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High-Functioning Autism plus Oppositional Defiant Disorder: The Greatest Parenting Challenge

“We have finally had a diagnosis for high functioning autism and ODD after 6 and a half years of hell… my son is now 14 and apparently there is no help available!! He has a diagnosis and his statement will be drawn up for educational purposes, but where does that leave us as a family...he is so difficult to take anywhere… our house has been slowly getting destroyed by temper tantrums… so far every door needs replacing and the walls are covered in holes. I have a 9 yr old daughter with epilepsy who is really beginning to dislike being at home… it seems every day our house is filled with arguments over petty things which often lead to violent outbursts… there is no medication for him apparently, but I as a mother cannot cope much longer… this is changing me as a person, I'm finding I'm snappy and irritable and finding it hard to just get on with everyday …things that seemed so easy before... any suggestions on where what or who to go to for help!?”

For moms and dads of kids with ASD level 1, or High-Functioning Autism (HFA), coping with violent and aggressive behavior is perhaps the most difficult challenge. Aggressive behavior in the HFA youngster occurs for a reason, just as it would with any other youngster. No kid ever just "acts out" for no apparent reason. The key is in the words "apparent reason" – there is ALWAYS a reason, but the major challenge for the parent is figuring out what that reason is.

Inappropriate behavior, whether mild or severe, generally occurs in order to:
  • Avoid something (e.g., the youngster may become aggressive and shout before getting on the school bus because he wants to avoid going to school)
  • Because of pain (e.g., the youngster may show a range of challenging behaviors to his mom or dad because he is in physical pain, such as having headache)
  • Fulfill a sensory need (e.g., the youngster may lash out or shout in the classroom if it is too noisy, busy, bright, hot or smelly)
  • Get something (e.g., he may lash out at another youngster because he wants to get the toy that the other child is playing with)

Thus, the first step in reducing or eliminating this behavior is to determine the need that it fulfills by looking at the four categories above.
 
==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

The second step is to teach your child a replacement behavior, which he can use to communicate what he wants or doesn't want. It may even involve using some of his obsessive or self-stimulating behaviors (e.g., hand-flapping, rocking, pacing, etc.) as a replacement behavior. This is far less intrusive to others than aggressive behaviors, but still serves the same purpose.

You can also encourage your son to express his feelings or negotiate verbally. Alternatively, he can communicate through other methods such as emotion cards, drawings, using symbols, or "talking" through a puppet. You know your youngster best, so you need to experiment and see what works best.

This process takes time and initially, depending on the behavior, you may not have time. If the behavior is severe, then you need to immediately remove your son from whatever situation he is in at the time. Simply insisting that he stop the behavior and participate in whatever is occurring will not work unless you remove him from the situation first.

Also, maintaining your son's routine will go a long way towards reducing the need for inappropriate or aggressive behavior in the first place. Routine is a great source of stability and comfort for kids on the autism spectrum.

In summary, try to identify the real cause of the behavior, and teach your son to communicate the real cause of the behavior to you in a less harmful manner. A good therapist can be a big help to you here. So don’t be afraid to ask for help with this issue.





==> For parents who are struggling with their defiant teenager's behavior, here are a bunch of suggestions to implement - immediately!


