Teaching Children and Teens with Asperger Syndrome and High-Functioning Autism

In this post, we will look at (a) the major challenges that Aspergers (high functioning autistic) students face in an educational setting, and (b) the appropriate classroom accommodations that teachers can utilize:

Poor Motor Coordination— 

Students with Aspergers are physically clumsy and awkward; have stiff, awkward gaits; are unsuccessful in games involving motor skills; and experience fine-motor deficits that can cause penmanship problems, slow clerical speed and affect their ability to draw.

Classroom Accommodations—

1. Students with Aspergers may require a highly individualized cursive program that entails tracing and copying on paper, coupled with motor patterning on the blackboard. The educator guides the student's hand repeatedly through the formation of letters and letter connections and also uses a verbal script. Once the student commits the script to memory, he can talk himself or herself through letter formations independently.

2. Do not push the student to participate in competitive sports, as his poor motor coordination may only invite frustration and the teasing of team members. The student with Aspergers lacks the social understanding of coordinating one's own actions with those of others on a team.

3. Individuals with Aspergers may need more than their peers to complete exams (taking exams in the resource room not only offer more time but would also provide the added structure and educator redirection these students need to focus on the task at hand).

4. Involve the student with Aspergers in a health/fitness curriculum in physical education, rather than in a competitive sports program.

5. Refer the student with Aspergers for adaptive physical education program if gross motor problems are severe.

6. When assigning timed units of work, make sure the student's slower writing speed is taken into account.

7. Younger students with Aspergers benefit from guidelines drawn on paper that help them control the size and uniformity of the letters they write. This also forces them to take the time to write carefully.

Academic Difficulties— 

Students with Aspergers usually have average to above-average intelligence (especially in the verbal sphere) but lack high level thinking and comprehension skills. They tend to be very literal: Their images are concrete, and abstraction is poor. Their pedantic speaking style and impressive vocabularies give the false impression that they understand what they are talking about, when in reality they are merely parroting what they have heard or read. The student with Aspergers frequently has an excellent rote memory, but it is mechanical in nature; that is, the student may respond like a video that plays in set sequence. Problem-solving skills are poor.

Classroom Accommodations—

1. Academic work may be of poor quality because the student with Aspergers is not motivated to exert effort in areas in which he is not interested. Very firm expectations must be set for the quality of work produced. Work executed within timed periods must be not only complete but done carefully. The student with Aspergers should be expected to correct poorly executed class work during recess or during the time he usually pursues his own interests.

2. Capitalize on these students' exceptional memory: Retaining factual information is frequently their forte.

3. Students with Aspergers often have excellent reading recognition skills, but language comprehension is weak. Do not assume they understand what they so fluently read.

4. Do not assume that students with Aspergers understand something just because they parrot back what they have heard.

5. Emotional nuances, multiple levels of meaning, and relationship issues as presented in novels will often not be understood.

6. Offer added explanation and try to simplify when lesson concepts are abstract.

7. Provide a highly individualized academic program engineered to offer consistent successes. The student with Aspergers needs great motivation to not follow his own impulses. Learning must be rewarding and not anxiety-provoking.

8. The writing assignments of children with Aspergers are often repetitious, flit from one subject to the next, and contain incorrect word connotations. These students frequently do not know the difference between general knowledge and personal ideas and therefore assume the educator will understand their sometimes abstruse expressions.

Emotional Vulnerability—

Students with Aspergers have the intelligence to compete in regular education but they often do not have the emotional resources to cope with the demands of the classroom. These students are easily stressed due to their inflexibility. Self-esteem is low, and they are often very self-critical and unable to tolerate making mistakes. Individuals with Aspergers, especially teens, may be prone to depression (a high percentage of depression in adults with Aspergers has been documented). Rage reactions/temper outbursts are common in response to stress/frustration. Students with Aspergers rarely seem relaxed and are easily overwhelmed when things are not as their rigid views dictate they should be. Interacting with people and coping with the ordinary demands of everyday life take continual Herculean effort.

Classroom Accommodations—

1. Affect as reflected in the educator's voice should be kept to a minimum. Be calm, predictable, and matter-of-fact in interactions with the student with Aspergers, while clearly indicating compassion and patience. Hans Asperger, the psychiatrist for whom this syndrome is named, remarked that “the educator who does not understand that it is necessary to teach students [with Aspergers] seemingly obvious things will feel impatient and irritated.”

2. Be aware that teens with Aspergers are especially prone to depression. Social skills are highly valued in adolescence and the child with Aspergers realizes he is different and has difficulty forming normal relationships. Academic work often becomes more abstract, and the teen with Aspergers finds assignments more difficult and complex. In one case, educators noted that a teen with Aspergers was no longer crying over math assignments and therefore believed that he was coping much better. In reality, his subsequent decreased organization and productivity in math was believed to be function of his escaping further into his inner world to avoid the math, and thus he was not coping well at all.

