratey JJ, Mikkelsen E, Sorgi P, et al. Autism: the treatment of aggressive behaviors. J Clin Psychopharmacol.1987;7 :35– 41
179.    Reed MD, Findling RL. Overview of current management of sleep disturbances in children: I—pharmacotherapy. Curr Ther Res.2002;63(suppl B) :B18– B37
180.    Research Units on Pediatric Psychopharmacology Autism Network. Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Arch Gen Psychiatry.2005;62:1266– 1274
181.    Research Units on Pediatric Psychopharmacology Autism Network. Risperidone treatment of autistic disorder: longer-term benefits and blinded discontinuation after 6 months. Am J Psychiatry.2005;162 :1361– 1369
182.    Reynhout G, Carter M. Social stories for children with disabilities. J Autism Dev Disord.2006;36 :445– 469
183.    Rogers SJ, DiLalla DL. A comparative study of the effects of a developmentally based instructional model on young children with autism and young children with other disorders of behavior and development. Top Early Child Spec Educ.1991;11 :29– 47
184.    Rogers SJ, Herbison JM, Lewis HC, et al. An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism or severe emotional handicaps. J Div Early Child.1986;10 :135– 148
185.    Rogers SJ, Lewis H. An effective day treatment model for young children with pervasive developmental disorders. J Am Acad Child Adolesc Psychiatry.1989;28 :207– 214
186.    Rogers SJ, Lewis HC, Reis K. An effective procedure for training early special education teams to implement a model program. J Div Early Child.1987;11 :180– 188
187.    Rogers SJ, Ozonoff S. Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence. J Child Psychol Psychiatry.2005;46 :1255– 1268
188.    Rogers SJ. Empirically supported comprehensive treatments for young children with autism. J Clin Child Psychol.1998;27 :168– 179
189.    Rogers SJ. Interventions that facilitate socialization in children with autism. J Autism Dev Disord.2000;30 :399– 409
190.    Rugino TA, Samsock TC. Levetiracetam in autistic children: an open-label study. J Dev Behav Pediatr.2002;23 :225– 230
191.    Sallows GO, Graupner TD. Intensive behavioral treatment for children with autism: four-year outcome and predictors. Am J Ment Retard.2005;110:417– 438
192.    Sandler A. Placebo effects in developmental disabilities: implications for research and practice. Ment Retard Dev Disabil Res Rev.2005;11 :164– 170
193.    Sankar E. Initial treatment of epilepsy with antiepileptic drugs: pediatric issues. Neurology.2004;63(10 suppl 4) :S30– S39
194.    Scahill L, Aman MG, McDougle CJ, et al. A prospective open trial of guanfacine in children with pervasive developmental disorders. Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. J Child Adolesc Psychopharmacol.2006;16 :589– 598
195.    Schaaf RC, Miller LJ. Occupational therapy using a sensory integrative approach for children with developmental disabilities. Ment Retard Dev Disabil Res Rev.2005;11 :143– 148
196.    Schepis MM, Reid DH, Behrmann MM, Sutton KA. Increasing communicative interactions of young children with autism using a voice output communication aid and naturalistic teaching. J Appl Behav Anal.1998;31 :561– 578
197.    Schopler E, Mesibov GB, Baker A. Evaluation of treatment for autistic children and their parents. J Am Acad Child Psychiatry.1982;21 :262– 267
198.    Schreck KA, Mulick JA, Smith AF. Sleep problems as possible predictors of intensified symptoms of autism. Res Dev Disabil.2004;25 :57– 66
199.    Schreibman L, Ingersoll B. Behavioral interventions to promote learning in individuals with autism. In: Volkmar FR, Paul R, Klin A, Cohen D, eds.Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Vol II. Hoboken, NJ: John Wiley & Sons; 2005:882– 896
200.    Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS. Trajectory of development in adolescents and adults with autism. Ment Retard Dev Disabil Res Rev.2004;10 :234– 247
201.    Shannon M, Graef JW. Lead intoxication in children with pervasive developmental disorders. J Toxicol Clin Toxicol.1996;34 :177– 181
202.    Shavelle RM, Strauss DJ, Pickett J. Causes of death in autism. J Autism Dev Disord.2001;31 :569– 576
203.    Shea S, Turgay A, Carroll A, et al. Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics.2004;114(5) . Available at:www.pediatrics.org/cgi/content/full/114/5/e634
204.    Short AB. Short-term treatment outcome using parents as co-therapists for their own autistic children. J Child Psychol Psychiatry.1984;25 :443– 458
205.    Sibinga EM, Ottolini MC, Duggan AK, Wilson MH. Parent-pediatrician communication about complementary and alternative medicine use for children. Clin Pediatr (Phila).2004;43 :367– 373
206.    Sinha Y, Silove N, Wheeler D, Williams K. Auditory integration training and other sound therapies for autism spectrum disorders. Cochrane Database Syst Rev.2004;(1) :CD003681
207.    Sinha Y, Silove N, Wheeler D, Williams K. Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review. Arch Dis Child.2006;91 :1018– 1022
208.    Smith MD, Haas PJ, Belcher RG. Facilitated communication: the effects of facilitator knowledge and level of assistance on output. J Autism Dev Disord.1994;24 :357– 367
209.    Smith T, Groen AD, Wynne JW. Randomized trial of intensive early intervention for children with pervasive developmental disorder. Am J Ment Retard.2000;105 :269– 285
210.    Smith T, Perry A. A sibling support group for brothers and sisters of children with autism. J Dev Disabil.2005;11 :77– 88
211.    Smith T. Outcome of early intervention for children with autism. Clin Psychol Sci Pract.1999;6 :33– 49
212.    Smits MG, van Stel HF, van der Heijden K, Meijer AM, Coenan AM, Kerkhof GA. Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial. J Am Acad Child Adolesc Psychiatry.2003;42 :1286– 1293