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…At 12, our son was as the 14 y.o. described in the initial question. We sought professional help and ended up hospitalizing him. Meds did help him with the anxiety and depression, and to control his outbursts, but he needed to be in the hospital where they could observe him first hand while determining the effects of the meds. You must take the steps to get control in order to proceed to the part where you teach him the social and other skills he is lacking. And through it all, firmness with empathy and love. When a horse refuses to go into a barn, you don't punish him. You look in the barn to see if there's a snake. These children really do feel distressed; they're usually not being manipulative. There's a balance of how to meet their needs without letting them run the show, and most of us just aren't magically going to get there.
•    Anonymous said…I know how you feel, we had a living hell for 13 years with our daughter, with no family to help, no respite and no support, finally someone listened and noticed it was more than naughtiness and now she's diagnosed with aspergers & medicated. She still has her moments, but she's a more like a normal kid now. It's definitely saved our family and given her a chance of a decent life. :)
•    Anonymous said…I think my stepson has ODD, he hasn't been able to go to school since he was 11 as he is unable to sit still, concentrate, and always gets soooo angry when he is unable to do something or feels intimidated.
•    Anonymous said…Im going through the same things!!! My family cant even stand to be around him, they want me to give him to the state!! his special EI based school doesnt want him either, they often threaten to have him taken away by the police...lots of notes sent home..every day, he cant handle school, he cant handle a daycare..where does he go??? How do I get back to work..im on a family leave, i have 2more wks left....michigan has very little resources....anyone?? any suggestions Im so running out of time....
•    Anonymous said…My heart goes out to these moms. Our family is in the same boat. We have a 15 yr old son. Very aggressive and easily angered. I love a lot of the information here and give kudos to your site but I thought this reply was a little lacking in actual help. Identification and replacing the behavior is a little simplistic for the situations. At 14 yrs of age these teens are not necessarily youngsters who can be easily removed from the situation or able to easily apply a change to the way they respond. Although the article did identify that it would take time there is a huge gap in how to do that. It just seems to lead to more frustration and the Mom's left feeling more alone and defeated. I was hoping to find a second page with the deeper answer. It reminds me of sitting in an IEP meeting during his 6th grade and the solution they wrote down for my son was "He will work on doing better to get into less fights with his classmates and he will work on finishing his homework." That was it... just a feeling of "do better" with no achievable action plan.
•    Anonymous said…My son also was diagnosed with ODD along with ADHD, anxiety disorder, AS and more. We put him on risperdal and the ODD practically disappeared-it was quite miraculous!! I think that his anxiety was overwhelming, causing the ODD.
•    Anonymous said…My son has a diagnosis of Asd, ADHD and possible ODD, he is also being tested now for premature puberty-he's eight. We feel lost, and feel there is no where to turn, we home educate him as he can't cope at school. You are not alone. Xxxxxx
•    Anonymous said…my son has adhd ,ODD and aspergers and we use ritalin,and risperdal the risperdal was my saviour he now sleeps like a baby and i have seen a huge difference in him the school says he chooses his behaviour and its non of the above but now the teach has implemented a eeward system for each 40 min session in the day we seeing huge improvement …its taken me 4 yrs to find what works but there is hope
•    Anonymous said…my son has adhd odd ocd tics and sensory issues very difficult.
•    Anonymous said…My son has also been diagnosed with ADHD, which makes it even more difficult.
•    Anonymous said…My son has AS and intermittent explosive disorder. Tantrums started around 3 and quickly turned into rages. Preschool made him worse. By the time he was diagnosed in Kindergarten we were at our wits end. We had tried parenting like we had with our other children but it wasn't working with him. With the diagnosis came a lot of info. Had to completely change the way we dealt with him. Wasn't popular among some family members, but slowly became better. Spent 3 yrs at spec ed school. Takes Tenex, (blood pressure med) that helps tremendously with rages. We were fortunate to have wonderful teachers and admins that bent over backwards to help him. Now at 11, he isn't perfect, but is actually enjoyable to be around most of the time. There are many situations that he just can't handle right now, and we don't force him. Life isn't perfect, but Hope is alive. Number one suggestion is to learn to remain calm in all situations, and don't react confrontationally. Learn to pick battles, and overlook lesser infractions to concentrate on the most important ones. Don't get into power struggles, you will never win. Small settings with as little stress as possible, makes for a more pleasant Aspie. Good luck and hang in there.
•    Anonymous said…My son has same diagnosis.
•    Anonymous said…Oppositional Defiant Disorder is very hard to deal with. At home, there are some days when everything seems to be a fight. At school, notes come home that my son is refusing to do work, not following directions, and sometimes yelling at and threatening adults. Sometimes it just makes me want to cry.
•    Anonymous said…Same problem with my 10 year old. About to lose my job sigh.
•    Anonymous said…There is help, you just have to find the right professionals willing to help and not give up with "sorry, there's just nothing we can do to help." Our 11 year old was diagnosed with ODD 3 years ago on top of the AS diagnosis he had received at 4 years. It's taken a lot of time and work, and some medication, to get to where we are, but he is doing very well. Tantrums are less frequent and severe (less, not gone!), he has friends, he's more manageable... ABA has been huge!!! And smaller school environment has also helped. In just a paragraph, I may have made it sound easy or simplistic. Believe me, it hasn't been, but there is definate progress and lots of hope.
•    Anonymous said…There is help. My youngest has adhd and odd. Are you in the uk? If you are send me a friend req and ill help you out
•    Anonymous said…These two go hand in hand every time.
•    Anonymous said... And very important to take time for you. It can be very difficult to do that with responsibilities such as you have but if you go down who's going to keep the steering the ship?
•    Anonymous said... behaviour modification training works with ODD behaviours. you need to over structure their lives from what they eat to what they wear., give them NO choices at all to begin with and then allow them a choice between two options once you get 100% compliance. Choices are the reward for compliance and appropriate behaviours. It was hell but I had to do that with with my child. it is easier when they are younger. ODD is behavioural and only behaviour therapy works long term for it! As for books of how to do Behaviour Modification training, go online or to your library, it is extreme parenting for the extreme child. the pay offs are huge and the alternate is a wrecked home and life for you and your child. Medications do help but the child needs to learn to comply and to control their actions. It is not easy but either we teach them or the prison system will and that is heart breaking and sad. The truth is there is very little help and support out there. Keep up your best efforts and do not be hard on yourself. At 14 he can work to help himself!
•    Anonymous said... Early, early, early diagnosis is key...so treatment can be started when they are open to it, and continue consistently over the years. Only then can we get somewhere. The preteen years are too late... My daughter was dx at 11. By then, hormones exacerbate all of it and it's much harder to help them get control.
•    Anonymous said... Get you a counselor to help you cope and him a cognitive behavior therapist my son is the same way I know how hard it is but don't be ashamed to get help I did and Im not as stressed as before. I still get frustrated alot and theres alot of arguments with my son but you have to learn to choose your battles read Tony Atwoods guide to asbergers syndrome it will help with ideas as well