3. Do not expect the student with Aspergers to acknowledge that he is sad/ depressed. In the same way that they cannot perceive the feelings of others, these students can also be unaware of their own feelings. They often cover up their depression and deny its symptoms.

4. Educators must be alert to changes in behavior that may indicate depression, such as even greater levels of disorganization, inattentiveness, and isolation; decreased stress threshold; chronic fatigue; crying; suicidal remarks; and so on. Do not accept the student's assessment in these cases that he is "OK".

5. It is critical that teens with Aspergers who are mainstreamed have an identified support staff member with whom they can check in at least once daily. This person can assess how well he is coping by meeting with him daily and gathering observations from other educators.

6. Prevent outbursts by offering a high level of consistency. Prepare these students for changes in daily routine, to lower stress (see "Resistance to Change" section). Students with Aspergers frequently become fearful, angry, and upset in the face of forced or unexpected changes.

7. Report symptoms to the student's therapist or make a mental health referral so that the student can be evaluated for depression and receive treatment if this is needed. Because these students are often unable to assess their own emotions and cannot seek comfort from others, it is critical that depression be diagnosed quickly.

8. Students with Aspergers must receive academic assistance as soon as difficulties in a particular area are noted. These students are quickly overwhelmed and react much more severely to failure than do other students.

9. Students with Aspergers who are very fragile emotionally may need placement in a highly structured special education classroom that can offer individualized academic program. These students require a learning environment in which they see themselves as competent and productive. Accordingly, keeping them in the mainstream, where they cannot grasp concepts or complete assignments, serves only to lower their self-concept, increase their withdrawal, and set the stage for a depressive disorder. (In some situations, a personal aide can be assigned to the student with Aspergers rather than special education placement. The aide offers affective support, structure and consistent feedback.)

10. Teach the students how to cope when stress overwhelms him, to prevent outbursts. Help the student write a list of very concrete steps that can be followed when he becomes upset (e.g., 1-Breathe deeply three times; 2-Count the fingers on your right hand slowly three times; 3-Ask to see the special education educator, etc.). Include a ritualized behavior that the student finds comforting on the list. Write these steps on a card that is placed in the student's pocket so that they are always readily available.

Impairment in Social Interaction— 

Students with Aspergers show an inability to understand complex rules of social interaction; are naive; are extremely egocentric; may not like physical contact; talk at people instead of to them; do not understand jokes, irony or metaphors; use monotone or stilted, unnatural tone of voice; use inappropriate gaze and body language; are insensitive and lack tact; misinterpret social cues; cannot judge "social distance;" exhibit poor ability to initiate and sustain conversation; have well-developed speech but poor communication; are sometimes labeled "little professor" because speaking style is so adult-like and pedantic; are easily taken advantage of (do not perceive that others sometimes lie or trick them); and usually have a desire to be part of the social world.

Classroom Accommodations—

1. Although they lack personal understanding of the emotions of others, students with Aspergers can learn the correct way to respond. When they have been unintentionally insulting, tactless or insensitive, it must be explained to them why the response was inappropriate and what response would have been correct. Individuals with Aspergers must learn social skills intellectually: They lack social instinct and intuition.

2. Students with Aspergers tend to be reclusive; thus the educator must foster involvement with others. Encourage active socialization and limit time spent in isolated pursuit of interests. For instance, a educator's aide seated at the lunch table could actively encourage the student with Aspergers to participate in the conversation of his peers not only by soliciting his opinions and asking him questions, but also by subtly reinforcing other students who do the same.

3. Emphasize the proficient academic skills of the student with Aspergers by creating cooperative learning situations in which his reading skills, vocabulary, memory and so forth will be viewed as an asset by peers, thereby engendering acceptance.

4. In the higher age groups, attempt to educate peers about the student with Aspergers when social ineptness is severe by describing his social problems as a true disability. Praise classmates when they treat him with compassion. This task may prevent scapegoating, while promoting empathy and tolerance in the other students.

5. Most students with Aspergers want friends but simply do not know how to interact. They should be taught how to react to social cues and be given repertoires of responses to use in various social situations. Teach the students what to say and how to say it. Model two-way interactions and let them role-play. The student's social judgment improves only after they have been taught rules that others pick up intuitively. One adult with Aspergers noted that he had learned to "ape human behavior." A college professor with Aspergers remarked that her quest to understand human interactions made her "feel like an anthropologist from Mars".

6. Older children with Aspergers might benefit from a "buddy system." The educator can educate a sensitive nondisabled classmate about the situation of the student with Aspergers and seat them next to each other. The classmate could look out for the student with Aspergers on the bus, during recess, in the hallways and so forth, and attempt to include him in school activities.