213.    Steingard R, Biederman J. Lithium responsive manic-like symptoms in two individuals with autism and mental retardation. J Am Acad Child Adolesc Psychiatry.1987;26 :932– 935
214.    Steingard RJ, Connor DF, Au T. Approaches to psychopharmacology. In: Bauman ML, Kemper TL, eds. The Neurobiology of Autism. 2nd ed. Baltimore, MD: Johns Hopkins University Press; 2005:79– 102
215.    Stigler KA, Posey DJ, McDougle CJ. Ramelteon for insomnia in two youths with autistic disorder. J Child Adolesc Psychopharmacol.2006;16:631– 636
216.    Sturmey P. Secretin is an ineffective treatment for pervasive developmental disabilities: a review of 15 double-blind randomized controlled trials. Res Dev Disabil.2005;26 :87– 97
217.    Sugie Y, Sugie H, Fukuda T, et al. Clinical efficacy of fluvoxamine and functional polymorphism in a serotonin transporter gene on childhood autism. J Autism Dev Disord.2005;35 :377– 385
218.    Syzmanski LS, King B, Goldberg B, et al. Diagnosis of mental disorders in people with mental retardation. In: Reiss S, Aman MG, eds.Psychotropic Medications and Developmental Disabilities: The International Consensus Handbook. Columbus, OH: Ohio State University Nisonger Center; 1998:3– 17
219.    Taylor B, Miller E, Lingam R, Andrews N, Simmons A, Stowe J. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population-based study.BMJ.2002;324 :393– 396
220.    Taylor BA, Jasper S. Teaching programs to increase peer interaction. In: Maurice C, Green G, Foxx RM, eds. Making a Difference: Behavioral Intervention for Autism. Austin, TX: Pro-Ed; 2001:97– 162
221.    Taylor BA. Teaching peer social skills to children with autism. In: Maurice C, Green G, Foxx RM, eds. Making a Difference: Behavioral Intervention for Autism. Austin, TX: Pro-Ed; 2001:83– 96
222.    Tordjman S, Anderson GM, Pichard N, Charbuy H, Touitou Y. Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder. Biol Psychiatry.2005;57 :134– 138
223.    Torrente F, Anthony A, Heuschkel RB, Thomson MA, Ashwood P, Murch SH. Focal-enhanced gastritis in regressive autism with features distinct from Crohn's and Helicobacter pylori gastritis. Am J Gastroenterol.2004;99 :598– 605
224.    Towbin KE. Strategies for pharmacologic treatment of high functioning autism and Asperger syndrome. Child Adolesc Psychiatr Clin N Am.2003;12 :23– 45
225.    Troost PW, Lahuis BE, Steenuis MP, et al. Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study. J Am Acad Child Adolesc Psychiatry.2005;44:1137– 1144
226.    Tsakanikos E, Costello H, Holt G, et al. Psychopathology in adults with autism and intellectual disability. J Autism Dev Disord.2006;36 :1123– 1129
227.    Tuchman R, Rapin I, Shinnar S. Autistic and dysphasic children II: epilepsy [published correction appears in Pediatrics. 1992;90:264].Pediatrics.1991;88 :1219– 1225
228.    Tuchman R, Rapin I. Epilepsy in autism. Lancet Neurol.2002;1 :352– 358
229.    Tuchman RF, Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates.Pediatrics.1997;99 :560– 566
230.    Turk J. Melatonin supplementation for severe and intractable sleep disturbance in young people with genetically determined developmental disabilities: short review and commentary. J Med Genet.2003;40 :793– 796
231.    Valicenti-McDermott M, McVicar K, Rapin I, Wershil BK, Cohen H, Shinnar S. Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. J Dev Behav Pediatr.2006;27(2 suppl) :S128– S136
232.    Venter AC, Lord C, Schopler E. A follow-up study of high-functioning autistic children. J Child Psychol Psychiatry.1992;33 :489– 507
233.    Vitiello B. An update on publicly funded multisite trials in pediatric psychopharmacology. Child Adolesc Psychiatr Clin N Am.2006;15 :1– 12
234.    Volkmar FR, Nelson DS. Seizure disorders in autism. J Am Acad Child Adolesc Psychiatry.1990;29 :127– 129
235.    Volkmar FR, Wiesner LA, Westphal A. Healthcare issues for children on the autism spectrum. Curr Opin Psychiatry.2006;19 :361– 366
236.    Weiskop S, Richdale A, Matthews J. Behavioural treatment to reduce sleep problems in children with autism or fragile X syndrome. Dev Med Child Neurol.2005;47 :94– 104
237.    Weiss M. Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism. Behav Interv.1999;14 :3– 22
238.    Weiss MJ, Harris SL. Teaching social skills to people with autism. Behav Modif.2001;25 :785– 802
239.    Whalen C, Schreibman L. Joint attention training for children with autism using behavior modification procedures. J Child Psychol Psychiatry.2003;44 :456– 468
240.    Wieder S, Greenspan SI. Can children with autism master the core deficits and become empathetic, creative, and reflective? A ten to fifteen year follow-up of a subgroup of children with autism spectrum disorders (ASD) who received a comprehensive developmental, individual-difference, relationship-based (DIR) approach. J Dev Learn Disord.2005;9:39– 61
241.    Wiggs L, Stores G. Sleep patterns and sleep disorders in children with autistic spectrum disorders: insights using parent report and actigraphy.Dev Med Child Neurol.2004;46 :372– 380
242.    Williams G, Sears LL, Allaed A. Sleep problems in children with autism.J Sleep Res.2004;13 :265– 268
243.    Williams KW, Wray JJ, Wheeler DM. Intravenous secretin for autism spectrum disorder. Cochrane Database Syst Rev.2005;(3) :CD003495
244.    Witwer A, Lecavalier L. Treatment incidence and patterns in children and adolescents with autism spectrum disorders. J Child Adolesc Psychopharmacol.2005;15 :671– 681
245.    Wong HHL, Smith RG. Patterns of complementary and alternative medical therapy use in children diagnosed with autism spectrum disorders. J Autism Dev Disord.2006;36 :901– 909
246.    Zollman C, Vickers A. What is complementary medicine? BMJ.1999;319:693– 696

