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Picky Eating in Children on the Autism Spectrum: Tips for Parents

"Our 8-year-old boy (newly diagnosed with ASD 1) refuses to eat anything ...and I mean 'anything' ...other than chicken tenders, mac n' cheese, and watermelon. On rare occasion, he might nibble on an apple (emphasis on 'nibble'). We are at our wits end and so tired of arguing that we have simply given in to his limited food preferences just to avoid conflict. It's much easier that way. Any advice on this frustrating issue would be greatly appreciated!!!"

Because of their sensitivity to smell, temperature, taste and texture, kids with ASD level 1, or High-Functioning Autism (HFA), are often "picky" eaters. Some develop fetishes, such as only eating beige-colored foods or foods with creamy textures. They often like very sour or very spicy tastes. Some develop chewing fetishes and as a result, they constantly suck on pens, pencils or times of clothing.

These young people also sometimes have issues with developing gastric problems, such as acid reflux, hiccups, diarrhea, vomiting, or constipation. They are susceptible to celiac disease, which is caused by poor absorption of certain nutrients. The danger is that celiac disease damages the digestive system.

Kids on the autism spectrum frequently suffer from Dermatitis herpetiformis, which causes skin rashes and tissue damage in the intestine. It has also been shown that gluten can aggravate behavioral symptoms in those who are sensitive to these foods.
 
It becomes a challenge for moms & dads to make sure their youngster gets proper nutrition. One trick that works for some parents is to change the texture of a despised food. For example, if your youngster will not eat peas, try serving pea soup. If she refuses orange juice, try orange slices. Most clinicians believe that the less you indulge food fetishes, the less entrenched they become. If the child creates a rule that "no foods can touch on my plate," it can easily become a lifelong rule if moms & dads do not intervene.

One promising food therapy is the "Gluten-Free Casein-Free Diet" or GFCF diet. The theory behind it is that a youngster with HFA can't digest casein (found in dairy) or gluten (found in grains). It is true that undigested molecules of these substances frequently show up in their urine samples. These amino acid chains (called peptides) affect neurological function and can worsen a youngster's symptoms. Peptides may have an opiate effect on some kids.

Moms & dads begin the diet by first eliminating either the casein or the gluten food group. No gluten means no bread, barley, rye, oats, pasta, all kinds of flour, food starch, biscuits, cereals, cakes, donuts, pie, pretzels, pizza, croutons, and even crumbs stuck in the toaster. You can substitute gluten-free products.

Next, you eliminate all dairy products including milk, cheese, goat's milk and cheese, ice cream, yogurt, most margarines, puddings, and so forth. If you eliminate the dairy group, you may have to give your youngster calcium supplements. You also need to cut out "trigger foods" including chocolate, food colorings, caffeine, and peanut butter. The GFCF Diet website offers all kinds of resources for moms & dads such as cookbooks, food products, and DVDs.

Many parents discover that the GFCF diet really helps their youngster. In an unscientific survey of over 2000 moms & dads who tried it, most saw significant improvement and 5 reported "miracles."

Research into diet and vitamin therapy for kids on the spectrum is very sketchy at this point. Nevertheless, many moms & dads try them. One scientific study of alternative therapies found that over half of all parents of kids with autism spectrum disorders have tried diets, herbs or vitamin therapy - and 72% felt they were worthwhile. Many parents swear by the GFCF diet, while others prefer the Feingold diet or megavitamin therapy.

You can buy supplements of herbs and vitamins specifically made for children with HFA. Such supplements often include calcium, fish oil, omega -3 -6 or -9, vitamin B-6, HNI enzymes and DMG or dimethylglycine. If you use these diets and therapies, the best thing to do is to keep written records of how often your youngster tantrums or exhibits other behaviors. This way you can tell if the therapy is working.

There have been a few scientific studies of the GFCF diet. In one three-month study of fifteen kids ages two to 15 years old, there was no difference between the kids who followed the diet and those who did not. However, researchers at the Loma Linda Medical Institute in California concluded that the diet was mostly helpful and improved nonverbal cognition, but that more double blind studies are needed.

Many moms & dads have tried the GFCF or Feingold diets and found that they were not worth the effort. These diets make it extremely hard to buy regular grocery foods or to eat in restaurants. If there are other kids, you end up cooking different meals for them. Trying to keep to the diets causes parental burnout and that may not be worth their benefits.


Can a Gluten-Free Diet Really Help?

A gluten-free, casein free diet is recommended for autistic kids - and grown-ups.

Often parents feel rather overwhelmed with such a restrictive diet, and only opt to embrace it as a last resort. The results produced by the diet varies markedly - but the keyword here is RESULT. You can expect some result.

Kids with autistic spectrum disorders usually have gastrointestinal problems as well, such as reflux, constipation, diarrhea, vomiting and hiccups. It is know that the proteins found in wheat, rye, oats, barley and dairy products (gluten and casein) aren't completely broken down in kids with Autistic Spectrum Disorders. These undigested proteins can leak into the bloodstream, potentially interfering with neurological processes by having an opiate-like effect upon their systems.
 
It's suggested that these undigested proteins (peptides) can reach toxic levels, with the youngster seeming to "crave" milk and wheat products. Symptoms of gluten/casein intolerance include red cheeks and ears, dry skin, runny nose, headaches, hyperactivity, tantrums and malformed bowel movements. Does this sound familiar?

So what results can the diet produce? Parents report a variety of outcomes, including improved sleep patterns, improved speech and communication, improved focus or attention span, improved social skills, improved personal hygiene habits, improved fine motor skills, improved intestinal function, increase in affection shown, and a reduction of tantrums and irritability.

So, a gluten-free, casein-free diet is definitely worth considering for your HFA son. You don't have to feel overwhelmed by the restrictive nature of the diet. I suggest simply starting slowly and eliminating one group (either gluten or casein) at a time. Once you're comfortable without wheat or dairy products, then you can tackle the next element. If you see a desirable result from eliminating one component, you may decide not to go any further.

One mother of an autistic son who is a picky eater states:

"For our family simply substituting gluten-free flour in all recipes I used was a simple but highly effective action. I'm a home-baker, so in any cakes, biscuits, slices and desserts I just substituted gluten-free flour in my usual recipes. I didn't add any extras like Xantham gum, and didn't have any failures.

Finding an alternative to bread was our biggest obstacle. The gluten-free varieties just weren't the same, so instead we excluded bread altogether. The gluten-free pastas on the market are excellent, but do tend to cook slightly quicker.