7. Protect the student from bullying and teasing.

Restricted Range of Interests— 

Students with Aspergers have eccentric preoccupations or odd, intense fixations (sometimes obsessively collecting unusual things). They tend to relentlessly "lecture" on areas of interest; ask repetitive questions about interests; have trouble letting go of ideas; follow own inclinations regardless of external demands; and sometimes refuse to learn about anything outside their limited field of interest.

Classroom Accommodations—

1. Do not allow the student with Aspergers to perseveratively discuss or ask questions about isolated interests. Limit this behavior by designating a specific time during the day when the student can talk about this. For example: A student with Aspergers who was fixated on animals and had innumerable questions about a class pet turtle knew that he was allowed to ask these questions only during recesses. This was part of his daily routine and he quickly learned to stop himself when he began asking these kinds of questions at other times of the day.

2. For particularly recalcitrant students, it may be necessary to initially individualize all assignments around their interest area (e.g., if the interest is dinosaurs, then offer grammar sentences, math word problems and reading and spelling tasks about dinosaurs). Gradually introduce other topics into assignments.

3. Some students with Aspergers will not want to do assignments outside their area of interest. Firm expectations must be set for completion of class work. It must be made very clear to the student with Aspergers that he is not in control and that he must follow specific rules. At the same time, however, meet the students halfway by giving them opportunities to pursue their own interests.

4. Children can be given assignments that link their interest to the subject being studied. For example, during a social studies unit about a specific country, a student obsessed with trains might be assigned to research the modes of transportation used by people in that country.

5. Use of positive reinforcement selectively directed to shape a desired behavior is the critical strategy for helping the student with Aspergers. These students respond to compliments (e.g., in the case of a relentless question-asker, the educator might consistently praise him as soon as he pauses and congratulate him for allowing others to speak). These students should also be praised for simple, expected social behavior that is taken for granted in other students.

6. Use the student's fixation as a way to broaden his repertoire of interests. For instance, during a unit on rain forests, the child with Aspergers who was obsessed with animals was led to not only study rain forest animals but to also study the forest itself, as this was the animals' home. He was then motivated to learn about the local people who were forced to chop down the animals' forest habitat in order to survive.

Insistence on Sameness— 

Students with Aspergers are easily overwhelmed by minimal change, are highly sensitive to environmental stressors, and sometimes engage in rituals. They are anxious and tend to worry obsessively when they do not know what to expect; stress, fatigue and sensory overload easily throw them off balance.

Classroom Accommodations—

1. Allay fears of the unknown by exposing the student to the new activity, educator, class, school, camp and so forth beforehand, and as soon as possible after he is informed of the change, to prevent obsessive worrying. (For instance, when the student with Aspergers must change schools, he should meet the new educator, tour the new school and be apprised of his routine in advance of actual attendance. School assignments from the old school might be provided the first few days so that the routine is familiar to the student in the new environment. The receiving educator might find out the student's special areas of interest and have related books or activities available on the student's first day.)

2. Avoid surprises: Prepare the student thoroughly and in advance for special activities, altered schedules, or any other change in routine, regardless of how minimal.

3. Minimize transitions.

4. Offer consistent daily routine: The student with Aspergers must understand each day's routine and know what to expect in order to be able to concentrate on the task at hand.

5. Provide a predictable and safe environment.

Poor Concentration—

Students with Aspergers are often off task, distracted by internal stimuli; are very disorganized; have difficulty sustaining focus on classroom activities (often it is not that the attention is poor but, rather, that the focus is "odd" ; the individual with Aspergers cannot figure out what is relevant, so attention is focused on irrelevant stimuli); tend to withdrawal into complex inner worlds in a manner much more intense than is typical of daydreaming and have difficulty learning in a group situation.

Classroom Accommodations—

1. A tremendous amount of regimented external structure must be provided if the student with Aspergers is to be productive in the classroom. Assignments should be broken down into small units, and frequent educator feedback and redirection should be offered.

2. Students with severe concentration problems benefit from timed work sessions. This helps them organize themselves. Class work that is not completed within the time limit (or that is done carelessly) within the time limit must be made up during the student's own time (i.e., during recess or during the time used for pursuit of special interests). Students with Aspergers can sometimes be stubborn; they need firm expectations and a structured program that teaches them that compliance with rules leads to positive reinforcement (this kind of program motivates the student with Aspergers to be productive, thus enhancing self-esteem and lowering stress levels, because the student sees himself as competent).

3. If a buddy system is used, sit the student's buddy next to him so the buddy can remind the student with Aspergers to return to task or listen to the lesson.

