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Anxiety: An Intrinsic Feature of High-Functioning Autism

“Why do children on the high functioning side of autism seem to experience more than their fair share of anxiety? And, are there any drugs that can be used to help with this problem?”

Young people with High Functioning Autism (HFA) are particularly vulnerable to anxiety. This vulnerability may be an intrinsic feature of HFA due to a breakdown in circuitry related to extinguishing fear responses, specific neurotransmitter system defects, and/or their inability to make social judgments throughout development.

Other reasons for anxiety in HFA children/teens include the following:

  • Limitations in generalizing from one situation to another often contributes to repeating the same social gaffes.
  • Limitations in their ability to grasp social cues - and their highly rigid style - act in concert to create repeated social errors. 
  • Many experience the discomfort that comes from somatic responses that are disconnected from events and experience.
  • The lack of empathy severely limits skills for autonomous social problem-solving. 
  • The social challenges of AS and HFA make it difficult for kids with the disorder to develop coping strategies for soothing themselves and containing difficult emotions. 
  • There is sufficient grasp of situations to recognize that others “get it” when they do not. 
  • They are frequently victimized and teased by their peers and can’t mount effective socially adaptive responses.



Several medications have been tried for treatment of anxiety in this population. There is no reason to suspect that kids with HFA are less likely to respond to the medications used for anxiety in “typical” kids. Thus, SSRIs, buspirone, and alpha-adrenergic agonist medications (e.g., clonidine or guanfacine) have been tried. 
 
The best evidence to date supports use of SSRIs. However, it is also true that young people on the autism spectrum may be more vulnerable to the associated side-effects. Disinhibition is particularly prominent, and can be seen with any of the SSRIs.
 
As one mother states: "Working with a psychiatrist, one trained especially with children, is vital in helping our Aspergers/HFA kids with their anxiety, to managed use of medications. Fine tuning is critical to the process. We also had enroll our child into a day program as weekly counseling wasn't keeping up with his anxiety and depression. Daily and intensive individual and group therapy are the focus of this program. 5 months in and we've seen dramatic improvement. We're about to start the transition back to his normal school (they tutor at the day program). Most important is to pay attention to the child's anxiety levels. We almost waited too long to take a big step toward doing something different." 
 
 
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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

Click here for the full article...

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

Click here to read the full article…

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

Click here to read the full article…

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

Click here to read the full article...

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

Click here for the full article...
 
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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
 
 
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Backward Chaining: A Cure for Task-Frustration

“Task-frustration” occurs when a child attempts to complete a particular task (e.g., tying shoe laces, riding a bicycle, doing a math assignment, playing a board game, etc.), but fumbles along unsuccessfully. 
 
As a result, he or she has a tantrum – or a meltdown! If you are a parent of a child on the autism spectrum, you have no doubt witnessed your child being overly-frustrated on numerous occasions over seemingly trivial incidents. Well, help has arrived! Read on…

“Backward chaining” can have different definitions for different fields, but when teaching life skills to young people with High-Functioning Autism (HFA), it refers to breaking down the steps of a task and teaching them in reverse order. This gives the youngster an experience of accomplishment and completion with every attempt.

Instead of the youngster starting at the beginning and getting lost somewhere through the process (with the parent having to complete the task), the parent does all but the last step and lets the youngster complete the work. Then the parent backs-off, doing less and less while the youngster does more and more, always finishing with the youngster performing the final step.

Backward chaining allows the HFA youngster to experience instant success. As more steps are added, he completes the newly taught step immediately, followed by the steps he has already mastered. This will minimize frustration and anxiety – and provide the youngster with a sense of achievement. This feeling of success will often increase his confidence and keep him motivated to learn and complete the entire sequence of steps.

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

Systematic use of backward chaining is extremely helpful because it:
  • Helps the child to successfully complete a task early in the progression
  • Facilitates transfer of procedural information to long-term memory
  • Keeps instructional input to a minimum, thus reducing demands on the child’s short-term or working memory
  • Keeps the child involved and challenged

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How to Use Backward Chaining—

First, be sure to define the target behavior. To teach your child to perform the links in a chain, you need to know exactly what those links are.  Sometimes the links are very obvious (e.g., teaching the alphabet). Other times, links are not so obvious.  Thus, perform the target behavior yourself and take note of all the steps involved.

Second, be sure that the steps in the chain are reinforced in sequence (i.e., reinforce them as they happen).  For example, once your youngster has mastered step 5 of a particular task, and you begin to teach step 4, you will be reinforcing steps 4 and 5.  You will either be reinforcing at the end of the chain, or at the end of as much of the chain as your youngster has learned.  What your child learns in a chain is not just the number of steps – she also learns to perform those steps in the correct order. 