•    Anonymous said... Hi im in the very same way as you my 14 year old son asbergers left home on tuesday to live with his dad he does not like to follow rules
•    Anonymous said... I'm sorry it's so so hard. It is unbelievably stressful and emotionally draining. I often find myself saying and doing mean things and I'm a Social Worker who knows a lot about communication Ect. I feel for you. I'm not sure where you live but in most areas there will be a practitioner who can either help support you or work with your lad. We have thought we might separate our family to try to minimise conflict in the future. I feel for you and know how helpless things can feel. Take care.
•    Anonymous said... My son (15) has Aspergers and ADHD and also has treatment for depression. He was diagnosed aged 12 and it took my breakdown and his feelings for ending it all to get him diagnosed. We have ritalin (40mg daily) and prozit (2.5ml daily) and agree it took him to want to accept his Asperger's and ADHD. 2 years ago we would have been happy with Ds at GCSE. With help from school, us and CAMHS we are hoping for Bs, Cs and maybe even one A. It is a difficult journey but with age can come maturity and although we are not out of the woods yet we can see the light at the end of the tunnel. You are definitely not on your own here. I remember the days of the smashed tv all to well. Chin up xx
•    Anonymous said... My son also had odd with aspergers and ADHD. We medicate the ADHD but only for school. At home, he gets therapy frequently to help him learn how to use words rather than rage and to manage himself. It's a long road. I would keep a journal and document the meltdowns to try to get to the bottom of the causes and then you may be able to come up with idea for avoiding them. The therapist might be able to help you with this too. Sometimes they just can't find the words and it's worth talking about it after the fact when all the drama is over to try to find out. Explore sensory input. For example my son will meltdown if he has to wear buttons. He cannot tolerate the way they feel on his skin. For the longest time, he would freak out and I couldn't figure why until I asked him one day out of the blue. Avoidance is key. Message therapy might also help. Experiment and try stuff. Hang in ther. Try to get out and have some fun of your own when things get to be too much.
•    Anonymous said... My son also has aspergers and adhd ,what u have just wrote is my daily life ,my home is destroyed ,nd getting no help with the educational aspect ,he is in main stream school ,nd is excluded presently twice a week ,I can't get a statement for some reason ,my sons education is at reception class standard ,and he is 12 years old ,I can really empathise with what u are going through ,I am a single mum ov 6 teenage kids ,so very hard to show the rest any attention x
•    Anonymous said... My son has the same diagnosis with Bipolar just added during his last inpatient stay. My ex husband and I both have dealt with destroyed homes, frequent suspensions from school, attacks on us and teachers. His 1st inpatient stay was a year in a facility specifically designed for kids on the spectrum. They adjusted medications and got him under control. Upon return to school, his behaviors began to escalate and it wasn't long before he was back in the hospital. At 10 yrs now, he has 5 hospital stays behind him, we've moved to a new school, finally got a great teacher that loves him no matter what and is working with us. His medication coupled with weekly individual and family counseling is working and we have had no meltdowns in 3 weeks. Progress is slow, but we are grateful. Hang in there, you are not alone
•    Anonymous said... My son is 15 and has been on medication since he was five. It has changed over the years, but the neurologist told us in second grade to treat the anxiety first then the other issues. Aspergers children suffer from the unpredictable and lack of structure. Once we got the anxiety under control we treated for ADD. Then at 14 he had some severe paranoia, stopped taking meds and punched a hole in the wall. He spent a week in care and was not allowed to leave until he was cooperative. He now takes a third medication for mood stability. It has been a difficult journey and there is no help out there. His counselor cancelled sessions because he has no psychiatric goals...I was floored. People question why we have issues in society...our mental health needs to be progressive for all of our kids. I am a teacher and there are so many kids affected! You're not alone!!!!
•    Anonymous said... My son just got back into our home from residential placement. He was there inpatient for 11 months. He originally at age 3 was diagnosed ADHD, once put inpatient at age 12 that diagnosis was changed to Aspergers along with Depression, ODD, RAD, it has been a very rough roller coaster ride. His bad behaviors out weigh his good. We have many services in place for him, but HE has to be willing to change his ways. We have 6 months set up for him. If he returns to his old self, self destruction, suicide, he will then be placed into a group home. All of you going through things like this or more. Realize you are NOT ALONE !!!!!
•    Anonymous said... My son was diagnosed with ADHD-hyperactive impulsive type with with signs of depression and anxiety along with ODD at the age of 6. His treatment is Vyvanse 30mg every day and he is supposed to go to counseling. We also work very closely with the principal, school psychologist, school counselor, and his teacher. We also take him to see our doctor every 6 months.We noticed signs when he was about 3 or so. We had him tested at 4 but the psychologist we took him to at that time couldn't make the diagnoses stating we would have to wait till he was school age. Prek and kindergarten was not pleasant. We are in a different school district fr when he was in kindergarten. He has been doing GREAT in first grade and second grade.
•    Anonymous said... There is medication to lessen irritability and aggression, also repetitive behaviors. Abilify. My almost 13 yr old daughter has been taking it for about a year, and from the beginning it helped (it does take about 3 weeks to get into the system).
•    Anonymous said... This is my family too. You are not alone. I had to move out with my 14 year old so everyone else could be happy and safe
•    Anonymous said... We use a great lady therapist , been through many of them she teaches social thinking skills, plus other techniques. He has changed so much. We also use a program that is part of a wrap around service child guidance resource center. They work at home , school and out in the community
•    Anonymous said... Why aren't there medications for that?
•    Anonymous said... Wow, I thought It was I who had written this, and forgotten, until I got to the 9 year old daughter part. I know EXACTLY how you feel, for awhile I had a permascowl. Our son is 14, on no meds and this is the worst year by leaps and bounds. Don't get me started on my precious necklace he took a pair of pliers to. We never talk about school, though we have gone to two p/t evenings with him in tow, but we decided early on, when we realized he was determined to rebel, to simply let him fail. (You can lead a horse to water, but you can't make him drink.). It is now January and that is exactly what he's doing, failing. HOWEVER, we are maintaining a relationship with him, mostly me, mom. I realized early on that tearing out our hair and handing out consequences was futile so decided to take a softer approach, and it's working. There are still consequences but not the anger and volatility that goes with it - and we are getting a positive response. Our psychologist says that as long as there is a true relationship, some sincere connecting, at some point, they will come around. If we lose that connection, we might lose them. And I will, even if it's just my fingertip on his shoulder for only a second, grab any opportunity to touch him. I like what our psych said, that's what I have for you. Oh, and remember to breathe. P.S. His school is amazing by the way - don't know how we'd cope without them.
•    Anonymous said... You can still do wraparound services (TSS, BSC) and social skills classes if they're available in your area; he should already be in individual therapy if he has such anger issues..
•    Anonymous said... You may private message me as all these suggestions are well intentioned but overwhelming and all children are still different apart from the diagnosis. I have been working in the Mental Health Field for many years - My husband and I also do therapeutic foster care. We currently have a 13 year old boy with Aspergers and an 11 year old diagnosed with Reactive Attachment Disorder. Support is key - Please let me know what area you live. Stay Strong!!

