Social Skills Deficits, Bullying, and the Onset of Post-Traumatic Stress Disorder in Kids on the Spectrum

“I’ve been reading that students who lack social skills are often bullied, and that this can lead to PTSD in some cases. Is it possible that things could deteriorate to this level? I’m worried that my HFA son may be traumatized in this way when [if] he returns to school after Christmas break.”

The short answer is yes. Research reveals a high incidence of Post-Traumatic Stress Disorder (PTSD) symptoms among young people who have been bullied. One study of 963 teenagers (aged 14 and 15) found symptoms of the disorder in about 33% of the teens who said they were victims of bullying. The study measured the extent of “avoidance behavior” and “intrusive memories” (2 of 3 defined PTSD symptoms).

Asperger’s (AS), also referred to as High-Functioning Autism (HFA), is first and foremost a social disorder. These young people are not only socially isolated much of the time, but also display an abnormal type of social interaction that can’t be explained by other factors (e.g., shyness, short attention span, aggressive behavior, etc.).

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

As compared to children with Autism, children with AS and HFA are notable for their lack of motivation to interact with others. However, their social difficulties often result from a lack of knowledge and skill in initiating and responding in various situations (e.g., the child may appear “weird” due to his insistence on sharing with peers an obsessive interest in dinosaurs, despite their rather obvious lack of interest in the topic).

The social problems of kids on the autism spectrum range from “social withdrawal and detachment” to “unskillful social activeness.” Nonetheless, even within this wide range, these young people can be socially stiff, emotionally blunted, socially awkward, inflexible, and can have difficulty in understanding nonverbal social cues.

Most children with AS and HFA are able to grasp the meaning of facial expressions, as well as match events with facial expression. But, problems occur when they have to deal with the simultaneous presentation of facial, body, voice, and situational cues. As a result, even when they actively try to seek out others, they encounter social isolation because of their lack of understanding of the rules of social behavior (e.g., eye contact, proximity to others, gestures, posture, etc.).

Kids on the autism spectrum are able to engage in basic social interactions (e.g., greetings), but have difficulty being able to engage in extended interactions or reciprocal conversations. Parents often describe their AS or HFA child as lacking an awareness of social standards and protocol, lacking common sense, displaying a variety of socially unaccepted habits and behaviors, and tending to misinterpret subtle social prompts and unspoken messages.

These young people also typically display emotional vulnerability and anxiety (e.g., they may become upset if they think others are invading their space or when they are in an unpredictable or novel social situation). In contrast to a “typical” child, the child on the spectrum doesn’t reveal how he feels in the early stages of anxiety. Consequently, he may reach a point of crisis and begin to “melt down” due to the fact that his peers are unaware of his discomfort – along with his own inability to predict, control, and manage uncomfortable circumstances. This behavioral display, in turn, causes the anxiety-ridden child to “stand out from the crowd,” which often makes him an easy target for peers who are prone to teasing and bullying the “odd balls.”

Even though they are known for their lack of social awareness, children with AS and HFA themselves are aware that they are different from their friends and classmates. Therefore, problems with self-esteem are common in these “special needs” kids. These problems often are particularly significant during the teenage years.

Unpredictable social situations make it difficult for kids on the autism spectrum to apply social rules in a consistent way. Social rules vary from situation to situation, and there are no solid and universal social conventions. This lack of social consistency is especially confusing for the AS or HFA child. She may discover that interactions that may be tolerated - or even reinforced - in one setting are rejected or punished in others. For instance, one 5th grader with HFA could not understand why her calling Mrs. Magina, her teacher, "Mrs. Vagina” in the restroom was the source of great delight to her peers, while saying this in the classroom, in the presence of Mrs. Magina, caused a much different response from peers.

As compared to their “typical’ peers, children with AS and HFA don’t acquire greater social awareness and skill merely as a function of age. All children are required to use increasingly sophisticated social skills and to interpret subtle social nuances as they progress through school. But, children diagnosed with AS and HFA often find themselves more and more in conflict with prevailing social norms as they move through adolescence and into young adulthood. As a result of these requirements and the experiences that follow, these “special needs” teens are vulnerable to developing a variety of problems. For instance, studies of teenagers diagnosed with AS indicated that they often experience increased discomfort and anxiety in social situations, along with a continuing inability to effectively interact with peers. Anxiety and depression may also appear at this time.

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

Bullies often target the child with AS or HFA due to the fact that his social deficits are so obvious. Bullies typically choose targets who are unable to mount an effective defense. The failure to recognize sarcasm and subtleties of speech often leads bullies to exploit the AS or HFA child by pretending to be his friend, while subtly mocking or hurting him, or creating a situation where he will be publicly shamed. This often occurs when bullies tell the AS/HFA child to do something - or ask him a vulgar question with implicit meanings that he may not detect immediately (e.g., “Do you like head?”).

Some children and teens on the autism spectrum can develop the early signs of PTSD or similar symptoms as a direct result of bullying. Parents may be able to determine if this has happened to their child by looking for the following symptoms:
  • always being on guard for danger
  • avoidance of people, places, or things that remind the child of the triggers that caused the anxiety
  • being easily startled or frightened
  • difficulty experiencing positive emotions
  • difficulty maintaining close relationships
  • feeling detached from family and friends
  • feeling emotionally numb
  • frequent flashbacks
  • frightening dreams that may or may not include aspects of the bullying incident
  • high levels of anxiety
  • hopelessness about the future
  • inability to discuss the source of the anxiety
  • increased incidence of panic attacks
  • irritability, angry outbursts or aggressive behavior
  • lack of interest in activities once enjoyed
  • memory problems, including not remembering important aspects of the bullying incidents
  • negative thoughts about self or other people 
  • overwhelming guilt or shame
  • re-enacting the bullying incident or aspects of it through play
  • trouble concentrating
  • trouble sleeping

Social anxiety (e.g., avoidance of public places or events, phone calls, conversation, etc.) can be exacerbated, with some AS and HFA children becoming highly insecure about attempting to form or maintain relationships with peers due to experiences with bullies who posed as friends.

In worst-case scenarios, bullying can lead the victim to suicide, sometimes called bullycide. But, even though most kids grow out of the “predator-prey” cycle of abuse, many child victims are still at risk for the long-term effects of PTSD later in life.

==> More information on how bullying affects kids on the autism spectrum...

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

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