Third, keep track of the results.  Should the task or a particular step be taught and reinforced a few more times? Is it time to move on to the next step in the task?  Has a particular step been mastered? These are decisions that must be made during the chaining process, and they can be made correctly only if you cautiously monitor the results you are getting.


Low-Frustration Tolerance in Children with HFA 



Examples of Backward Chaining—

Example #1: To teach your HFA youngster how to change the sheets and pillow cases on her bed, you can break down the steps as follows:
  1. Remove the pillow cases
  2. Remove the pillows
  3. Remove the blanket(s)
  4. Remove the top sheet
  5. Remove the fitted sheet
  6. Put on a clean fitted sheet
  7. Put on a clean top sheet
  8. Replace the blanket(s)
  9. Put on clean pillow cases
  10. Replace the pillows

To start, you could do steps 1 through 8, and then let your youngster put the clean pillow cases on the pillows, and put the pillows on the bed. When that can be done consistently, you could do steps 1 through 7, and then let your youngster pull up the blanket(s), put cases on the pillows, and put the pillows on the bed. When she becomes comfortable with each step, the step before it is introduced, always with the goal of having her finish the task successfully.

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

Example #2: To teach your HFA youngster how to tie his shoe laces, you can break down the steps as follows: 
  1. Take a lace in each hand, crossing the laces into an "X"
  2. Insert one lace through the bottom of the "X" and pull both laces tight
  3. Make a small loop with one of the laces
  4. Hold the loop with the thumb and index finger of one hand
  5. Take the other lace and swoop it around the loop
  6. Move the thumb and index fingers enough so that the swooped lace can be seen through the little hole
  7. Identify the swooped lace and grab hold it
  8. Pull the swooped lace and the loop at the same time in opposite directions, pulling slowly but firmly to tighten the laces into a bow

In this example, you will perform steps 1 through 7, allowing your child to tighten the laces into a bow at the end of the task. Once your child can perform this last step, have him work on both steps 7 and 8 …then steps 6, 7 and 8 …and so on.

Example #3: Educators can also make use of backward chaining. For example, in teaching a complex word (e.g., “hypothesis”), the educator could model the last part of the word (“sis), then the middle (“the”), and finally the first part of the word (“hypo”), pausing to allow the child to repeat the word parts.

Using the backward chaining technique is ideal for promoting skills development in HFA children, because starting out with the easier steps that occur at the end of a task will encourage them to persist and learn the harder “first steps” later. So, the next time you are struggling to teach your youngster a basic self-help skill, consider backward chaining. It may be just what your child needs to build confidence and lead him or her to success.

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

Click here to read the full article…

---------------------------------------------------------------

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

Click here for the full article...

--------------------------------------------------------------

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

Click here to read the full article…

------------------------------------------------------------

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

Click here to read the full article…

------------------------------------------------------------

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

Click here to read the full article...

------------------------------------------------------------

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

Click here for the full article...
 
------------------------------------------------------------
 
A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
By

Eliminating Thinking Errors in Children on the Autism Spectrum

Philosophers have long known that your thoughts can be your own worst enemy. As Shakespeare once said, "There is nothing either good or bad, but thinking makes it so." Children and teens with Asperger's and High-Functioning Autism are especially vulnerable to such “thinking errors” due to a phenomenon called “mind-blindness."

In this video, we will look at some examples of popular thinking errors used by kids on the autism spectrum, and how parents can help these children view their situation more accurately. 




Resources for parents of children and teens on the autism spectrum:
 


BEST COMMENT:

Mark, I must tell you - just based on the first and only video of yours that we watched, we have had an amazing breakthrough. The combination of information and clear delivery just turned a light on. What struck us in particular was that because of his Aspergers, we need to 'teach him how the world works'  - and in our case, to do this appropriate to his 8 or 9 year old emotional maturity level. In the background we also see how his OCD combines with those factors to create extreme stress for him and everyone else.We believe the paranoia just resulted from the years of his escalating stress, etc.

Back to the breakthrough: with great effort to pay attention, we were able to apply our new understanding to interacting with him last night and it was amazing! In a matter of hours he was a completely different kid - like he was years ago in terms of the way he talked, engaged, and he even got excited about being engaged in his passion for music. Our new behavior really, probably for the first time, made him feel understood and more safe (I expect that was subconscious).

This is a kid who walked in one day at about 10 years old and informed us he had learned Pi - he could recite 383 digits off the top of his head. By 12-13 yrs he had become an incredible musician, playing in bands w kids 17 & 18. He did the same thing with cooking and was working in a professional kitchen at 13.... all of his own doing. Then of course everything fell apart. It's a combination of amazing gifts and childlike innocence & naivety - not understanding how the world works as you said.

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