*   Anonymous said... Our son is 9 years old and we are experiencing the same. Fortunately our doors are solid wood and our walls are thick mud brick so he can't damage anything. We have him on medication and it helps a lot. When he isn't on it it is just awful. He is in respiradone which is an anti psychotic drug that calms aggression as well as Concerta (Ritalin for concentration) and Fluoxitine (antidepressant). Even on all this he is a very challenging child and causes major problems. His school is very supportive and we have a myriad of people helping us. We also have a 14 year old with dyspraxia ADHD inattentive and a 5 year old with a heart condition which has been a tough road and not helped our 9 year old. We just don't have the energy to follow through on all the suggestions we are given. We just want this living nightmare to end but dreams are free. He is very unpredictable.
•    Anonymous said… I agree with a lot that's already been said so won't repeat... Just wanted to say firstly, there IS help for your son and secondly, you need help and support too. Take care of yourself. Consider anti anxiety meds or anti depressants and see a therapist that you can 'offload on'.
•    Anonymous said… I feel your pain, there is most definitely meds and speak to them about behaviour therapy. Good luck x
•    Anonymous said… May I just ask what the problems are that everyone encounters? I'm at the very beginning of the process and I'm absolutely terrified. My son will be 3 in Feb and I'm almost certain it is aspergers/high functioning autism he will be diagnosed with eventually. His outbursts are becoming more and more aggressive and I was hoping that getting a diagnosis would help me help him as I'm clueless about what to do. There's so much information out there but what works and what do you trust?
•    Anonymous said… Mood stabilizer!! Our daughter takes it for strong ocd which can turn into a manic situation at times. She also takes prozac and lithium. We tried 11 meds in 4 yrs before finding this best combo. She herself she's she's feels like its a dream and doesn't want to go wake up. Keep trying!!! Get therapy.
•    Anonymous said… My grandson is also in the same boat and my Son and daughter in law at wits end .
•    Anonymous said… My life same. I feel your pain I used these guys for nutrients and neurofeedback http://adhd.com.au drug free treatment . Also Nurtured Heart Approach parenting. By Howard Glasser saved my life. It's about building inner wealth
•    Anonymous said… My son is 14 & also has these issues, but there is help. We do alot of things still like brushing, listening therapy ect that even at his age do continue to help. He takes prozac & clonidine & so far so good.....not perfect but manageable. Good days & bad but much better then it was.....good luck to you
•    Anonymous said… my son is waiting to be diagnosed for Aspergers after 8 yrs of hell which is still continuing. hes bin on meds for ADHD but no longer on them as he got TICS really bad, hes under child psychiatrist who dismissed his hearing voices as 'something we all experience!!!!!' r u kidding me!!!!! it ttook my son whose 11 a lot of courage to even tell the shrink this n angered him that she didnt believe him!! his words.
•    Anonymous said… Once he is diagnosed often times insurance will cover for in home help. Or they may cover a portion of the cost. I will ask around.
•    Anonymous said… We are all very similar.I lay in bed heartbroken as my son with aspergers gave his playstation and games to this woman who friended him on line said she would come over and play games. As we all know...they are dying for friendship. She took them and said she'd brig.g them back. We don't know her name or where she lives.he had her text number he told her to bring them back or we would call the police. She said she didn't care. The police wouldn't do anything. So hes hysterical and demands a new system and games. Sorry son tough lesson. He through a major fit. I had to have him stay with his dad. I can't handle him. He's 18 and 6' tall and 200 lbs. I have holes in my walls too
•    Anonymous said… We took the biomed approach for both my aspies, drugs just made my teen gain 30 lbs and turned her into a zombie. Biomed found 2 conditions, Pyroluria and Methlyation issues in both, 1 kid is an Overmethylator, my other is an Undermethylator. ODD/OCD issues are almost always caused by Undermethylation which is treatable without drugs! (all 3 issues are) its a long road but a year after starting treatment I had 2 very different kids! My teen is now a happy straight A student but we also do a lot of different therapies from OT to address sensory issues to the emotional stuff but without treating the biomed stuff its hopeless.
•    Anonymous said… You could be describing my situation exactly. My son was diagnosed with high functioning ASD earlier this year after taking 7 years to get a diagnosis. He is now also 14 years old. I have also replaced doors and filled in holes in walls, as well as replacing trashed carpets, electrical equipment etc. He also has a younger sister who isn't allowed to do teenage sorts of things like play her music. We too were left with nowhere to go after the diagnosis. So what I did was contact my MP and asked him to complain on my behalf to the NHS, saying how disgusting it was that a young boy should just abandoned like this. My MP put in a complaint to the Chief Executive of the NHS, Simon Stevens, who then got in touch with my local Young People's Service at the 2gether Trust, to report back to him with progress. My son now has several appointments lined up with a child psychologist who specialises in ASD who, I hope, is going to help my son accept his condition and help prevent some of these meltdowns. I'm not sure if it will be successful but at least I feel that I'm doing something. I hope this helps and best of luck x