COMMENTS & QUESTIONS [for August, 2014]

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


I just wanted to say that I have gotten so much good information from this site, and especially the Adult Aspergers Chat website. This video describes me perfectly. How did you get inside 'my' head? :) http://www.myaspergerschild.com/2014/07/getting-inside-head-of-child-with-high.html

Plus I'm not a 10 year old boy, I'm a 34 year old female, not yet diagnosed but I am going to pursue it soon.
Thanks so much!


Thank you for getting back to me welcoming me. I’ve heard grate things about your page, and hopefully it can help me cope a little better. Going thru the first week of training right now and so far I think your course is wonderful. I believe it is the answer to my prayers. I plan to implement everything to the fullest.



I'm also a clinician and found this so helpful for my practice!! I was dating someone with Aspergers and I thought I understood everything but he just could not commit and he would not go to counseling to understand how his relationships failed. Your audio instruction really turned the light on and I'm so happy that I bought it. Best $19.00 I ever spend.

Hope you are enjoying your Labor Day weekend :)

Anastasia Geramanis, LCSW



I have two adopted (at birth) drug exposed  children.  Last night had big family meeting with son (methadone) who has  RAD and other problems such as ADHD etc.  I actually was looking up "how to give up"  on google because it is not in  my nature and I don't know how to do that. I  Found a book I was going to order and then looked up  "how to give up on a child with Reactive Attachment disorder".....instead I found YOU. My son is not hugely symptomatic but has all the classic symptoms... but being told you are not loved or even liked and his sister is a meth baby that he doesn't like her either (this is in a stone cold even toned statement).  Which came as no surprise since he barely ever says hi to her and treats her like a leper and I've heard it many times before.   He does all you describe...mumbles, forgets what you say, flinches when you barely touch him,  has tried to ruin every family get-together,,,,stop having dinners together because by the time I was done with the constant little verbal jabs my stomach was in knots.

I just subscribed to your newsletter and today.. and miraculously you talked about melt downs.  My daughter now 19 has really huge meltdowns ...the problem is she tries to hit her head or hit things like lamps, and windows.  It is a constant vigil and a constant trying to keep her from melting down...which makes me feel abused all day and makes it that we kind of give in to  everything she wants....add her RAD brother (not biological) and well let's say ....it's not a party.

Long story short......sorry.  I just bought your "aspergers melt down" package (although she isn't autistic) ...haven't read it yet......and all the info that you gave about RAD teenager...is my child to a "T".  I was praying last night and although I go to church every Sunday...I'm not a big prayerer...I asked for a message from God and found you.  I don't know how that will play out yet....but as always hope springs up when  I'm about to throw in the towel.  All I ever wanted was to be was a mom...the kool aid mom, the going on outings Mom, the pizza at my house mom for my teenage children mom. Even the mom who helps her child with daily struggles and illnesses.....but this??? My daughter has apraxia and although she says maybe a 100 words  we've never had a "conversation".  Neither of them really have never used the words....ever "I love you Mom".

thanks for doing what you do!!! I will read your material with hope and an open mind!!!   I've tried literally everything available out there for both of them....and just between you and me I'm getting physically and mentally  tired!!!!!

Thank you for being there!!


Mr. Hutten,

Hello.  My name is Lisa.  I'm seeing a man who has a 21-year-old son with Asperger's.  Sadly, this boy never got his GED (took it, but never passed it).  He just sits at home.  The mother raised him while father worked 2 jobs.  They are divorced but all live together.

Well, I am seeing the father.  It is a strange situation.  They are doing nothing to help son gain independence.  He just sits at home.  Heartbreaking.  They act like he's only one with this problem.

My question:  I'm going camping this weekend with the father and son.  I get stressed around his son due to his compulsive non-stop talking about zombies, etc!  What do I do to survive this weekend trip?  I have gone fishing for the day with him and got short with him at a restaurant as I was overloaded.  I'm afraid same will happen this weekend....

I find it a real shame as this boy needs a life and they act like he's helpless. Makes me sick.  Father doesn't want to try helping as "she" (mother) controls everything.

Any advice to at least get me through the weekend???!!!

Thank you SO MUCH for any advice!


Dear Mark,

Have been reading your materials about Launching your Adult Children with Aspergers. I am impressed with your knowledge and approach. Are you available as a phone and online coach?

I gave my son your question answer from the 36 yr old man who said he didn’t feel he was meant for this planet. It touched him a bit because he has been  more cheerful since I gave it to him and said he would consider talking to you. We live in Washington state but I think that it would be via phone or computer appeals to him more as he can communicate and pace in his own environment. He managed to transfer successfully to a 4 yr college away from home (The Evergreen State College, an hour away in Olympia )  after wandering through high school and community college and will be a junior next year. Though he survived two quarters away at college last year, I know he had a couple of melt downs and had a couple this summer also.

I know we need support but our insurance only covers generic therapists in their network and they don’t necessarily understand and are frequently unhelpful. He has refused to disclose his diagnosis at college and has not wanted to be seen as special ed any more. He had a Aspergers teaching assistant  through 11th grade after I threatened to send him to a private school. He signed up for Air Force and got through basic training but failed at Air Traffic Control School and they re-diagnosed him with Aspergers and discharged him. I was very impressed he made it through basic training. He most recently worked part time as a dishwasher at an upscale supermarket deli kitchen while in Community College.