4. In the case of mainstreamed children with Aspergers, poor concentration, slow clerical speed and severe disorganization may make it necessary to lessen his homework/class work load and/or provide time in a resource room where a special education educator can provide the additional structure the student needs to complete class work and homework (some students with Aspergers are so unable to concentrate that it places undue stress on moms and dads to expect that they spend hours each night trying to get through homework with their student).

5. Seat the student with Aspergers at the front of the class and direct frequent questions to him to help him attend to the lesson.

6. The educator must actively encourage the student with Aspergers to leave his inner thoughts/ fantasies behind and refocus on the real world. This is a constant battle, as the comfort of that inner world is believed to be much more attractive than anything in real life. For young students, even free play needs to be structured, because they can become so immersed in solitary, ritualized fantasy play that they lose touch with reality. Encouraging a student with Aspergers to play a board game with one or two others under close supervision not only structures play but offers an opportunity to practice social skills.

7. Work out a nonverbal signal with the student (e.g., a gentle pat on the shoulder) for times when he is not attending.

==> The Complete Guide to Teaching Students with Aspergers and High-Functioning Autism

Employing Older Teens and Young Adults with Aspergers: 10 Tips for Employers

Teens and adults with Aspergers (high functioning autism) may experience some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary. Be aware that not all teens and adults with Aspergers will need accommodations to perform their jobs, and many others may only need a few accommodations.

Accommodation Ideas—

1. Employees with Aspergers may have difficulty communicating with co-workers or supervisors.

• Allow worker to have a friend or coworker attend meeting to reduce or eliminate the feeling of intimidation.
• Allow worker to provide written response in lieu of verbal response.
• Provide advance notice of date of meeting when worker is required to speak to reduce or eliminate anxiety.
• Provide advance notice of topics to be discussed in meetings to help facilitate communication.

2. Employees with Aspergers may experience difficulty managing time. This limitation can affect their ability to complete the task within a specified timeframe. It may also be difficult to prepare for, or to begin, work activities.

• Divide large assignments into several small tasks.
• Provide a checklist of assignments.
• Set a timer to make an alarm after assigning ample time to complete a task.
• Supply an electronic or handheld organizer, and train on how to use effectively.
• Use a wall calendar to emphasize due dates.

3. Employees with Aspergers may exhibit atypical body movements such as fidgeting. Atypical body movements are sometimes called stimulatory behavior, or "stimming." These body movements often help calm the person or assist them in concentrating on tasks, but can also disturb co-workers at times.

• Allow worker to use items such as hand-held squeeze balls and similar objects to provide sensory input or calming effect.
• Allow the worker to work from home.
• Provide private workspace where worker will have to room to move about and also not disturb other by movements such as fidgeting.
• Provide structured breaks to create an outlet for physical activity.
• Review conduct policy with worker.
• Schedule periodic rest breaks away from the workstation.

4. Employees with Aspergers may not be familiar with or understand abstract concepts like corporate structure, hierarchies of responsibility, reporting requirements, and other structural elements of the workplace.

• Adjust method of supervision to better prepare worker for feedback, disciplinary action, and other communication about job performance.
• xplain corporate structure to worker, using visual charts and clear descriptions of positions and reporting structure. Do not assume that worker will understand structure from a simple chart of job titles.
• Povide concrete examples to explain consequences of violating company policy.
• Provide concrete examples to explain expected conduct.
• Review conduct policy with worker.
• Use services of the Worker Assistance Program (EAP) if available.

5. Employees with Aspergers may have difficulty managing stress in the workplace. Situations that create stress can vary from person to person, but could likely involve heavy workloads, unrealistic timeframes, shortened deadlines, or conflict among coworkers.

• Allow worker to make telephone calls for support.
• Allow the presence and use of a support animal.
• Modify work schedule.
• Provide praise and positive reinforcement.
• Provide sensitivity training for workforce.
• Refer to EAP.

6. Employees with Aspergers may experience decreased concentration. They report intolerance to distractions such as office traffic, worker chatter, and common office noises such as fax tones and photocopying.

• To reduce tactile distractions: Instruct other workers to approach the Aspergers employee in a way that is not startling, such as approaching from behind, touching the worker, or other tactile interactions, if the worker is bothered by those interactions.

• To reduce auditory distractions:

1. Hang sound absorption panels
2. Provide a white noise machine
3. Purchase a noise canceling headset
4. Redesign worker's office space to minimize audible distractions
5. Relocate worker's office space away from audible distractions

• To reduce visual distractions:

1. Install space enclosures (cubicle walls)
2. Redesign worker's office space to minimize visual distractions
3. Reduce clutter in the worker's work environment
4. Relocate worker's office space away from visual distractions

7. Employees with Aspergers may have difficulty getting or staying organized, or have difficulty prioritizing tasks at work. The worker may need assistance with skills required to prepare and execute complex behavior like planning, goal setting, and task completion.