I suggest you email all the major distributors of snack foods, such as muesli bars and fruit slices and ask for a list of their gluten-free products. This helps with easy identification at the store.

Eating out is difficult at first, but if you mention you're gluten-free most restaurant or cafe chefs will gladly prepare something gluten-free. (Of course, this rules out the fast food chains who aren't so obliging!)

For our family the diet finally eliminated all our son's known trigger foods such as peanut butter, chocolate and caffeine in sodas. We stayed on the diet strictly for 10 months before gradually reintroducing gluten. We have seen no return of the eliminated characteristics in our son . We have continued to use gluten-free pasta and flour in our cooking.

I believe that the gluten-free diet had a detoxifying effect not only on our son, but on all of us, and the benefits have been obvious. So be adventurous and try a gluten-free/casein-free diet for your Aspergers child ....you may be nicely surprised!"

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

==> Videos for Parents of Children and Teens with ASD
 
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COMMENTS FROM PARENTS:

Anonymous said...
This is so true, my son is 8 and will only eat with his hands and only processed foods n is a VERY fussy eater, he also still has a dummy, well 3 actually plus he has to have 3 rags which he cuddles constantly at home!

Anonymous said...
GOOD INFO. BUT I DEFINATELY THINK THE MORE PARENTS ROLL OVER WHEN A KID SAYS THEY DON'T LIKE SOMETHING, IT BECOMES A SLIPPERY SLOPE. AND AN UPHILL BATTLE WHEN YOU COME TO YOUR SENSES AND REALIZE THE KID IS IN CHARGE.

Anonymous said...
My 19 year old eats a specific Subway sandwich five days a week. At least he gets lettuce on it!

Anonymous said...
my sons were extremely picky before going gluten and dairy free. we did this due to food intolerances but it did work in our case. my boys now eat a better variety of food but still not as much of variety as i would like. we do alot of pureeing fruits and veges here!

Anonymous said...
I used to think the same thing, until I realized my daughter might actually starve herself because I was too hard-headed to comply with her simple requests. "Rolling over" isnt the preferred path but it keeps the kiddos content at least for a little bit. Thats what we're in it for anyways, isnt it?

Anonymous said...
my 7 year old son will only eat cereal for breakfast lunch and dinner and its starting to scare me. he will actually starve his self before he will eat anything else. he has always been tiny but his eating habits arnt helping. i have tried everything i can to get him to eat other things nothing works...i buy the gummy bear vitamins and he takes them fine thats all i can do

Anonymous said...
My son is still a picky eater, but has come a LONG way. He will eat foods from all food groups. He received ABA therapy and I remember how hard it was to get him to eat one pea (it took almost a week and two trained therapists!) To this day he still hates peas but will eat green beans like crazy! He has become more willing to try new things in the past year and that's a huge accomplishment for him. He announced last summer that he wanted to try grilled corn and brocolli and we were speechless! I hesitate to try the gluten free thing unless it is proven to be medically necessary for his condition, but I'm certainly not putting down anyone who has had success with it.

Anonymous said...
I put adam on school dinners its helped Adam he still as a thing he has to smell the food first diary products he hates have to get milk down in a milk shake

Anonymous said...
our 13 yr old aspergers son has just been diagnosed as coeliac(proven with a biopsy). He has always been sensitive to taste and texture of food usually only having one brand of the few foods he does eat. his fav foods are toast, biscuits and nuggets(all contain gluten) Does anyone have any suggestions in how we get him to at least try other foods or gluten free varieties? I know we have to get him off gluten but he has a meltdown over any new food.

Anonymous said...
My son craves carbs (breads, cereals) and sweets. We had to put him in OT when he was three because he wouldn't eat but maybe three things. He would literally gag and throw up at a pizza commercial or if I served certain foods for dinner. It is def a texture thing, but also anything the color of green he won't eat. It's very frustrating to have to make two different meals all the time (one for the family and one just for our son). OT helped with the food issue and he slowly began to increase the different types of food he would eat.

Anonymous said...
We tried the gluten-free route and did not see much of a difference, other than the outrageous cost to make gluten-free food. It was overwhelming to go grocery shopping and all that cooking only for our son to turn his nose up to the food anyway. We just try to make sure he is eating a healthy balance and encourage him to try new foods.

Anonymous said...
Really good to hear it from his point of view!

Anonymous said...
Great to listen from this perspective!! TY

Anonymous said...
Yep, this story is all too familiar to me. My son is quite a challenge to feed! And when we visit a friend or relative, I always have to advise: The best bet is to keep it plain and simple. Don't add alot of seasonings, don't smother it with any sort of sauce, don't mix foods together, don't cut such and such this way or that, I know what food battles to fight and which are completely futile. Some say if he gets hungry enough he'll eat it....but my son WILL hold out on you and you can watch him get ill doing so. He has always refused rice and all legumes except for CREAMY peanut butter. He won't eat crunchy nuts or salad or uncooked carrots. Forget pie or any other desert that has a mixture of flavors or textures. Yep, he's a plain vanilla man! I know just how to prepare what fruits, vegetables, and meats he will eat. I make sure he eats a nutritionally balanced diet on a daily basis, so at some special occasion where I'm not in charge of the food I just ease up and let him get whatever (at least there is usually some plain bread he will eat) so everybody can have a nice time. As a parent sometimes you just have to adapt and work with it just a tad. For example, my son is famous for not liking Mexican food. But I have discovered that he will eat plain chicken fajita meat ordered a la carte and some plain flour tortillas. So when we go to a Mexican restaurant that is always what he gets....and everybody is happy. The way I view it is that nobody is standing over me forcing me to eat something I can't stand, so, while I do try to encourage my son to branch out a bit, I know when to give him slack.

Anonymous said...
i don't even like my foods touching :) my son had portion rules- as he grew to 6 ft tall, he wasn't eating more to accommodate his growth spurt. it took many months to help him adjust to the proper caloric intake- he was skin and bones in the meantime.