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Aspergers, ADHD, and ODD

Question

My 8 year old Aspie also has ADHD and Oppositional Defiant Disorder [ODD]. I can deal with the ADHD and the Aspergers …it’s the ODD I am having a hard time with. How do deal with it and what works with dealing with this disorder? What do you do as far as discipline? We are at our wits end with this part of his diagnoses and would love some advice.

Answer

Aspergers (high-functioning autism) is often not be the only psychological condition affecting a particular youngster. In fact, it frequently coexists with other problems such as:
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Bipolar Disorder
  • Depression (Major Depressive Disorder or Adjustment Disorder with Depressed Mood)
  • Generalized Anxiety Disorder
  • Obsessive Compulsive Disorder
  • Oppositional Defiant Disorder (ODD)

Oppositional Defiant Disorder, also known as ODD, is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others.

DSM delineates the criteria for ODD as follows:

A. A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present: often loses temper, often argues with adults, often actively defies or refuses to comply with adult requests or rules, often deliberately annoys people, often blames others for his or her mistakes or misbehavior, is often touchy or easily annoyed by others, is often angry and resentful, is often spiteful or vindictive.

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functions.

C. The behaviors do not occur exclusively during the course of psychotic or mood disorder.

D. Criteria are not met for Conduct Disorder, and if the individual is age 18 years or older, criteria are not met for Anti-social Personality Disorder.

Facts on Oppositional Defiant Disorder—
  • 15% of ODD kids develop some form of personality disorder
  • 20% of kids with ODD have some form of mood disorder, such as Bipolar Disorder or anxiety
  • 35% of these kids develop some type of affective disorder
  • 50-65% of ODD kids also have ADD or ADHD
  • 75% of kids with Oppositional Defiant Disorder above the age of eight will still be defiant later in life
  • Kids with CD and ODD are also at high risk for criminality and antisocial personality disorders in adulthood
  • Many of these kids have learning disorders
  • ODD is more common in boys than in girls before puberty
  • ODD is reported to affect between 2 and 16 percent of kids
  • Once kids enter adolescence, it is extremely difficult for moms and dads to change the ODD behavior

Symptoms of Oppositional Defiant Disorder—

Kids with ODD show defiant, hostile, and negativistic behaviors lasting at least six months, of which four or more of the following behaviors are present:
  • actively defies or refuses to comply with adults' requests or rules
  • argues with adults
  • blames others for his or her mistakes
  • deliberately annoys people
  • is angry or resentful
  • is spiteful and vindictive
  • loses temper
  • mean and hateful talking when upset
  • often being touchy or easily annoyed by others
  • seeking revenge

Causes of Oppositional Defiant Disorder—

There has been no systematic research into the causes of ODD; however, there are two theories as follows:

• Learning Theory: ODD comes as a response to negative interactions. The techniques used by moms and dads and authority figures bring about the oppositional defiant behavior.

• Developmental Theory: ODD is really a result of incomplete development. For some reason, ODD kids don't master the tasks that other kids master during their toddler years. They get stuck in the toddler stage (2-3 years old) and never really grow out of it.

Treatment of Oppositional Defiant Disorder—
  • Cognitive-Behavioral Psychotherapy to assist in problem solving and decrease negativity
  • Family Psychotherapy to improve communication
  • Individual Psychotherapy to develop effective anger management
  • Parent Training Programs to help manage behavior
  • Social Skills Training to increase flexibility and improve tolerance to frustration with peers
  • Stimulant Medication is prescribed only when ODD is accompanied by another disorder such as ADD or ADHD

Treatment is particularly important because kids with ODD are also at high risk for criminality and antisocial personality disorders in adulthood.

What Moms and Dads Can Do—
  1. Avoid power struggles.
  2. Build on the positives.
  3. Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both parents will do with the Aspergers child.
  4. Exercise and relax. Use respite care as needed.
  5. Give effective timeouts.
  6. Give the youngster praise and positive reinforcement when he shows flexibility or cooperation.
  7. Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount of time.
  8. Manage your stress.
  9. Offer acceptable choices to your Aspergers child, giving him a certain amount of control.
  10. Pick your battles carefully.
  11. Prioritize the things you want your youngster to do.
  12. Remain calm and unemotional in the face of opposition.
  13. Set up reasonable, age-appropriate limits with consequences that can be enforced consistently.
  14. Stay involved in things other than your youngster with ODD, so that your youngster doesn't take up all of your time and energy.
  15. Take a break if you are about to make the conflict with your youngster worse. This is good modeling, so be sure to support your youngster if he decides to take a time-out to prevent overreacting.
  16. Try to work with other adults that are involved with your youngster, such as educators, coaches, and your husband or wife.

What Teachers Can Do—

It is important for educators to be aware of the disorders that their students are suffering from. Educators may or may not see symptoms of ODD at school. Even if the symptoms are not present at school, it is helpful to know what the moms and dads are dealing with at home. The more you communicate with the family and understand the situation, the better you will be able to help.