• Allow supervisor to prioritize tasks.
• Assign a mentor to help worker.
• Assign new project only when previous project is complete.
• Develop color-code system for files, projects, or activities.
• Provide a "cheat sheet" of high-priority activities, projects, people, etc.
• Use a job coach to teach/reinforce organization skills.
• Use the services of a professional organizer.
• Use weekly chart to identify daily work activities.

8. Employees with Aspergers may have difficulty exhibiting typical social skills on the job. This might manifest itself as interrupting others when working or talking, difficulty in listening, not making eye contact when communicating, or difficulty interpreting typical body language or nonverbal innuendo. This can affect the individual's ability to adhere to conduct standards, work effectively with supervisors, or interact with coworkers or customers.

• Social skills on the job:

1. Encourage all workers to use appropriate social skills.
2. Provide a job coach to help understand different social cues.
3. Provide concrete examples of accepted behaviors and consequences for all workers.
4. Use role-play scenarios to demonstrate appropriate social skills in workplace.
5. Use training videos to demonstrate appropriate social skills in workplace.

• Working effectively with supervisors:

1. Adjust supervisory method by modifying the manner in which conversations take place, meetings are conducted, or discipline is addressed
2. Establish long term and short term goals for worker
3. Give assignments verbally, in writing, or both, depending on what would be most beneficial to the worker (e.g., use of visual charts)
4. Identify areas of improvement for worker in a fair and consistent manner
5. Offer positive reinforcement
6. Provide clear expectations and the consequences of not meeting expectations
7. Provide detailed day-to-day guidance and feedback

• Interacting with co-workers:

1. Allow worker to transfer to another workgroup, shift, or department
2. Allow worker to work from home when feasible
3. Encourage workers to minimize personal conversation, or move personal conversation away from work areas
4. Help worker "learn the ropes" by providing a mentor
5. Make worker attendance at social functions optional
6. Provide sensitivity training to promote disability awareness

9. Employees with Aspergers may experience memory deficits that can affect their ability to complete tasks, remember job duties, or recall daily actions or activities. They also may have difficulty recognizing faces.

• Allow additional training time for new tasks.
• Allow worker to use voice activated recorder to record verbal instructions.
• Encourage worker to ask (or email) with work-related questions.
• Offer training refreshers.
• Prompt worker with verbal cues.
• Provide worker directory with pictures or use nametags and door/cubicle name markers to help worker remember coworkers' faces and names.
• Provide pictorial cues.
• Provide written instructions.
• Safely and securely maintain paper lists of crucial information such as passwords.
• Use a flowchart to describe the steps involved in a complicated task (such as powering up a system, closing down the facility, logging into a computer, etc.).
• Use post-it notes as reminders of important dates or tasks.

10. Employees with Aspergers may experience difficulty performing many tasks at one time. This difficulty could occur regardless of the similarity of tasks, the ease or complexity of the tasks, or the frequency of performing the tasks.

• Create a flow-chart of tasks that must be performed at the same time, carefully labeling or color-coding each task in sequential or preferential order.
• Explain performance standards such as completion time or accuracy rates.
• Identify tasks that must be performed simultaneously and tasks that can be performed individually.
• Provide individualized/specialized training to help worker learn techniques for multi-tasking (e.g., typing on computer while talking on phone).
• Provide specific feedback to help worker target areas of improvement.
• Remove or reduce distractions from work area.
• Separate tasks so that each can completed one at a time.
• Supply proper working equipment to complete multiple tasks at one time, such as workstation and chair, lighting, and office supplies.

Questions to Consider:

1. Can the worker with Aspergers provide information on possible accommodation solutions?
2. Do supervisory personnel and workers need training regarding Aspergers?
3. How do these limitations affect the worker's job performance?
4. Once accommodations are in place, would it be useful to meet with the worker to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
5. What accommodations are available to reduce or eliminate problems? 
6. Are all possible resources being used to determine accommodations?
7. What limitations does the worker with Aspergers experience?
8. What specific job tasks are problematic as a result of these limitations?

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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.

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Aspergers Children and Seasonal Affective Disorder

Does your Aspergers (high functioning autistic) child or teen seem to have a change in mood as the seasons change?

A form of depression that follows a seasonal pattern, SEASONAL AFFECTIVE DISORDER (SAD) appears and disappears at the same times each year. Aspergers children with SEASONAL AFFECTIVE DISORDER usually have symptoms of depression as winter approaches and daylight hours become shorter. When spring returns and the days become longer again, they experience relief from the symptoms and a return to a fairly normal mood and energy level.

Signs and Symptoms—

Like other forms of depression, the symptoms of SEASONAL AFFECTIVE DISORDER can be mild, severe, or anywhere in between. Milder symptoms minimally interfere with the child’s ability to participate in everyday activities, while more severe symptoms can interfere much more.