I need support also as this has been a long journey with another son with ADHD and my first husband also having Aspergers. I am remarried to a supportive man but none of us are exactly


I am reaching out regarding my son who is 14.  He is diagnosed with HFA.  He has obsessive qualities, as well as ADHD. 

I am experiencing difficulties with helping him to regulate his anger, especially after he comes home from a visit with his father.  I am divorced as of April, 2014, and this has been very stressful for him.  He is not interested in a counseling relationship, so I am not pushing that, although I feel as if it would help him to mediate the emotional response that he has to his father and I no longer living together.

I am an LCSW and a psychoanalyst and I work with children in my practice, even kids on the spectrum, but I'm always interested in learning how to handle things better or to see if there is something that I am not handling correctly, so any input you can provide regarding how to help him with this change will be helpful.

He is demonstrating periods of blind rage, where I feel scared and I'm sure he does too.   He has never hurt anyone, but he is very angry, so that is why I am reaching out.


Thank you, Mark! I was able to find you eBook for the teachers and staff at my son's school.  Timothy just turned 14.  His therapist gave him an IQ test last year and he was in the 98%!  This year, he was accepted into MENSA!  I'm very proud of him.  Unfortunately, 7th grade didn't go so well for him.  I'm sure it was partly due to going into 7th grade, however, it was mostly because I don't think the teachers have a clue about the ASD and HFA.  I want to offer them as much information as I can so Timothy doesn't slip through the cracks and so that he received the education he deserves.  I appreciate all you are doing for parents and children with ASD/HFA!



I greatly appreciate your extremely fast response time..it is an amazing world. Thank you for taking the time and making the effort to have this website. It’s a new discovery for me.

My wife and I have a concern regarding our 12 year old son, starting 7th grade soon. His birthday is Sept 19, 2001. He was diagnosed with HFA a few years ago after having extreme trouble coping in 4th grade. Since then he has been doing so much better in school and at home. The boy is very smart, gets A and B grades,  lots of enrichment at home and has two or three friends.

We decided to test him for giftedness. Basically, he missed the cut off by three points of IQ having tested at 127. We talked to his counselor who liked the idea of the gifted testing as something positive. My son is ok with missing the mark, but wryly says the 3 points shortfall makes it worse. We’ll test him again next year.

Simultaneously with the gifted testing, the school added an accelerated 7th grade math class and gave a timed qualification test, which he got a 25% score. This was mixed in an algorithm with other benchmarks. He doesn’t qualify mostly because of the timed test. 

My wife is all over this and wants to push the school into getting him into the advance math class because his other benchmarks on math are high. I firmly disagree, thinking only of the things we learned about his condition: “get him to like school, education is not a race, control anxiety, frustration, etc.

We’ve been unsuccessful in finding any resources to help us sort out the matter of the accelerated class (to me this is really about how much frustration the boy can take) and the dual diagnosis; how this could help or hurt. We do know that IEP takes precedence over the GIEP, in our state of Pennsylvania.

Needless to say, this is causing some parental stress. I appreciate any thoughts or resources.


Mr. Hutten,

Our 14 year old daughter has Asperger Syndrome and is extremely intelligent.  We have had her to OT for Sensory therapy where they used the 'How Does Your Engine Run" protocol.  We have had her to Social Skills training.  We have her in counseling.  You name it, we've been there.  The problem?  She knows what to do in certain instances, like what she needs to do to have her engine just right, how give and take goes in a conversation, how relationships work, etc, but does not know when and how to apply them in real life circumstances.  How can this be taught? Thanks!


My grand son is diagnosed with HFA /aspergers....so he loves animals, family his little sister
so very very smart and his MOM is at times exhausted...Thank God he is now in 2nd grad and with a teacher that has had special ed training however they live on the Big Island of Hawaii and guess what that is a challenge in and of itself....MOm is currently looking for things that will be good for him to connect iwht such a robotics....what do you think of course he has no ADHD like once thought back when they first suspected something....He is so amazing..I would love if he go into and individual sport as I know in my heart of hearts he would excel..like say swimming which he is good at...r even the gaming that young adults do and that is very big...there is a program in another country where the kiddos actually can make odles of money doing these games. do you know much about this he would be awesome since he does the mind craft excellently. Your thoughts on these ideas are much appreciated as I am a concerned grand mother and mother <>

Dear Mark,

I don't expect a response, just wanted to e-mail to vent some frustration.   He is trying to get me sucked  in by saying things like “Is that what you are learning from your parenting class?” I had addressed a compliment I   was giving him this morning when driving him to work, about what I noticed about him and football, and admiring his perseverance, despite two knees surgeries and still hanging in there, and how it must be tough for him, being with all of the other kids and no previous injuries and him not having much playing time.  He goes to St. Xavier, which is good private school in the Cincinnati area.   I just keep my best “poker face” on and don’t respond.  We are  having a family discussion tonight and I am presenting chore charts.  I told him Sunday nights are our family dinner nights  and to talk about the upcoming week, how the past week has gone, etc.  Week 3 looks extremely interesting as this describes what has been happening for years, so lots for me to learn. 

After dropping him off, I just told myself a bunch of “good things” about our situation, #1 being, he holds it together with everyone else and is not a problem child at school or work. 

He does see a counselor and I told him about this too and he thinks it’s great and just asked me to keep him posted how the weeks go and what is presented each week. 

Thanks again for your course. I think it is a great source for me right now.


Dear Mark,

You are a true expert.  Unfortunately there are many mom experts here in the USA who give very bad advice and/or don't see red flags until late in the game.  Looking back, my son's black/white thinking should have been addressed.  I sought help when he was 5 and on, but he made eye contact and had great physical skills.  He did not fall into the typical diagnosis.  Now that he is almost 20 it is clear he has Aspergers and it is so hard to find help. 