Anonymous said...
my son has always been like this hes 14 now and getting a little better..but can totally relate

Anonymous said...
My son will only eat crunchy foods or foods that are pureed. I learned early on how to make smoothies with veggies. :) And yes I know all about him "holding out". He would rather starve and be sick then eat something with a weird texture. Sometimes at restaurants he just doesn't eat. I'm okay with that but some family members would rather give in and buy him a milkshake which is SO irritating. I turn my back for a second and he's holding an ice cream cone. Please, if you are reading this and you are a family member that under minds the mothers' wishes, PLEASE STOP you are not helping....done ranting now. :)

Anonymous said...
I love reading or hearing from other more verbal teens. My son has a hard time getting what is in his head out of his mouth - but he loves it when i find these little nuggets of asperger wisdom...It makes sense to me that he can only think of the taste of one food a time. I can't wait to ask him if that is what it is like for him, we are very sucessful at comimg up with plans once we know what his brain is saying and what his desires are saying. I might get a hug for this one! I am so thankful that everyone shares their experiences, so that other families can benefit.

Anonymous said...
My son would go rather starve too than eat foods that are mushy.

Anonymous said...
My daughter is 5 and she would rather starve than eat just about anything. She won't even drink milk-shakes or smothies. Basically she survives on pediasure!


Anonymous said...
Yes that's basically all they eat....we quit fighting it...he is ten and only eats burritos,Mac cheese and nuggets and pizza and hot dogs sometimes if they look right.he was eating Lil pepperoni pizzas and picked Pepperoni's off so we bought same ones n cheese but he won't eat them because they look nasty...we can't give him chips with his food or he won't eat the burritos or main food...nothings changed just food...if we buy somethn n a different pkg he may never eat it again.his aunt gave him Mac and cheese n a blue box and he would never eat it again lol its very frustrating and challenging.we just gave up and give him vitamins...and if u try to make a good meal like say he likes green beans,,chic nuggets,Mac cheese and biscuits and I'm so happy cuz he loves those he can only eat one of them...so Dont knock yourself out trying I've done it for years just be happy he eats the one thing....good luck

Anonymous said...
Vitamins, and a good fish oil supplement.

Anonymous said...
My son is 8 and we dont treat him any different, but then again we never did. Both our boys eat what we eat. If they dont like it then they can go hungry. Yes he complains most of the time but he eats his diner. We keep our 8 year old on a very tight leash, he knows where the boundaries are what is not exceptionable behavior. Because he is so smart many times if we show him videos and let him research why its so important to say eat healthy he gets right on board and sometimes takes it to an extreme. My don LOVES burritos and would eat them all day every day. As a parent you cant coddle them just because they have a diagnoses. When he has a melt down I know its because its because of his "issues" but he MUST learn how to cope with this and learn to not let it cripple him. Its so hard as a parent and it breaks my heart to see him struggle but I also see how he is learning to cope and grow.

Anonymous said...
My very picky eater is now almost 10. For the last few years, I have had the few healthy foods that he eats on hand all the time. Finally, we went to a doctor who said that he has to cut out white carbs and sugar. He is old enough now to understand that healthy foods make an impact on his health and on how long he will live. Sometimes waiting it out really works well.

Anonymous said...
That's all they eat, plain cheese pizza, nuggets, chips, chicken strips, no fruit or veg, it's hard but the more you push and argue the more they back into a corner. It's the only control a child has is food intake. Coke and cordial too. I feel for you xx. He will come right later on but it's going to be a very long time. Also if it doesn't look right they won't even try it or not cooked by the right person. It's really tough but just no control at all. The hardest years are between 12 - 17

Anonymous said...
I am grateful that I introduced my son to healthy food very early in his life, I always felt that something was wrong with him because of his meltdowns and obsessions when I spoke to the pediatrician she suggested that he had asperger, and she was right, right now I am learning to cope with the tantrums and the never ending questions but I am glad that may son eats healthy with lots of vegetables even though he craves for oily food and from time to time i would let him eat pizza or chicken nuggets

Anonymous said...
My son is now 12 and started out eating like all others their fruits and veggies early in life...however very quickly started showing his dislike for food if it were to chunky or over or under cooked, or not the right temperature...or brand...he only eats about 5 things no matter how I try..Janes chicken nuggets, spaghetti with red sauce no meat, pancakes with raspberries, delissio thin crust cheese pizza, and if I'm lucky yogurt....vanilla....at one point I even had to heat his yogurt to get him to eat it. I resort to vitamins ! This is a sensory issue and if anyone tells you it's behavioural they are 100% wrong!

Anonymous said...
i think intruducing healthy food very early makes a big difference but there many things that can be done. I recommend mixing the good with the bad steam veg and rice with chicken nuggets you have to try it wont be easy but not impossible. I do not recommend forcing the child it doent work with my son so i wont work with your child either

Anonymous said...
Yep! My 9 yr old basically eats carbs and that's it. We rely on Carnation breakfast milk and vitamins for nutrition at the moment.

Anonymous said...
My 13 yr daughter only eats a handful of 'healthy" foods so i just rotate these meals around. You would think it would be boring but she likes the predictability. It wasnt worth the stress of the tantrums of force feeding when she was younger...... my mum.says i am too soft but at least meal times are quality family time over trauma time. Her blood tests for iron, vit D etc always come back good which surprises me. I had to think smart, be crrative at times and accept reality to stay sane.....
The hardest thing is dealing with judgement from others..... but i know I am doing the best I am and she certainly isnt malnourished or starving...Good to hear from others with the same issues and that I am not alone. ... and that its NOT my fault.....
X

Anonymous said...
Occupational therapy can help tremendously with decreasing oral sensitivities (when they won't eat certain foods because of how they feel) and expanding picky diets beyond chicken nuggets, mac and cheese, etc. It is costly if insurance doesn't cover it though. I agree that it is sensory (not behavioral) and the focus should be on desensitizing the child to texture, smell, and even sight of foods in order for them to attempt to expand their food choices.

Anonymous said...
Maybe try social stories about children trying a new food and liking it?

Anonymous said...
Don't under estimate milk and bread. I know it's not perfect but you are doing your best.....I know you are!!!! Xx

Anonymous said...
Mine is sixteen and it's chicken, cheeseburgers or pizza

Anonymous said...
As a wee one mine ate everything now my son is 14 and I'm totally jealous that your kids eat pizza and burgers. Mine wants to try pizza but it takes a long time to work up to it and if you open the box and he sees it. That's game over. I feel badly for our kids with the stresses they go through and the things they are missing out on.

Anonymous said...
Yes my 6 year old would never try pizza, or any 'meal'...just bread, milkshakes and some fruit.