The symptoms of SEASONAL AFFECTIVE DISORDER are the same as those of depression, but occur during a specific time of year. It's the seasonal pattern of SEASONAL AFFECTIVE DISORDER — the fact that symptoms occur only for a few months each winter (for at least 2 years in a row) but not during other seasons — that distinguishes it from other forms of depression.

Symptoms of SEASONAL AFFECTIVE DISORDER may include:

• Changes in eating: craving simple carbohydrates (e.g., comfort foods and sugary foods); tendency to overeat (which could result in weight gain during the winter months)
• Changes in mood: irritability and/or feelings of hopelessness or worthlessness most of the time for at least 2 weeks; tendency to be more self-critical and more sensitive than usual to criticism; crying or getting upset more often or more easily
• Changes in sleep: sleeping much more than usual (which can make it difficult for children to get up and get ready for school in the morning)
• Difficulty concentrating: more trouble than usual completing assignments on time; lack of usual motivation (which can affect school performance and grades)
• Lack of enjoyment: loss of interest in things that are normally enjoyable; feeling like tasks can't be accomplished as well as before; feelings of dissatisfaction or guilt
• Less time socializing: spending less time with friends in social or extracurricular activities
• Low energy: unusual tiredness or unexplained fatigue

The problems caused by SEASONAL AFFECTIVE DISORDER — such as lower-than-usual grades or less energy for socializing with friends — can affect self-esteem and leave the Aspergers child feeling disappointed, isolated, and lonely, especially if he doesn’t realize what's causing the changes in energy, mood, and motivation.

Fall and Winter SEASONAL AFFECTIVE DISORDER—

Winter-onset seasonal affective disorder symptoms include:

• Anxiety
• Appetite changes, especially a craving for foods high in carbohydrates
• Depression
• Difficulty concentrating
• Heavy, "leaden" feeling in the arms or legs
• Hopelessness
• Loss of energy
• Loss of interest in activities you once enjoyed
• Oversleeping
• Social withdrawal
• Weight gain

Spring and Summer SEASONAL AFFECTIVE DISORDER—

Summer-onset seasonal affective disorder symptoms include:

• Agitation
• Anxiety
• Irritability
• Poor appetite
• Trouble sleeping (insomnia)
• Weight loss

Causes of SEASONAL AFFECTIVE DISORDER—

It's believed that with SEASONAL AFFECTIVE DISORDER, depression is somehow triggered by the brain's response to decreased daylight exposure. How and why this happens isn't yet fully understood. Current theories focus on the role of sunlight in the brain's production of certain key hormones that help regulate sleep-wake cycles, energy, and mood.

Two chemicals that occur naturally in the body are thought to be involved in SEASONAL AFFECTIVE DISORDER:

1. Melatonin, which is linked to sleep, is produced in greater quantities when it's dark or when days are shorter. Increased production of melatonin can cause sleepiness and lethargy.
2. Serotonin production increases with exposure to sunlight. Low levels of serotonin are associated with depression, so increasing the availability of serotonin helps to combat depression.

Shorter days and longer hours of darkness in fall and winter can increase melatonin levels and decrease serotonin levels, which may create the biological conditions for depression.

In addition, the child’s biological clock (circadian rhythm) is altered. The reduced level of sunlight in fall and winter may disrupt the body's internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.

Risk Factors—

Factors that may increase your risk of seasonal affective disorder include:

• Being female. Seasonal affective disorder is diagnosed more often in females than in males, but males may have symptoms that are more severe.
• Family history. As with other types of depression, those with seasonal affective disorder may be more likely to have blood relatives with the condition.
• Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.
• Living far from the equator. Seasonal affective disorder appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter, and longer days during the summer months.

Complications—

Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, seasonal affective disorder can get worse and lead to problems if it's not treated. These can include:

• School or work problems
• Social withdrawal
• Substance abuse
• Suicidal thoughts or behavior

Seeing the Doctor—

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

• Is your child taking any medications, supplements or herbal remedies?
• Do any blood relatives have seasonal affective disorder or another mental health condition?
• Does your child have any other physical or mental health conditions?
• Have his symptoms been continuous or occasional?
• How severe are the symptoms?
• What are the symptoms?
• What, if anything, appears to worsen the symptoms?
• What, if anything, seems to improve the symptoms?
• When did your child first begin having symptoms?

Your doctor may also ask other questions depending on your individual situation.

Tests and Diagnosis—

To help diagnose seasonal affective disorder, your doctor or mental health provider will do a thorough evaluation, which generally includes:

• Physical exam. Your doctor or mental health provider may do a physical examination to check for any underlying physical issues that could be linked to your child’s depression.