Please think of addressing this topic sometime.  Unfortunately, I believe (I am sure) a label will depress him.  Skills training will be wonderful.  I know the former from conversations with him. We are not a one size fits all world.

Thank you.


Well, dinner and family chores weren’t a success on Sunday..  He didn’t show up to the table and stayed in his room, and played his music loudly, having the attitude and cussing.  He has been doing things on purpose that, you made me realize, provided intensity to him from me getting upset.  But, I ate by myself and he did text me to say he might be out for dinner, but he didn’t.  At this point, is when I usually give up when I try something “new” and say nothing works and rant and rate.  But the videos and advice are like a tape in my head to keep trying and not give up this time.  I only have two years left to make a big impact. 

So, I thought, what would Mark say to do?  So, I put up the bedroom chore chart I wanted to start this week and explain being on discipline, and the rules to follow since school started this week.   I have to tell you how extremely hard it is for me to stay calm and this is when I usually start to “lose” it and tensions flair. 

So, when he went to sleep, I took his computer away for his rude behavior the night before and told him he was on discipline when he asked where it was the next morning.  When he asked what that meant, I told him since he didn’t show up to the family meeting, he needs to read the chart and show up next  Sunday.

Last night, he actually gave me  his computer at 9:30 after a gentle reminder and I thanked him and told him as time goes on, he can earn more  time if rules are followed.  And, when I picked him up from football Monday night, he actually asked me to come inside and see his locker, which lead to a 1 hour tour of him showing me around school and snuck me in the varsity locker room for a few minutes!! 

Monday night when I got home, I was stressed out from work and usually when I come home and see messes that are made, I blow up and I see things that he knows bothers me, so he is trying to get me to explode.  But, I don’t say a word  about it, took a shower and went to my room for the night.  

Things may not be going as fast as I would like them too, but it’s going to take a lot of time.  Just like losing weight, we don’t gain or lose overnight, so this is going to take a lot of time too. Oh, and I LOVE the idea of a gift card for the chores, since he just LOVES Chiplote, what a great idea!


Hi Mark, 

Our daughter is a 27 year old aspire, her name is R____.  After she graduated from college she has an emotional breakdown and moved back home. It was almost 2 years before she began to function again and leave the house.  Just in the last 3 or 4 months she will go to the grocery store or Walmart for herself.  R____ is in her last year of graduate school majoring in counseling. She is going to help families with autistic children. She is brilliant in this environment. She is now with a 6 year old autistic little girl who has never spoken.  After being with R____ for 3 weeks Maddie said her first word!  She has worked with her personal Counselor/mentor in support groups for moms of autistic children. She has been a life saving resource for these women because she understands the mind of their children.

At home is different. She cannot follow a "house rule" to save her life. She has highly incensed our neighbors by not leashing her dog and letting her poop in their yards. Some how leash laws don't apply to R____! She says she is going to ruin his life and kill all the grass in his yard! Her room is indescribable, holes in the wall where she bashes her head,filthy carpet, weeks old dirty dishes. She hates it this way, but when she faces it she becomes so overwhelmed that she is frozen and simply cannot clean it up. She wants to clean it but winds up walking circles around the house and accomplishing nothing, she can do this for 3 hours at a time.  I keep a very nice home and knowing that one corner of it is condemnable is hard for me.  Relationally the only meaningful conversations we have are over text message.   She will go into a rage and become very verbally abusive because of how she interprets how "I am looking at her" . R____ and her father get along well, very well compared to R____ and I. With me the biggest obstacle is that she will go into a long and detailed description of what I am thinking (all very negative)  and feeling and melt down because of it.  I have informed her as long as she is incorrectly reading my mind and "knowing" what I am going to do we will never get better in our relationship.  I have grieved and been emotionally fragile over this since she was 14.

She was only diagnosed 8 months ago. We we really lost before that - 14 doctors all said nothing was wrong. She used to cry and scream and breakdown because "something is very very badly wrong with me and no one will tell me what it is." The excruciating pain she felt and I felt is unexplainable. I would give my right arm for her to not live in daily pain.  She has very high social anxiety - after a social event she must go to bed for at least a day. She can be dominating and full of bravado in social situations to compensate for her fear. She says how would you feels if when you walked into a room and you could see every person pointing a machine gun at you, that's how I feel all the time!

Here is what I have been trying to navigate since she was 14: how do we have a relationship? I seem to have a unique ability to really set her off. I vacillate between loving her deeply and admiring her courage to wanting to throw her in front of a bus. Oh, and here is the key thing, in the past I have taken all this personally. Recently I have realized it is almost a scape goat phenomenon. What ever is not working at home is clearly my fault. I am the target. David (my husband) and I have clearly observed that he can say the exact same thing to her and she can accept it and even use it as being helpful. If I say the exact same thing it sets her off in  a rage.  It breaks my heart and R____'s that we cannot have a relationship. And it is very difficult for me to navigate the emotions AND have another adult living here that cannot follow house rules.  This is all very hard for David as well, but at least he is not the target of so much angst!


My 25 yr. old daughter does nothing all day except drink and play computer games.  She sits in her room full of dirty dishes, she drinks, and has a boyfriend around the corner who also does nothing (30 yrs. old takes pills parents don't make him work).
At one point right out of high school she took 2 college classes but she struggled and has no desire to go back.  Has a car and driver's license but is afraid to drive on highway so she won't go anywhere.  I have to work all day so I can't be there to be a "cop" and enforce anything.  I am divorced and dad is dysfunctional so he is not in the picture. 

The other problem is this is the house she was born into so I don't think she knows how to be an adult in this house.  Although we are going to lose this house to foreclosure.
Miraculously I just make her agree to give me $80 a month for room and board b/c she gets disability and doesn't think she should have to contribute towards household expenses.  She just uses is for booze and weed. The house is filthy.  I go home from work to a sink full of dirty dishes.