Anonymous said...
My 9-year-old is super picky also. His diet was limited but he would eat a couple vegetables and fruits. About a year ago though he felt bad all the time and after a million tests, we found out he had very low iron and needed iron drops. These drops tasted so awful that he swore up and down he would eat better if he could stop taking them and he made an actual real effort to try new things. Now he will eat more of a variety and even though he doesn't love these foods I just remind him that it's that or the drops and it motivates him. His iron levels have been good every since. It's still a chore. Everything has to be so plain. No foods mixed together. No spice.

Anonymous said...
My 9 year olds diet is very limited. Dry bread, milk, beef burgers and cheese pizza. I got myself into a state thinking I needed him to try other foods and so many people saying ' he should eat what he is given or go hungry' and making me feel bad about his diet. When I saw his dr he had lost weight, the dr told me not too worry and feed him what he likes so he is getting the calories needed. I am so glad I listened, he is a much calmer child at mealtimes without being challenged, he put back on the weight he had lost. He has also started to ask to try new foods , he recently ate an apple ( I wanted to cry!!!) he also asked for me to blend 1/2 a banana in his milk, it wasn't a hit but he still tried something! My advice to anyone having a hard time or worrying is too ignore all the people giving their 'perfect parent' advice and just let your child eat what they like and come to you when they are ready for change x x x

Anonymous said...
My son has always been very picky too, and it got down to him only eating rice crackers. He lost a great deal of weight and as it turns out he has ulcerative colitis, diagnosed at 8 years. Once i sorted his flares and he takes probiotics and magnesium, his appetite is now much better. He's almost 14. I juice a combo of fruit and veg every morning now, and if it's got pineapple in it, and beetroot or purple carrot in it to make it pink, he enjoys drinking it.

Anonymous said...
I have heard a gluten free diet helps with Asperger's. Have u tried that?

Anonymous said...
I know from experience that this is frustrating! I have heard and tried it all from having them help shop, help cook, grow it! And so far nothing works... but, your son is eating and although it is repetitious, it is relatively well rounded. Protein, grain, dairy, fruit. One thing that has helped is sneaking veggie puree into the mac and cheese (cauliflower, carrots, etc...) but that had to be done with care as not to alter the flavor too much! I also slowly added whole grain pasta so that it .


Anonymous said...
Because my 7 year old son is such a picky eater, and was underweight, his doctor recommended V8 Fusion. This way he can still be picky, but at the same time get his daily recommended amount of fruit and vegetables. I give him 8 oz in the morning with breakfast and 8 oz in the evening with dinner. We have also had the my food can't touch issue in our house. It was to the point where there was typically multiple small plates (one for each food) on the table. On Monday my son said "Mom, I think it's time I have all of my food on one plate." I was floored! After the initial shock, we were doing a victory dance in celebration. Wohoo!
 

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What You Need To Know About Individualized Education Programs


"Our daughter is experiencing severe meltdowns due to the new school year. We recently were forced to make a trip to the Children's Hospital. Every person we've seen asks if she has an IEP. She does not, just a 504. The school district says she does not qualify for an IEP, which I question since all the mental health professionals think she should have one. Why does she need an IEP, and what should be included that will help this child?"

Not all children who have disabilities require specialized instruction. For children with disabilities who do require specialized instruction, the Individuals with Disabilities Education Act (IDEA) controls the procedural requirements, and an IEP is developed. The IDEA process is more involved than that of Section 504 of the Rehabilitation Act and requires documentation of measurable growth.

For children with disabilities who do not require specialized instruction but need the assurance that they will receive equal access to public education and services, a document is created to outline their specific accessibility requirements. Children with 504 Plans do not require specialized instruction, but like the IEP, a 504 Plan should be updated annually to ensure that the child is receiving the most effective accommodations for her specific circumstances. 

There is perhaps no process as frustrating for parents and teachers alike as the IEP process. As a team process, it is designed to help parents and teachers develop a program that is in the best interest of the child. All too often, the schools experience a lack of resources, which leaves the parents feeling that they are not receiving the support that they need. 

The IEP process is critical to the educational success of the child, and with success can leave parents feeling empowered to make a difference in the life of their child. Parents and teachers need to develop an IEP process that enables both parties to feel as though their concerns are heard, and the child's needs are being met.

Here are some important resources that will assist both parents and teachers in coming up with the most effective IEP possible:


COMMENTS:

•    Anonymous said... We have gone through a similar situation. It took 2 full years to get an Aspergers diagnosis, and the school STILL didn't want to acknowledge anything because of his grades. Early elementary was bumpy from behavior issues, but once we learned his triggers it all subsided. He had to take an IQ test, which the special Ed teacher and the state tester felt was not accurate since he deliberately started answering questions with nonsense once he was tired of it. We never did qualify for an IEP, but were able to get a 504. We really don't have much in the plan, since luckily we have been " bump" free for awhile. I just let his teachers know his triggers, and he is allowed to remove himself from the classroom of he begins to feel overwhelmed. ( this does have to be monitored, however, as he can be quite manipulative) we have been so fortunate that as he has gotten older and school has gotten harder he is actually doing much better. I was concerned with middle school being just too much with all the changes, but we have been incident free for 2 years. Turns out that class is over before he is "done". Keep pushing for what you feel is best, you know your aspire better than anyone and are the very best advocate they have!!! Best of luck!
•    Anonymous said... The Occupational Therapy part of the IEP will be very important, at least for my Aspie, in the eval part of this. This will help with any accommodations that are needed in the classroom such as a desk corral, placement of desk, etc. An IQ test should also be included but it is hard with an Aspie to be accurate. I am sure you know that YOU know best of what your child needs! Stick to your guns!
•    Anonymous said... Tell them your child has AUTISM because they understand that. Not everyone understands Aspergers. It is on the spectrum so you are telling the truth. Make the school district test her again. They cannot refuse you an IEP meeting.
•    Anonymous said... One of the hardest things we needed to decipher growing up was the difference between meltdowns that were due to Aspie things and meltdowns that were mere behavior problems. Once we realized that not all of his tantrums were from the disability, it cut way down on the total meltdowns and we were able to deal with the real issues from Aspergers. It also helped us realize his queues before the meltdown happened so that we could redirect before he became overloaded or overestimulated.
•    Anonymous said... My son has a 504 plan. His school feels he doesn't need a IEF because he "behaves well." I recently requested a meeting with his teacher and school guidance counselor to review his 5. I addresses my concerns to both regarding his attention/anxiety regarding his reading. I was basically told, in a nice way I'm jumping the gun.
•    Anonymous said... If she has Aspergers/Autism she should have an IEP. You can have a behavioral developmental pediatrician diagnose her and bring the paper work to your school.
•    Anonymous said... I have students who have 504s. The good thing is, teachers can still make any accomodations for these students that they deem necessary to improve the student's learning. My Asperger's/ADHD son has neither right now, because he gets good grades. Therefore, his school has determined he doesn't qualifiy for any special services.
•    Anonymous said... I am going through a similar situation with my son and his school right now. I live in NC. My son is 15 and in the 10th grade. He was diagnosed this past July with ASD, Asperger's Syndrome (he also has Graves Disease, medical PTSD, Depression, and anxiety disorder). He refuses to go to school. So far, this school year, he has only attended the first three days of school, and then his anxiety and panic got the better of him. I had to put in writing to the school, to request an evaluation for an IEP. Now, by law, they have 60 (or 90, I forgot) days to have him tested. I had tried to have him tested this past June, but I was talked out of it by the lady in charge of special education. She said that my son is "too smart" (honors classes) and does not misbehave in school, so she felt that we should wait til the new school year and if anything, sign up for a 504 plan. Her real reasoning was because it was the beginning of the summer, and she said that it would be harder for her to find someone to do the testing. Now, he is falling behind in school because of his social fears and anxiety, and they are just getting worse every day. If she would have just listened to me in the beginning, then his school year would not have started off like this. We are coming up on the one year anniversary of his father's death this month, which is making his situation even worse.
•    Anonymous said... A lot of this comes down to money, at least in the UK. To get an IEP the child needs to be statemented, but this is done by council employees that know as soon as it is done and an IEP setup, they council will have to provide some extra funding. We struggled to get our boy through, having to fight every turn and the problems tearing the family apart. We found a family support worker as part of social services (different money pot to education) who worked with us for over a year to get our boy statemented and an IEP, as well as moving him to a school that understood his needs and teaching us to understand his needs. He was way behind in his education the past school not bothering with him, but I'm so proud of him now, he's caught up everything this past year and moved to the top class where I know he'll continue to excel, what a change and family life has turned around to being fun and relaxed again.
It really makes me mad though families have to fight as hard as they do to get the help provided, the fight is hard enough to handle a child with these issues let alone fighting the authorities that were put there to help.

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Does My Student Have High-Functioning Autism?

“I’m a teacher and I think one of my students may have high functioning autism. What things should I look for in determining whether or not this child may have the disorder? Also, is it too early to approach the parents about my concern?”

If you have a basic knowledge of the symptoms associated with high-functioning autism (HFA), and based on that knowledge, you suspect the disorder in one of your students, advise the parents of your concern now. It’s better to know than not to know, and the sooner treatment can begin - the better!

If the student in question is having a greater degree of language difficulties than other peers his/her age or has diminished communication skills, and also exhibits a restrictive pattern of thought and behavior, he/she may have HFA. 
 
One peculiar symptom of the disorder is the youngster’s obsessive interest in a single object or topic to the exclusion of any other. The youngster living with HFA wants to know all about this one topic.

Here are a few more traits to look for:
  • Although kids on the autism spectrum can manage themselves with their disorder, the personal relationships and social situations are challenging for them. 
  • These young people have some traits of Autism, especially weak social skills and a preference for sameness and routine. 
  • Kids with HFA typically develop a good to excellent vocabulary, although they usually lack the social instincts and practical skills needed when relating to others. 
  • They may not recognize verbal and non-verbal cues or understand social norms (e.g., taking turns talking or grasping the concept of personal space). 
  • They typically make efforts to establish friendships, but may have difficulty making friends because of their social awkwardness. 
  • Developmental delays in motor skills (e.g., catching a ball, climbing outdoor play equipment, pedaling a bike, etc.) may also appear in the youngster.

 ==> A comprehensive list of traits associated with HFA can be found here.

The main difference between Autism and HFA is that the youngster suffering from HFA retains his early language skills. It is classified as an Autism Spectrum Disorder, one of a distinct group of neurological conditions characterized by a greater or lesser degree of impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behavior. 
 
Unlike young people with Autism, HFA kids retain their early language skills. In Autistic kids, language is often absent, lost, limited, or very slow to develop. In HFA, however, language development often falls within normal limits.

Advise your student’s parents that many moms and dads find comfort and build acceptance with help from support groups, counseling, and a network of friends, family, and community. A diagnosis is best made with input from caregivers, doctors, and educators who know or who have observed the youngster. 
 
A diagnosis is based on a careful history of the youngster’s development, psychological and psychiatric assessments, communication tests, and the parents’ and clinicians’ shared observations. When making a diagnosis, the health professional will see if the boy or girl meets the criteria published in the Diagnostic and Statistical Manual of Mental Disorders, a publication of the American Psychiatric Association.

You can best serve this student by learning about HFA and providing a supportive classroom environment (see link below). Remember, the student, just like every other youngster, has his or her own strengths and weaknesses and needs as much support, patience, and understanding as you can give. Visual supports, including schedules and other written materials that serve as organizational aids, can be very helpful for students on the autism spectrum.


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

==> Videos for Parents of Children and Teens with ASD
 
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 COMMENTS:

•    Anonymous said... I sure one of my son's teachers had mentioned it to me. He didn't get diagnosed until he was 11, and so missed out on early treatment and intervention. After he was diagnosed I had teachers, coaches and other parents say "I thought that might be it"...why oh why didn't they say anything? I had never even heard of it before.
•    Anonymous said... My daughter was recently diagnosed at 4. Her preschool teachers brought it to my attention. We dismissed it because we didn't see Autism. Then...when we read and did some research, it hit us like a ton of bricks that almost everything mentioned was her to a tee. Do it gently and explain to the parents that this is not a bad thing, and she/he will lead a normal life. Aspies just approach things differently. They see life differently.
•    Anonymous said... Teachers should approach this discussion with a positive attitude and lightly. As someone who was thrown this "he has autism" in kindergarten, I was angry and unconvinced. I didn't know really anything about Aspergers/high functioning autism, and I dismissed the discussion until second grade when a much more polite discussion was brought to me about my son's habits and issues. As a parent, I didn't know that a talking, caring, sensitive and smart child could be aspergers/autistic. The best thing I did to convince myself was to go over to school and observe my son at recess. I then did alot of research and started checking off symptoms...this combined is what convinced me.