• Medical tests. There's no medical test for seasonal affective disorder, but if your doctor suspects a physical condition may be causing or worsening the depression, your child may need blood tests or other tests to rule out an underlying problem.

• Detailed questions. Your doctor or mental health provider will ask about your child’s mood and seasonal changes in thoughts and behavior. The doc may also ask questions about your child’s sleeping and eating patterns, relationships, school, or other questions about his life. You may be asked to answer questions on a psychological questionnaire.

Seasonal affective disorder is considered a subtype of depression. Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health provider to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms.

To be diagnosed with seasonal affective disorder, your child must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

The following criteria must be met for a diagnosis of seasonal affective disorder:

• The periods of depression have been followed by periods without depression.
• There are no other explanations for the changes in your mood or behavior.
• The child has experienced depression and other symptoms for at least two consecutive years, during the same season every year.

Prevention—

There's no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage your child’s symptoms, you may be able to prevent them from getting worse over time. Some parents find it helpful to begin treating their child before symptoms would normally start in the fall or winter, and then continue treatment past the time symptoms would normally go away. If you can get control of your child’s symptoms before they get worse, you may be able to head off serious changes in mood, appetite and energy levels.

Treatment—

Treatment for SEASONAL AFFECTIVE DISORDER, which varies depending on the severity of the symptoms, includes:

1. Talk therapy (psychotherapy). Helping to ease the sense of isolation or loneliness, talk therapy focuses on revising the negative thoughts and feelings associated with depression. It also can help children understand their condition and learn ways to prevent or minimize future bouts.

2. Medication (pharmacotherapy). Medications, which might be used in combination with talk therapy and light therapy, may be prescribed for a youngster or adolescent with SEASONAL AFFECTIVE DISORDER and should be monitored by a doctor. Antidepressant medications help to regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy. Tell your doctor about any other medications your youngster takes, including over-the-counter or herbal medicines, which could interfere with prescription medications.

3. Light therapy (phototherapy). More troublesome symptoms may be treated with a stronger light that simulates daylight. A special light-box or panel is placed on a tabletop or desk, and the person sits in front of it briefly every day (45 minutes or so, usually in the morning) with eyes open, glancing — not staring — occasionally at the light (to work, the light has to be absorbed through the retinas). Symptoms tend to improve within a few days or weeks. Generally, light therapy is used until enough sunlight is available outdoors. Mild side effects of phototherapy might include headache or eyestrain. Lights used for SEASONAL AFFECTIVE DISORDER phototherapy must filter out harmful UV rays. Tanning beds or booths should not be used to relieve symptoms of SEASONAL AFFECTIVE DISORDER. Their ultraviolet rays can damage skin and cause wrinkles and age spots, and even lead to skin cancer such as melanoma. Phototherapy should be used with caution if someone has another type of depressive disorder, skin that's sensitive to light, or medical conditions that may make the eyes vulnerable to light damage. Like any treatment, phototherapy should be used under a doctor's supervision.

4. Increased light exposure. Because the symptoms of SEASONAL AFFECTIVE DISORDER are triggered by lack of exposure to light and tend to go away on their own when available light increases, treatment for SEASONAL AFFECTIVE DISORDER often involves increased exposure to light during winter months. For someone with mild symptoms, it may be enough to spend more time outside during the daylight hours, perhaps by exercising outdoors or taking a daily walk. Full-spectrum (daylight) light bulbs that fit in regular lamps can help bring a bit more daylight into winter months and might help with mild symptoms.

Lifestyle and Home Remedies—

If the symptoms are severe, your child may need medications, light therapy or other treatments to manage seasonal affective disorder. However, there are some measures your child can take on his own that may help. Try the following:

• Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make your child feel better about himself, too, which can lift his mood.

• Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if your child spends some time outside within two hours of getting up in the morning.

• Make the environment sunnier and brighter. Open blinds, trim tree branches that block sunlight or add skylights to your home. Sit closer to bright windows while at home or school.

Alternative Medicine—

Several herbal remedies, supplements and mind-body techniques are commonly used to relieve depression symptoms. It's not clear how effective these treatments are for seasonal affective disorder, but there are several that may help. Keep in mind, alternative treatments alone may not be enough to relieve symptoms. Some alternative treatments may not be safe if your child has other health conditions or takes certain medications.

Supplements used to treat depression include:

• Melatonin. This natural hormone helps regulate mood. A change in the season may change the level of melatonin in the body.
• Omega-3 fatty acids. Omega-3 fatty acid supplements may help relieve depression symptoms and have other health benefits. Sources of omega-3s include fish such as salmon, mackerel and herring. Omega-3s are also found in certain nuts and grains and in other vegetarian sources, but it isn't clear whether they have the same effect as fish oil.
• SAMe. This is a synthetic form of a chemical that occurs naturally in the body. SAMe hasn't been approved by the Food and Drug Administration to treat depression in the United States. However, it's used in Europe as a prescription drug to treat depression.
• St. John's wort. This herb has traditionally been used to treat a variety of problems, including depression. It may be helpful if your child has mild or moderate depression.