Click here for a complete parenting-course on how to deal with the Aspergers child who also has Oppositional Defiant Disorder.

Asperger Syndrome and Attention Difficulties

Question

My question is my 13 yr old Asperger daughter does not pay attention to what is going on around her. Like if something looks dangerous, she doesn't seem to mind…. does not really pay attention crossing road or in parking lots, gets in trouble at school for doodling rather than listening, and so on. Is this part of Aspergers?


Answer

In the past, kids with Asperger Syndrome (now called high functioning autism) would sometimes get an ADHD diagnosis when they just couldn't focus in school. Today, we know a lot more about the differences between Aspergers and ADHD. Still, there are many similarities that can be difficult even for therapists to straighten out.

Theoretically, the distinction is easy enough. Asperger Syndrome is a part of the Autistic spectrum with emotional, social and possible verbal/motor impairments. ADHD and others may also have social components, but they're executive function disorders that usually go away as the youngster grows up. They also don't have the autistic traits often found in Asperger Syndrome kids. Asperger Syndrome is different in that children often have an almost uncanny ability to apply laser-like focus on a topic of interest to the exclusion of everything else, such as a teacher. ADHD, meanwhile, may not be able to focus on the teacher either, but that's because the attention is bouncing around all over the place. Thus, Asperger-related attention problems are more about striking balance between interests, and especially the ability to prioritize what is necessary rather than merely what the youngster happens to find interesting.

Some folks like to joke that they haven't quite received a bill until they open the envelope, so they don't have to worry about it just yet. A youngster with Asperger Syndrome can disregard requests to focus on “uninteresting” things in a similar way, simply blocking it out. Or, it could be the inability to maintain focus despite good efforts (kind of like how it's impossible to stay clear-headed at 2 AM when your whole body is crying out for sleep). No more can you “will” yourself to snap into an alert and rested state than an Asperger Syndrome kid may be able to snap into focus on a dull subject instead of an interesting one.

Either way, this is not something the youngster can help, nor does scowling and lectures help. You're more likely to drive the child away – and do everybody involved a disservice. Instead, talk to your daughter and try to pinpoint the problem. Every case is unique, so you have to look for tricks that help you and your youngster get around those particular problems. The key here is to follow up and give reminders without losing your temper. You can't just say, for example, "Remember to feed the cat at 5:00 PM" …and then get angry when it doesn't happen on its own.

There are many other tricks that may be equally or even more helpful. Again, discuss the nature of the challenges with your youngster with the goal of figuring out workable solutions together. Finally, never lose sight of the fact that even the most perfect plan is bound to have slip-ups; this is not the fault of your child, and she is probably just as frustrated as you are even if she lacks the tools to express it properly.

 
COMMENTS:

•    Anonymous said... Describes my son, who is now 31, to a T. Wish there had been a support group back then. He continues to struggle with focusing attention. On some things, he can be hyper focused seemingly ignoring other things around him. Then there are other situations where he doesn't seem focused at all. No he does not drive. He worked for 6 years but no longer. He is highly intelligent & high functioning, but he often stays to himself.
•    Anonymous said... Exactly what I'm dealing with! Seems rare for my son to be thinking or talking about what is relevant!!! Drives me insane!!! I need to learn more about this and ways to deal and cope with it!
•    Anonymous said... I am mostly concerned that the educators are "chastising." Sensory breaks and quiet environment are crucial.
•    Anonymous said... I feel like this not only explains my own 8 year old aspie but also myself.
•    Anonymous said... I'm easily distracted... Oh a squirrel
•    Anonymous said... it is all part of autism spectrum disorder...they will have distractions and moments of behavior issues...
•    Anonymous said... it might be beneficial to get the school resource teacher involved to help w/the teacher & your son!! Our resource teachers helps w/all of my son's struggles & helps his teacher in a positive reinforced way & they all get along so well & are productive in class!! good luck!
•    Anonymous said... my 7th grader is having a lot of difficulty with this right now...she was doodling and when that was taken away from her she started pulling her hair out...after redirection and an increase in meds we are starting to see improvents.
•    Anonymous said... My child has HFA and ADHD combined type and always struggled with staying on task...
•    Anonymous said... My daughter is very smart but has a very hard time focusing on school work and homework or a subject on hand, down to chores. She already got three F's, even one subject with an A at the first quarter but now F.....frustrating but not giving up yet. Some testings are going to be needing to see how far she is doing.
•    Anonymous said... My son was given a squishy stress ball in class , at first to stop him from finding other things to fiddle with and less distracting for the others, it turned out to be great because he could concentrate more, his hands were busy so he was happy and listened to class , Melissa Buckel Rokusek sounds like the same thing for your son when drawing
•    Anonymous said... My step son was using his drawings as his fidget. One of the teachers decided to test how much information he was getting from the class, he passed with flying colors. I think that doodling focuses him on what is actually being said. He also doodles while watching movies (after he can repeat every word). So sometimes its not a bad thing.
•    Anonymous said... sounds a lot like my son. we're going to be homeschooling for a while to see if he can learn to focus his attention on schoolwork. he hasn't been able to function in a class room environment. such a bright boy, we just need to help him focus on the things he needs to focus on in order to do well. drives me insane too.
•    Anonymous said... Sounds alot like my son. He is in fourth grade and every teacher he has had has said that he is very intelligent. But his grades do not reflect that since he is too distracted at school to do better.
•    Anonymous said... sounds alot like my son. His teachers, aides, counselors all say he is super smart. But his grades do not reflect this because they say he doesn't pay attention in class most of the time. I don't think he does it on purpose, but I think his mind wanders. He is 10, but hasn't had an iq test yet.
•    Anonymous said... Sounds like my son.
•    Anonymous said... Stimulants do help with this in my experience with my son. Seems to improve his meltdowns too
•    Anonymous said... This describes my son exactly! We have been dealing with attention issues all through school. I am quite sure he would test as gifted, but his current grades do not reflects it. We always hear he needs to pay more attention, but so far have not found a solution. He reacts badly to stimulants. My son admits he has too many ideas in his head to concentrate.
•    Anonymous said... This is exactly my son!
•    Anonymous said... This just came up at our annual for my daughter. She needs to be redirected because she gets lost in her thoughts. Do any of you have any goals on IEP for dealing with this?
•    Anonymous said... This sounds very much like my 14 y.o. He's very intelligent, but his schoolwork suffers because his attention slips easily while in class.