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Dealing With Your Child's Frustrations: Tips for Parents of Kids on the Spectrum

"I would like ideas on how to deal with my (HFA) son’s frustrations. He will either dig his heels in and refuse to do what he is supposed to do, or he shuts down and then we have a time away so he can get himself together to discuss the problem. It seems he works himself up over things that are not that big a deal."

Children with High Functioning Autism (HFA) and Asperger's (AS) overreact to crowds, confusing situations, sensory stimuli, and situations in which they are asked to do things they don’t want to do. Situations or problems that seem minor to most of us are a “big deal” to those with the disorder because they don’t know how to handle them.

Low frustration-tolerance originates from the youngster’s dysfunctional and irrational beliefs. Behaviors are then the result of avoiding frustrating events which, paradoxically, lead to increased frustration and even greater mental stress.

Low frustration-tolerance occurs when the youngster gets upset and has an unwillingness or inability to tolerate the necessary short-term discomfort that is sometimes required for long-term gain. The opposite of this would be HIGH frustration-tolerance. High frustration-tolerance is simply the ability to tolerate or cope with discomfort and hard work in the short-term in order to achieve one's long term goals.

Removing your son from a stressful situation and giving him time to calm down is an excellent idea. Then if he is willing to discuss the problem, you may be able to help him learn how to handle a similar situation in the future. His frustration and stubbornness are due to the anxiety he feels and his inability to handle situations ...he can’t help those feelings.

Generally, there are two therapeutic approaches to working with the anxiety seen in kids on the autism spectrum. The first is cognitive psychology, which is an approach that focuses on the child’s mental processes (e.g., problem solving, memory, language, etc.). A cognitive psychologist will want to know how your son perceives and solves his problems.

A cognitive psychologist will be able to help your son figure out exactly what triggers his anger. The psychologist will help him change the negative environment that fuels his anger and develop various age-appropriate techniques for coping with anxiety.

The psychologist’s recommendations might be simple (e.g., lowering lights and sound levels), or it could be more complex, and therapy might become long term. In addition to cognitive psychology, medication may be recommended for your son. A psychiatrist can prescribe medications that will help reduce your son’s frustrations and reduce his anxieties.

Please note that antidepressants like Zoloft and Prozac have been prescribed for HFA and AS kids, but they have also been known to cause serious problems. Ask the psychiatrist to explain all of the behavioral changes and discuss the possible side effects of any medication that is prescribed.

The second approach for helping your son - and one of the most frequently recommended interventions for kids with the disorder - is for you, as a parent, to make his life structured and consistent. If he has chores to do around the house, they can be done on a certain day and at a specified time. He can leave for school at the same time every day, and he can be expected to return home at a certain time every day, also.

Structure can be built into his life for recreational activities, in addition to his school obligations and chores. If he enjoys video games, a time can be set aside that is predictable for the both of you. He can complete school homework and chores while looking forward to the recreational time that he knows will occur at the same time every day.

Your son is becoming easily frustrated over things that he perceives as too challenging. You can provide a “wrap-around” treatment for him by surrounding him with a psychologist that he can talk to, medication he can use to reduce anxiety (if warranted!), and a predictable home environment each day.


 


Comments:

Anonymous said...
We have the exact same problem with our 14-years old ASD son. Even the psychologist couldn't get him to talk (AT ALL), and this psychologist is known as an autism expert and well-loved by his clients and peers in our area. We should probably try another doctor, but money is tight and insurance doesn't cover it and we were frustrated with that first attempt which lasted an entire school year. The second piece of advice, to give our son a routine schedule, is what we need to do. His life is quite routine, and it's the disruptions that are so hard because in any life there will be interruptions and disruptions. We will work on being even more consistent, however, and we REALLY need to get better at allowing him screen time as a reward. This Aspergers stuff really makes me work harder at being a better parent!

Anonymous said...
I have a 17 yr old son with HFA/ADHD, His routine now is constant unexpected change and as our life is a struggle to plan anything because something ends up changing. I found this was a struggle in the beginning & a few difficult moments but now that he is older I now realize this turned out to be a benefit because now his routine is kaos & he has learned to work with it. Just in case here is some back ground. My son was quite low functioning in the beginning he started off non verbal and by kindergarten could form 3 word sentences.He was not aloud to attend more than 2.5 hrs of school a day until Grade 6, by grade 9 he was on the honour roll, by grade 11 he was on the high school football team, He now will be graduating with his peers. I am a single mom and have never been able to afford the ABBA therapy or much of anything else his therapy consisted of a neighbors daughter who was beyond a blessing to us who was going to university & grew up with a special needs uncle. Prayers, Love, discipline & learning the language of Autism was what I used.

Anonymous said...
I still though have a son that won't talk about how he is feeling, this became a challenge when my daughter went through medical distress with having to call 911 over 60 times. My son explained when my Nana passed during that time that he new who should feel sad & he would miss her but beyond the moment of being told he didn't have the same response to feelings like we did they were dealt with then gone,

Anonymous said...
I have a pretty structured routine for my son (who will be 15 in a couple of days) and for the most part he does fairly well with small disruptions to the routine. The issue's we are having is when it comes to social functions. If we are able to, we try to find a quiet out of the way place for him to go and sit when he gets over whelmed, but I don't know how to help him with the white noise, or how to help him deal with the crowds of ppl. He is able to handle public school fairly decent, but it's fairly structured in the school setting as well, but at wedding's or charity events, it's chaos and I don't know what do to help.

Anonymous said...
We have a "chill out" list. He helped us make it. Its a list of things for him to do to, well, CHILL OUT! swing, wear his weighted vest, color, play with the cat, run, take a walk, etc. You get the idea. He can help make the list when he's calm and thinking clear. Sometimes we pick from the list, and sometimes we just tell him to go pick from the list. so far so good....

Anonymous said...
We suggest ways for our 13 year old to chill out. Also, before going out like to a restaurant or such, we have him make a "plan B" just in case "plan A" doesn't work out.

Anonymous said...
My daughter does the same thing. I try to talk in a low monotone just to make sure she stays calm. Then I'll pose several solutions and then let her choose...right or wrong. And, as always, just be there for them!! It's frustrating on our end too!
 

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Applied Behavioral Analysis for Kids on the Autism Spectrum

"I've heard that ABA therapy is very effective for children with high functioning autism. Is this true, and how does it work?"