Hi Mark,
I wanted to know if it is possible to change a 15 year old boys behavior with autism? My son was just recently diagnosed with Aspergers or HFA. Unfortunately, there is a really long sad story on how we got here and he is now a ward of the state of Nebraska. Having trouble getting the right help in our little town of 25,000 and have spent so much money. Sure could use some guidance. I have enjoyed your articles and may purchase your book in hope that the place where my son is currently at will put it to use. Thanks.


Hi if you get this i have a question - can you tell me how to find someone who could help my 18 yo to get some help   He doesn't trust anyone, will only talk to people in the 2 groups he goes to. Though he talks to people he still says he hates all people (!!) and doesn't have friends- he doesn't see that he can do anything about it he just blames everyone. Too difficult! I m desperate for any help to find anyone here? Thank you so much



I just ran across your skyping page and I am so excited.  I was just thinking today that
someone should be willing to do this!

I have an adult son, 31, who has AS and is struggling with depression and anxiety issues.
He has really drug his feet about medication, and I totally understand that.  But there
are days his depression and anxiety interfere with work.  He's very aware of himself and I
have been so proud of his efforts and the different ideas he tries to keep himself focused.

How much do you charge for your sessions?  He doesn't have insurance, but we can help
him pay.  Would you be able to tell in a few sessions if he needs medication?


Hi Mark,

I am a Mental Health Counselor in New York.  I have been doing Play Therapy with a child who appears to be on the PDD spectrum.  I have another child brought to me by parents who also appears to be on that spectrum. My question is:  Your website includes comments by parents who refer to their child as having Autism, and others as Aspbergers.  In other places on the web (where I first found your link) I read of parents who received these dx when their chilfen were younger, and later received dx of ADHD which seemed to be more accurate and helpful in terms of getting appropriate help.

Well, I am sure my question is not uncommon.  I am looking to give the best possible support to these parents and children.  I already learned a lot from your two short videos.  During my sessions with these and many other children my intuitive understanding of what they need and my connection with them, and/or their parents, produces progressive results which keeps them coming back – which is not my goal; rather, I want to be the best counselor I can be for them all.

So, can you distinguish for me the appropriateness of your program for parents with children with these different diagnoses?  I am interested in learning more and also in providing parents with resources to help their child.  It would not be appropriate for me to render a diagnosis, but I want to respond appropriately when I see the symptoms of behavior on the PDD spectrum, or, in general, children with really challenging behaviors which can both due to neurological issues and/or environmental difficulties such as (often the case) parental divorce.

Several parents have told me they were advise by many people NOT to get a psychiatric diagnosis because the child would then be labeled, put into special classes, etc. -- better to try to work through counseling and parenting help.   I can understand their point, and think the individual development and daily circumstances of each child might lead to an inacurate diagnosis or educational placement.  So, I want to help them as best I can with this quandary.


Hello Mark;

I´m a clinical psychologist and art therapist from central Mexico (Guanajauto) . I´m working with a 13 year old boy with "borderline" Asperger´s (his diagnosis is uncertain as he spent his first 10 year untreated and living in a remote area) .
He is facing problems at school after several tantrums, and in the upcoming term he will be accepted on probation. I´m putting together a set of readings as part of a joint effort with the teachers, the mother and myself to provide this young boy with the chance to attend school and lead a positive life.
Although I´m ready to get your ebook, I wonder if you also have anything directly aimed to therapists which help us update on the issue. My best source of communication and continued education is the internet here. No specialty bookstores or libraries.

Thank you and congratulations on your commitment.


My husband and I are at the ‘end of our rope’ with our 21 year old son, not ‘yet’  diagnosed with Aspergers, but I am sure he has it.  He is angry/ “offended” that I am thinking Aspergers, he is not progressing at all towards maturity.  College for 2 years has not gone well, he ‘sort of’ tried to get work all summer, then was hired at a great position, and fired within a week due to tardiness.  I am an RN, my husband—a mechanical design engineer, and we just cannot figure him out.   We have a dtr who is at the extreme opposite, very mature and functioning well as a 19 year old, for the most part. We need help, and it looks as this may help.  Please respond and I would love to buy this book/get some real help.  I am soooo exasperated.  I never thought parenting would be this hard, it has been an unbelievably hard journey, esp the last 2 years when I assumed things would improve with age/maturity.


Hi Mark,
I stumbled across your website tonight while (once again) looking up Aspergers traits in my 5-year-old son. He hasn’t been diagnosed, but he fits many of the characteristics, and more/different ones seem to show up over time. We’ve been going to play therapy with him for 7 months, but not much progress has resulted. He had a meltdown the other day that clearly fell within the description of a meltdown (vs. a tantrum - your video on that was so enlightening!) We also have a NT 4-year-old son, and the tactics that work with one don’t work with the other.

I am interested in buying and downloading your ebooks immediately. Both books - My Aspergers Child and Teaching Social Skills and Emotion Management - seem equally relevant and important. Can you offer a suggestion of the best order in which to buy/read/apply them? I see that My Aspergers Child/OPS comes with a lot more support, which is great. But I also think the Social Skills & Emotion Management piece is urgent - those exact struggles in preschool were what flagged the issue and led us to therapy and to enrolling him in a half-time school/homeschool for Kindergarten.

Thank you for your time in answering my question and for these wonderful resources. I look forward to the help they will provide our family.


Dear Mark,

We have not met, but I’ve recently become familiar with your work. I’m the President of a 30+ year old radio syndication firm in Chicago, and through your web site, OnlineParentingCoach.com, I’ve come to realize that your expertise and perspective combine to bring a unique voice in the world of parenting. I am very impressed.