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Can Aspergers be treated? Yes!

Is there a cure for Aspergers?

No. Aspergers (high-functioning autism) can currently not be cured and the condition is life-long. However, with correct treatment and therapy, many people with Aspergers can go on to lead normal lives and may even excel in certain areas of occupational functioning.

Can Aspergers be treated?

Yes, most definitely! However, because Aspergers is a relatively new diagnosis in the field of developmental psychology and psychiatry, many treatment approaches are still in the developmental stages and lots of work still needs to be done in this area. One thing has definitely been established - the sooner treatment begins - the better! This applies especially to remedial, educational and therapeutic intervention. While there is no specific treatment or 'cure' for Aspergers, there are many interventions which can significantly improve the functioning and quality of life of people and kids with Aspergers.

Social Skills Training—

This should be one of the most important components of a treatment program. Kids with Aspergers can be helped to learn social skills by an experienced psychologist. Body language and nonverbal communication can be taught in much the same way as one would teach a foreign language. Kids with Aspergers can learn to interpret nonverbal expressions of emotion and social interaction. This can assist them with social interaction and peer relationships and prevent the isolation and depression that often occurs as they enter adolescence. Teenagers can sometimes benefit from group therapy and can be taught how to use the teenage 'slang' and language forms of their peer groups.

Educational Intervention—

Because kids with Aspergers may differ widely in terms of IQ and ability levels, schools should learn to individualize educational programs for these kids. Some of them may cope well in a mainstream class with additional support, while others may need to receive specialized education. In all cases, teachers should be aware of the special needs of Aspergers kids, who often need a great deal more support than first appears necessary.

Psychotherapy—

Psychotherapeutic approaches which focus on supportive therapy, the teaching of social skills and concrete behavioral techniques are more effective than approaches which concentrate on emotional in depth therapy, which may be too uncomfortable and stressful for the person with Aspergers. Kids can benefit from play therapy and 'story' therapy aimed at raising awareness of nonverbal communication, development and teaching of empathy and learning of social skills.

Diet—

Although there is no conclusive evidence, there are strong suggestions that changes in diet may significantly reduce the symptoms of some kids with Aspergers. Many moms and dads report that their kids become much more manageable when certain classes of food are eliminated from the diet. These include dairy products, sugar, gluten, wheat and some artificial colorants and preservatives like MSG and tartrazine. It is worthwhile consulting a trained nutritionalist to assist with dietary intervention and moms and dads should not simply eliminate important foods from their kid's diets without expert advice.

Psychopharmacological Interventions or Drug Therapy—

Many kids and adults with Aspergers do not need any form of medication, while others need to be treated symptomatically While there are no specific 'Aspergers' drugs, psychiatric drugs can be used to treat some of the problems which may manifest or be associated with Aspergers, such as ADD/HD, depression, mood swings, temper tantrums, irritability, aggression, obsessions and compulsive behaviors and anxiety. Many of the drugs used to treat the other Pervasive Developmental Disorders like Autism are also used to treat some of the associated symptoms of Aspergers. These include Ritalin, Adderall, Paxil, Strattera, Prozac, Risperal and others.

Like many psychiatric drugs, these often come with unwanted side effects and the risk of addiction and their benefits should always be weighed against the potential harm they could cause, particularly in the case of kids. Remember that you should always consult your doctor before altering or discontinuing any prescription medication. It is also important to realize that there are effective herbal and homeopathic alternatives to many of the prescription drugs. As with any medication, it is always best to consult your doctor before changing or discontinuing any prescribed medicines.

Natural alternatives—

Herbal and homeopathic remedies can be viable alternatives to the synthetic drugs and may be just as effective, with far fewer risks and side effects. Depending on the symptoms that need treatment, Native Remedies recommends the following remedies to assist in an overall treatment plan. Herbal remedy for depression, mood swings, repetitive behaviors, irritability, and aggression. These may all be symptoms of serotonin imbalance and may show improvement with the use of our 100% herbal MindSoothe Jr. formula. The ingredients of MindSoothe Jr. have been clinically proven to assist in balancing serotonin levels and act as SSRI's (Selective Serotonin Re-uptake Inhibitors) in much the same way as the synthetic SSRI's do.

Herbal remedy for anxiety (calm and soothe)—

Tranquilizing drugs may be very effective in calming autistic kids and adults, who can easily become highly distressed and volatile over seemingly small changes in their environment. However, many tranquilizing drugs are also addictive and individuals may build up tolerance, resulting in the need for increasingly higher doses. PureCalm is a herbal formula which has been especially formulated to calm and soothe kids and adults without the risk of side effects and potential addiction. Available in easy to administer drop form, the dosage may be adjusted to suit kids or adults. PureCalm may be taken on its own when needed for quick symptomatic relief, and is also safe to use with most prescription and herbal medicines.