Mind-body therapies that may help relieve depression symptoms include:

• Acupuncture
• Guided imagery
• Massage therapy
• Meditation
• Yoga

What Parents Can Do—

Talk to your doctor if you suspect your youngster has SEASONAL AFFECTIVE DISORDER. Doctors and mental health professionals make a diagnosis of SEASONAL AFFECTIVE DISORDER after a careful evaluation and a checkup to ensure that symptoms aren't due to a medical condition that needs treatment. Tiredness, fatigue, changes in appetite and sleep, and low energy can be signs of other medical problems, such as hypothyroidism, hypoglycemia, or mononucleosis.

When symptoms of SEASONAL AFFECTIVE DISORDER first develop, moms and dads might attribute low motivation, energy, and interest to an intentional poor attitude. Learning about SEASONAL AFFECTIVE DISORDER can help them understand another possible reason for the changes, easing feelings of blame or impatience with their youngster or adolescent.

Moms and dads sometimes are unsure about how to discuss their concerns and observations. The best approach is usually one that's supportive and nonjudgmental. Try opening the discussion with something like, "You haven't seemed yourself lately — you've been so sad and grouchy and tired, and you don't seem to be having much fun or getting enough sleep. So, I've made an appointment for you to get a checkup. I want to help you to feel better and get back to doing your best and enjoying yourself again."

Here are a few things you can do if your Aspergers youngster or adolescent has been diagnosed with SEASONAL AFFECTIVE DISORDER:

1. Be patient. Don't expect symptoms to go away immediately. Remember that low motivation, low energy, and low mood are part of SEASONAL AFFECTIVE DISORDER — it's unlikely that your youngster will respond cheerfully to your efforts to help.

2. Encourage your youngster to get plenty of exercise and to spend time outdoors. Take a daily walk together.

3. Establish a sleep routine. Encourage your youngster to stick to a regular bedtime every day to reap the mental health benefits of daytime light.

4. Find quality time. Spend a little extra time with your youngster — nothing special, just something low-key that doesn't require much energy. Bring home a movie you might enjoy or share a snack together. Your company and caring are important and provide personal contact and a sense of connection.

5. Help with homework. You may have to temporarily provide hands-on assistance to help your youngster organize assignments or complete work. Explain that concentration problems are part of SEASONAL AFFECTIVE DISORDER and that things will get better again. Children and adolescents with SEASONAL AFFECTIVE DISORDER may not realize this and worry that they're incapable of doing the schoolwork. You may also want to talk to the teachers and ask for extensions on assignments until things get better with treatment.

6. Help your youngster to eat right. Encourage your youngster to avoid loading up on simple carbohydrates and sugary snacks. Provide plenty of whole grains, vegetables, and fruits.

7. Help your youngster understand SEASONAL AFFECTIVE DISORDER. Learn about the disorder and provide simple explanations. Remember, concentration might be difficult, so it's unlikely your youngster will want to read or study much about SEASONAL AFFECTIVE DISORDER — if so, just recap the main points.

8. Participate in your youngster's treatment. Ask the doctor how you can best help your youngster.

9. Take it seriously. Don't put off evaluation if you suspect your youngster has SEASONAL AFFECTIVE DISORDER. If diagnosed, your youngster should learn about the seasonal pattern of the depression. Talk often about what's happening, and offer reassurance that things will get better, even though that may seem impossible right now.

Coping and Support—

Following these steps can help your child manage seasonal affective disorder:

• Practice stress management. Learn techniques to manage stress better. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors
• Socialize. When your child is feeling down, it can be hard to be social. Help him make an effort to connect with friends he enjoys being around. They can offer support, a shoulder to cry on, or a joke to give your Aspie a little boost.
• Stick to the treatment plan. Take medications as directed and attend therapy appointments as scheduled.
• Take a trip. If possible, take winter vacations in sunny, warm locations if your child has winter seasonal affective disorder – or to cooler locations if he has summer seasonal affective disorder.
• Help your Aspie to take care of himself. Get enough rest and take time to relax. Participate in a regular exercise program. Eat regular, healthy meals.

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

==> Preventing Meltdowns and Tantrums in Asperger's Children

==> Discipline for Defiant Asperger's Teens

==> Teaching Social Skills and Emotion Management

==> Launching Adult Children with Asperger's: How to Promote Self-Reliance 

==> Everything You'll Ever Need to Know About Parenting Asperger's Children

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

==> AudioBook: Unraveling The Mystery Behind Asperger’s and High-Functioning Autism

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