In the story attached, you will read that I am the father of 13-year-old triplets. I can attest first-hand to the fact that when they were born, they did not come with instruction manuals.

As you'll also read, I've lived far from the most ideal childhoods. My wife and I have certainly done the best job possible to make sure that our children do not wind up on the therapist's couch for the same reasons that I did. However, we jokingly say that it will certainly end up being for something else.

The dynamics between children and their parents have changed dramatically over the past five to ten years. Part of this has been driven by technology and the fact that children have cellular phones at very young ages. In fact, when my kids got their cell phones, I was shocked to find out that they never actually make phone calls, all they do is text.

Who knew?

At the same time the way in which children interact with each other, even the way they begin the dating process, is very different than it was just a decade ago.

I'm looking for someone to host a talk radio program for us on these topics.
I'd like to speak with you about this opportunity.

Our business model is to attempt to build brands that can generate revenue across multiple media platforms. There’s a Chinese menu full of things we can discuss from short form radio to subscription blogs, e-zines, and even television. Our long form television production partner is Towers Productions. You can check out their website at www.towersproductions.com.

We are speaking with other candidates about potentially hosting a show for us like this, but I'd like to talk with you about this opportunity.

Please take a look at both attachments. One talks about our business model and the other one is a story from Inside Radio that talks about me and my company.

Our next program change is in about four weeks. We identified several other people in this space that we are reaching out to as well. If you're interested, I need to hear from you as early as possible. At that time, I will also provide you references on our company.


Dear Mr Hutten
I am divorced from a woman who is on the spectrum. The problem is that we have a seven year old daughter whom we share-care.
My daughter seems to be showing classical signs of HFA, however, the mother is putting all kinds of "road-blocks" in preventing having
My daughter being properly assessed. It is quite exasperating, knowing the importance of early intervention. I would greatly value any suggestions
Or advice in trying to somehow overcome this impasse.
Very grateful for any assistance and many thanks in anticipation.
R R M.


Hello, My daughter is 11 years old and in the 6th grade. She was diagnosed with Aspergers almost 3 years ago. She just started 6th grade at a small private school after attending a public school since kindergarten. We moved her because she was unhappy at her old school because she was experiencing some teasing and had trouble fitting in and making friends at her old school. Also her class had 32 kids which made it difficult for her to concentrate. Additionally her father and I have divorced in the last year. She attends a social skills group and also gets some one on one social skills training. Shes just started counseling because Im concerned about anxiety and depression which runs in the family. I thought she was happy at her new school but today the teacher pulled me aside and said that Mila was not doing her work and was hitting herself under the table. Later in a keyboard class, she hit the keyboard out of frustration. I asked Mila what happened and she said she didnt understand the work but the teacher said she didnt think the work was too difficult for her. She often displays destructive behavior when she is frustrated and my attempts to help her only makes her more frustrated. Her teacher asked me how to help her in these situations and I didnt have a good answer. Honestly, I dont feel like I have a good grasp at all of how to deal with her behaviors so I tip toe around trying not to make her angry. I know we need a lot more help than you can give but am once again at a loss on how to help her and worried her new school may not be the solution I had hoped. Any suggestions? 


Thanks for your support.  My 8 year Asperges/ADHD has started refusing to go to school.  Information supplied already has lead me to subscribe to as as a great resource.!!!  Thank god for people like you it keeps parents like myself a little sane!!!



My Aspergsr boyfriend does not have any tolerance for my two kids (from a previous marriage). Is this typical for people with Aspergers?


Unfortunately, many adults on the autism spectrum do not tolerate frustration well, and are perennial pessimists with a negative attitude (e.g., “nobody understands me” … "good things don't last" … "my future looks rather depressing"). These individuals often feel unappreciated, underpaid, cheated, mistreated and misunderstood. They may chronically complain and criticize, and they may blame their failures and defeats on others, posing as victims of a heartless “neurotypical” world.

The combination of low-frustration tolerance and a negativistic personality in adults with Asperger’s is quite unfortunate because the individual (a) has difficulty being patient with the process while at the same time (b) viewing himself as someone who is always in a one-down position. The mantra of this person goes something like: “The things that I want to achieve should come quickly and easily – and when they don’t – I’m a failure.”


Dear Mark,

I am a grateful follower of your postings as we navigate trying to help our 20 year old son who was not diagnosed until his teens. High achiever in high school, but his world blew apart with a failed launch to college. Two years later he remains acutely depressed and anxious despite meds and therapy.

He is lost without the structure of school, and knows no other way to measure his worth, but believes he is "broken" and is too afraid to move forward for fear of failure.

We are starting to think a structured environment where he can learn social and life skills and have assistance with executive function if/when he is ready to return to college might be important. My research has led to some possibilities, but since they are all a huge investment, I am wondering if there are any truly outstanding programs we should be considering?


Dear:  Mr. Hutten,
    I have a son with very mild autism and, I am getting very frustrated.  I can afford to provide for him the rest of his life.  He has taken so long to register for college that it will be next semester before he will attend but, so far this has been going on for over a year now!  He has a job but, eats all his income and, then some!  What he doesn't eat he spends of porn, and, amazon.  He makes very little income at his current job and, I need him to be able to live on his own, as much as that scares me.  I don't know where he would be able to live basted on income and, the fact that he puts EVERYTHING off to the last minute!!!  He also doesn't keep up with his medication for blood pressure and, is over weight causing health issues.  Help, I don't know where to go or what to do!!!  I am becoming more and, more depressed over the situation after all these years and, have my own dilemmas.  My children are taking a toll on me.  I am aggravated with both my kids anymore.  It is time for my son to move out, I feel.  I was a single mom for most of there lives and, my ex-husband has never taken an interest in his children unless forced to!  He hasn't help raise them unless paid to do so!  I bare all the burden along with my new husband, Tony.  Tony is also getting aggravated with the situation!  Please guide me on what to next to appease this situation and get him out on his own.