It is often difficult to understand why the child with ASD level 1 or High-Functioning Autism (HFA) behaves the way he does. However, there is a reason for his behavior, and Applied Behavior Analysis (ABA) helps us understand the behavior and determine a method of support for the child so that he no longer needs the behavior to meet his needs.

Using ABA, you can determine the antecedents to behavior, identify the behavior, and identify the consequence for the behavior, or what is currently maintaining the behavior. Using this process, you can determine alternative behaviors that are more appropriate, yet will meet your child's needs, without displaying the inappropriate behavior. This aids moms and dads in understanding their child better and helps outline a method to change their behavior.

ABA is widely recognized as a safe and effective treatment for Autism Spectrum Disorders. It has been endorsed by a number of state and federal agencies, including the U.S. Surgeon General and the New York State Department of Health. Over the last decade, the nation has seen a particularly dramatic increase in the use of ABA to help children and teens with HFA to live happy and productive lives. In particular, ABA principles and techniques can foster basic skills (e.g., looking, listening and imitating) as well as complex skills (e.g., reading, conversing and understanding another person’s perspective).

ABA treatment can include any of several established teaching tools:
  • verbal behavior
  • pivotal response training
  • incidental teaching
  • fluency building
  • discrete trial training

1. An ABA-related approach for teaching language and communication is called "verbal behavior" or VB for short. In VB, the therapist analyzes the youngster’s language skills, then teaches and reinforces more useful and complex language skills.

2. Pivotal response training uses ABA techniques to target crucial skills that are important (or pivotal) for many other skills. Thus, if the youngster improves on one of these pivotal skills, improvements are seen in a wide variety of behaviors that were not specifically trained. The idea is that this approach can help the youngster generalize behaviors from a therapy setting to everyday settings.

3. Incidental teaching uses the same ideas as discrete trial training, except the goal is to teach behaviors and concepts throughout a youngster’s day-to-day experience, rather than focusing on a specific behavior.

4. In fluency building, the therapist helps the youngster build up a complex behavior by teaching each element of that behavior until it is automatic or "fluent," using the ABA approach of behavioral observation, reinforcement, and prompting. Then, the more complex behavior can be built from each of these fluent elements.

5. In discrete trial training, an ABA therapist gives a clear instruction about a desired behavior (e.g., “Pick up the paper.”); if the youngster responds correctly, the behavior is reinforced (e.g., “Great job! Have a sticker.”). If the youngster doesn’t respond correctly, the therapist gives a gentle prompt (e.g., places youngster’s hand over the paper). The hope is that the youngster will eventually learn to generalize the correct response.

Through ABA, moms and dads can learn to see the natural triggers and reinforcers in their youngster’s environment. For example, by keeping a chart of the times and events both before and after Michael’s temper tantrums, his mom might discover that Michael always throws a temper tantrum right after the lights go on at night without warning. Looking deeper at the behavior, Michael’s mom might also notice that her most natural response is to hug Michael in order to get him to calm down. In effect, even though she is doing something completely natural, the hugging is reinforcing Michael’s temper tantrum.

According to the ABA method, both the trigger (lights going on at night without a warning) and the reinforcer (hugging) must be stopped. Then a more appropriate set of behaviors (e.g., leaving the room or dimming the lights) can be taught to Michael, each one being reinforced or prompted as needed. Eventually, this kind of approach will lead to a time when the lights can go on without warning and Michael still does not throw a temper tantrum.


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

==> Videos for Parents of Children and Teens with ASD
 
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Parents’ Comments:

•    Anonymous said... my 12 year old son started 3 weeks ago. It is hard right now, but I know it will get better when we get past all of his manipulation. he likes to control situations if they become difficult he will refuse and shut down . we are trying to stand our ground and undue some bad behaviors that have formed over years of us giving in...
•    Anonymous said... my 7 year old son has been in ABA therapy for about 6 months (only 3 hours per week). We are seeing slight improvement in eye contact and listening skills. From a parent's perspective, it seems like they are just playing with your child, but they have assured me that there is a method to their madness.
•    Anonymous said... it's a therapy. It will only work if the child is receptive. Our 7 year old likes the attention and is doing okay. I would like to more results, but anything is better than nothing. I love my boy and I want him to be able to function happily through life so i want more than he is getting but that is what it is.

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Video Game Obsessions in Kids on the Autism Spectrum

"How can I get my son (high functioning autistic) to focus less on his favorite video game (Call of Duty) and spend more time doing other things? He is truly obsessed with war games. It's all he ever talks about."

One of the hallmarks of ASD level 1, or High Functioning Autism (HFA), is the child's tendency to be obsessed with particular topics. He might want to constantly talk about video games, race cars, cartoon characters, movies, or even bugs. 
 
It can be very frustrating for parents and teachers to deal with an obviously bright, articulate youngster who is somehow "stuck" in one particular frame of reference.

How can you get a child on the autism spectrum to have less obsessive thoughts and ideas? The honest answer is: You will not be able to entirely eliminate them. Some HFA kids will gradually leave one special interest behind, only to quickly fixate on a new one.
 

There are two ways to classify these thought-consuming interests. Some are considered "primary obsessions," and others are "secondary interests." Often it's difficult to tell which of the two you're dealing with.

Primary obsessions are intense enough that it is very difficult to get the youngster to think of anything else. The obsession monopolizes conversation and daily activities. It may also interfere with schoolwork. The youngster is consumed by the thoughts.

Secondary interests are a challenge and are somewhat obsessive for the youngster, but ultimately can be managed. Not only that, but secondary interests can be used as motivators to help the boy or girl succeed in school or improve behavior. 

Here are some suggestions:

1. Working with your son's teacher, use the "favorite" topic to promote learning. If he likes war video games, apply them to math problems (e.g., "If there are 5 tanks on the battlefield, and then 7 more line up, how many tanks in all?"). Art projects that teach different techniques could involve the topic. Science experiments could address the topic in some way. Reading can be promoted by providing your son with books on the topic. Use the interest as a starting point, and then build upon it, slowly expanding his areas of interest.

2. Use the topic to motivate good behaviors. Buy a book associated with the topic. Your son can read it when homework is finished, or after sitting quietly. Perhaps allow him to watch a movie on WWII when he's completed a job around the house.

3. Reward your son for making conversation that is correctly related to what's going on at the moment (something other than his special interest). For example, if your son looks at the sky and says, "I see an airplane," and that's a comment which is appropriate and in the moment, then immediately respond with attention and praise (e.g., "You're right! I see it too! Look, it's very far away. You've got good eyes. Do you think you'd like to fly in a plane someday?").

4. Give less of a response to random, meaningless comments about the obsession. If your son mentions the obsessive topic when it has nothing to do with what's currently going on, either don't respond, or act confused. For example, gently reply, "We're not on the topic of video games right now," or "why are you talking about that?" If your son becomes agitated, give a simple "ummm hmmm" with little eye contact. Then ask him a question, which requires him to engage in the present activity or conversation.


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

==> Videos for Parents of Children and Teens with ASD
 
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PARENTS' COMMENTS:

•    Anonymous said... A nine year old that plays video games and surfs the net for hours does not become a computer programmer or video game maker. They become 25 year olds that play video games and surfs the net all day. The electronics allow them to be non-verbal, non-social, and obsessive, all the things that are comfortable for my 16 year old. He can control his environment and is confident and competent within the world of the game. I found that he is more social and plays well with other kids at his level, especially other aspies. I took the video games away completely and internet time is at the end of the day as a reward for good behavior. Some days this really sucks and he turns from aspie to a-hole. But he has friends, he plays some sports, and can be social. You have to make them uncomfortable so they will be comfortable in the long run.
•    Anonymous said... By the way, words written out of grief of mama heart, not to frustrate anyone who posted on the set limits topic. And I meant "advice".
•    Anonymous said... Explain how video games can be addicting. Compare and contrast to something else that is addicting. Then ask how will they know when playing their game becomes a problem for them. What are the signs they see? How can they monitor themselves? Do they need a timer set for instance...All children on the spectrum unwind with video games but they must be taught to self monitor themselves and balance that with outdoor activities.
•    Anonymous said... I appreciate the "set limits" thoughts BUT, my 9 year old Aspie is ONLY interested in video games, computers and electronic devices. I get frustrated with the onslaught of advise to replace the activity because in the case of autism, sometimes you simply cannot. We had him in play therapy since he was a tiny toddler and he has NEVER EVER played. So yes...I homeschool...then he has chores...but by afternoon when all is done there is literally nothing else that can occupy his time. Outside stuff? No. Legos, puzzles, coloring, cars, board games, books...absolutely no interest. If you take away the electronics (which of course I have done a million times), he simply doesn't replace it and he does nothing (and that hurts a mama's heart). I had to rant a bit here because I am up to my eyeballs in advise that doesn't work and it is very frustrating. I wish my son could learn to love other activities (and it is not that we don't try - he starts archery class tomorrow) but it is what it is sometimes.
•    Anonymous said... I think Erik has hit the nail right on the head. You can't help your children by doing things that make them comfortable, especially when they have Aspergers. Most day-to-day things make a kid with Asperger's uncomfortable and the only way to help them grow is to push them out of their comfort level and do the things that don't come naturally.
•    Anonymous said... My boy is more violent and less caring for others especially his siblings when he has been playing fast action video games. We completely banned him from them over a year ago and his behaviour has much improved. He was a little upset, but he knows they affect him and get him into trouble, so those times when he is logical it's easy enough to get over the reasons why which he's accepted. thereare plenty of other games he can play, even some educational ones, he loves maths games.
•    Anonymous said... my boy loves anything to do with games and the internet! too... think I let him play on them too long myself... But then he says you like Facebook and being online too Mom!... He's right it is very addictive.... kids can't just go play outside like I did as a kid, that's why I let both my kids be online and on games more then I should.... Wish my kids could have the freedom that I had..... Say la vie... Goodluck will def be reading the comments
•    Anonymous said... there are a lot of jobs in video games, computers and electronic devices. is he interested in taking them apart and putting them back together? enroll him in computer class or take him to video game conventions for socialization. buy him books or check out books at the library about the video game. get the call of duty lego sets. embrace the obsession. he may outgrow it and appreciate that you accepted it or he may turn the obsession into a career.
•    Anonymous said... try introducing him to sports games, like NBA 2013 or FIFA which is a fun soccer game- my son switched from Halo and Call of Duty to the sports xbox games and loves them.
•    Anonymous said... We also have limits on time for video games. It's my sons down time after school. He gets 30-45 mins depending on what events we have for the evening (homework, etc). I don't let him earn the time but we have a printed schedule that he helped create that I refer to if I have a problem.
•    Anonymous said... We set a daily time limit on video games. He has to do chores to earn the time.
•    Anonymous said... When you take the video games away and he doesn't replace them, how much time are you giving him to choose something else? Maybe he hasn't gotten bored enough. He's old enough, in spite of his condition, to make the choice to be bored. Though it may be upsetting to you to see him "doing nothing" its not hurting him a bit. Adults go to meditation retreats and do nothing for days on end, and its considered a good thing. My son likes to do two things - legos and TV. Due to discipline issues, I took both away for a week. The first day was HELL, I can't believe we made it a day, gradually we did things he didn't normally do and it turned out to be not so bad.
•    Anonymous said... Wow this is my son to a tee, he to is addicted to "call of duty" on his xbox. i hate it he will play al day and have the night if i let him. he is 14yrs old, and was into legos for awhile but he's starting to outgrow them. i just worry in the future that it will be more important then the things he needs to do like school or work. im finding it very hard to set limits.

*   Anonymous said... I didnt see this thread and just posted about this same issue. Its sooo hard. My daughter is getting 'lost' in the world of Pokemon and i do get her interested in other things but Pokemon are everything to her. They are real to her and she relates to them. Its excluding other things. I know its a result of her trying to organize her world and feel safe but i want to help her feel safe somehow without always needing them. i hired her a babysitter over the summer i knew was aware of pokemon but little did i know the 21 year old girl was still obsessed with them herself and it put my daughter over the edge! i feel like she gets angry that i'm not a big pokefan myself. its almost like her and the pokemon vs the world. sad. i wish there were a better way to help her with her anxiety. i get her outside a lot and spend time with her and have done everything i can to get her socialized/friends. i advocate for her at school (but still believe its her big stressor) and i know that there are changes in our life that are hard. i got her a counselor but all she talked about there was pokemon and she didnt connect with her... thanks for letting me vent

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Understanding Suicidal Ideation in Adolescents with Autism Spectrum Disorder (ASD)

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