Hello mark

Thank you for being so accessible.  There is nothing like this here in regional Australia and to get counselling from a professional you have to go through ridiculous hoops with mental health care plans first, then finding the right gp etc.

My son is very creative with clothes and hair design and loves a party.  But he has developed some newly associated compulsions and very destructive repetitive behaviours and has felt suicidal all within the last 18 months.  He is not working or studying.  He has been ordered by our court system to attend counselling sessions because of anger management issues but needs constant prompting and reminding to do just every day tasks like showering and putting clothes on.  He currently lives with his father who is also a high functioning aspergers individual.  His father does work and looks after himself without assistance and is currently trying to help his son launch into adulthood and productivity but it seems our son couldn't care less about developing good independent productive habits. He seems to only live from moment to moment.

How much do you charge per session? I myself have severe health issues and I am not working at present.. I derive a weekly disability payment from the  federal govt.


I am writing to you with question I am searching for help for my friend who's daughter now 47 has relied on her all of her life. They are in crisis right now as daughter was just evicted & mother drove 3 hrs to collect her & her things, guilt & fear motivating her one more time to take in her daughter. I am only in town for another day & & trying to help by steering mother & adult child to help. It is not a good situation. The mother has already raised her granddaughter (daughter of her 47 year old). Children have ruined her financially, her health is bad & she doesn't have capacity for this, yet as a parent is held hostage by fear of what happens to her daughter when she is left alone to fend for herself.
It looks like your site focuses on children & young adults. Do you have or can you point to resources for a situation with Adult children with Aspergers who have failed to launch who are well into their 40s & 50s?
Is there hope?


Hello Mark,

My son is now 21 years old. He was diagnosed with adhd when he was about 7. I have not been sure about that diagnoses for many years and I now think he may have high functiong Aspergers. He has several of the tendencies, although not all. He has had trouble holding a job. He is overweight. He did graduate from high school, ( not an easy task), but has had trouble going to college. Is there a test to take to find out if he has Aspergers and at this late date, is there much to help him? He knows he is different". Is there anyone who can help us in our area? We live in the Seattle-Tacoma are of WA.


Dear Mark,

I haven't been in touch with you for a long time, but your columns and books have helped our family a lot, and our son is maturing slowly and learning ...often the hard way, but not always.....

My younger sister had children later than I did, and her 6-year-old daughter has many of the same attributes of my son, Will.  He wasn't diagnosed with Asperger's until he was nearly 13, and the doc said this was too because we didn't have more time to work with him in therapy, home and at school when he was more likely to be ameniable to treatment.

My sister's pediatrician said that girls with Asperger's or high-functioning autism are "never" diagnosed before 10. That sounds fishy to me. What do you say?

So far, Caroline has done fine in school and easily makes friends, but my sister's been involved as a volunteer at school, which certainly helps; and Caroline had an older, wise, easy-going male teacher last year for first grade who played up her strengths and tried hard to teach her to read, but simply couldn't but didn't sweat it or make Caroline feel worried or like a failure. She's in the NYC school system at a good school, but the school is  fairly rigid about certain things and tests with lots of immigrant kids with hard-driven parents, and Caroline is prone to dig in her heels and want to do her own thing. She's very good at math and art and engineering-type stuff, but they do want her to have learned to read by now. She'll enter second grade in a week, and will turn 7 in early November so she's a young second grader, but they require kids to follow a strict calendar and be in a certain grade if their birthdays are in certain months in New York. My sister's a HUGE book reader and reads to Caroline constantly and Caroline loves books; she just hasn't learned to read yet.

Her older brother didn't pick up on reading very fast, but now is a great reader in third grade. He doesn't seem to have Asperger's...more normal smart kid anxiety overthinking, eager-to-please kind of kid.

Sorry...more than you need to know...But I just can't help but think getting Caroline tested and diagnosed and armed with an IEP now is better than some teacher saying she's lazy or won't mind...or forcing her to read and making her hater reading, which is what my sister worries about....

My sister and husband aren't pushovers. They provide structure and are better disciplinarians than we are with their children and demand good manners....

Advice? And where best in New York to turn to get tested?


Hi Mark,
I bought and read your ebook. How I wish I had found it when my son was younger.
We are in the process of getting a proper diagnosis for my son who is now almost 20, but in the meantime I can find nothing to help with strategies to help him.
I think he is in denial that he has a problem even though he is willing to pursue a potential diagnosis.
 Much of the time he cannot see how his behaviour affects others...it is always someone else's fault.
The problem is that he is unmanageable. He is aggressive towards his family a lot of the time. I see him as deeply unhappy. He hangs out with people of his own age who abuse him emotionally. He thinks they are his friends but they will only let him hang out with them if he buys alcohol for them.
Recently one of his 'friends' stole my engagement ring but my son will not cooperate with the police by giving names and addresses of people who were at out house that day as he feels he will 'lose his friends'!
What can I do? I feel that he doesn't want our help but it's breaking my heart to see him losing the little self esteem and confidence that he has. I feel I am running out of options....I have, all his life been asking from help from his schools, taken him to ed psychs, all to no avail. He displays so many of the classic aspergers traits but no teacher or test has ever said 'yes he has this problem', he has always never been 'bad' enough to get help. He has already been in trouble with the police.
If you can advise me I would be grateful, or if you have colleagues in the UK who I could speak to that would be helpful. I feel very isolated. I don't want a counsellor, I don't need to examine my feelings, I need solution based strategies.


Raising Kids with Autism Spectrum Disorder: Parents' Grief and Guilt

Some parents grieve for the loss of the youngster they   imagined  they had. Moms and dads have their own particular way of dealing with the...