Herbal remedies for ADHD, hyperactivity and concentration—

Like the benzodiazepines and tranquilizing drugs, the psycho-stimulants come with documented side effects and potential for dependency. Yet many moms and dads find it very difficult to deal with Aspergers kids who also have symptoms of ADHD, hyperactivity and concentration problems. For the treatment of hyperactivity, restlessness and lack of concentration, Native Remedies has developed two highly effective remedies: Focus ADHD Formula is a 100% herbal remedy which has been especially formulated to treat the symptoms of ADHD in kids and adults alike. Focus comes in a tincture an is easily administered as drops in some juice or water. Native Remedies also offers BrightSpark, a safe and effective homeopathic formula. BrightSpark can be effectively used on its own or it can be combined with Focus ADHD Formula for severe or stubborn cases or for kids with defiance and anger problems.

Herbal remedy for tantrums—

Many Aspergers kids have violent tantrums, sometimes seemingly without cause. Tantrums may often be a result of the youngster's frustration at being unable to communicate or understand, and may also be a response to changes in routine or environment. Tantrum Tamer, a specially formulated homeopathic remedy, uses proven homeopathic ingredients which can greatly reduce or eliminate distressing and hard to handle tantrums. Tantrum Tamer dissolves easily in the mouth and is pleasant tasting and readily accepted by kids. Remedies may be used independently or in combination.

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children

Oppositional Defiant Behavior in Children and Teens with Aspergers Syndrome

The American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM IV), defines oppositional defiant disorder (ODD) as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months. Behaviors included in the definition include the following:

• actively defying requests
• arguing with adults
• being touchy, easily annoyed or angered, resentful, spiteful, or vindictive.
• blaming others for one's own mistakes or misbehavior
• deliberately annoying other people
• losing one's temper
• refusing to follow rules

OPPOSITIONAL DEFIANT DISORDER is usually diagnosed when an Aspergers youngster has a persistent or consistent pattern of disobedience and hostility toward parents, teachers, or other adults. The primary behavioral difficulty is the consistent pattern of refusing to follow commands or requests by adults. Aspergers kids with OPPOSITIONAL DEFIANT DISORDER are often easily annoyed; they repeatedly lose their temper, argue with adults, refuse to comply with rules and directions, and blame others for their mistakes. Stubbornness and testing limits are common, even in early childhood.

The criteria for OPPOSITIONAL DEFIANT DISORDER are met only when the problem behaviors occur more frequently in the Aspergers youngster than in other Aspergers kids of the same age and developmental level. These behaviors cause significant difficulties with family and friends, and the oppositional behaviors are the same both at home and in school. Sometimes, OPPOSITIONAL DEFIANT DISORDER may be a precursor of a conduct disorder. OPPOSITIONAL DEFIANT DISORDER is not diagnosed if the problematic behaviors occur exclusively with a mood or psychotic disorder.

Prevalence and Comorbidity—

The base prevalence rates for oppositional defiant disorder (ODD) range from 1-16%, but most surveys estimate it to be 6-10% in surveys of nonclinical, non-referred samples of parents' reports. In more stringent population samples, rates are lower when impairment criteria are stricter and when the information is obtained from both parents and teachers, rather than from moms and dads only. Before puberty, the condition is more common in boys; after puberty, it is almost exclusively identified in boys, and whether the criteria are applicable to girls has been discussed. The disorder usually manifests by age 8 years. OPPOSITIONAL DEFIANT DISORDER and other conduct problems are the single greatest reasons for referrals to outpatient and inpatient mental health settings for kids, accounting for at least half of all referrals.

Diagnosis is complicated by relatively high rates of comorbid, disruptive, behavior disorders. Some symptoms of attention deficit hyperactivity disorder (ADHD) and conduct disorder overlap. Researchers have postulated that, in some kids, OPPOSITIONAL DEFIANT DISORDER may be the developmental precursor of conduct disorder. Comorbidity of OPPOSITIONAL DEFIANT DISORDER with ADHD has been reported to occur in 50-65% of affected kids.

In some Aspergers kids, OPPOSITIONAL DEFIANT DISORDER commonly occurs in conjunction with anxiety disorders and depressive disorders. Cross-sectional surveys have revealed the comorbidity of OPPOSITIONAL DEFIANT DISORDER with an affective disorder in about 35% of cases, with rates of comorbidity increasing with patient age. High rates of comorbidity are also found among ODDs, learning disorders, and academic difficulties. Given these findings, kids with significant oppositional and defiant behaviors often require multidisciplinary assessment and may need components of mental health care, case management, and educational intervention to improve.

Risk Factors and Etiology—

The best available data indicate that no single cause or main effect results in oppositional defiant disorder (ODD). Most experts believe that biological factors are important in OPPOSITIONAL DEFIANT DISORDER and that familial clustering of certain disruptive disorders, including OPPOSITIONAL DEFIANT DISORDER and ADHD, substance abuse, and mood disorders, occurs.

Studies of the genetics of OPPOSITIONAL DEFIANT DISORDER have produced mixed results. Under-arousal to stimulation has been consistently found in persistently aggressive and delinquent youth and in those with OPPOSITIONAL DEFIANT DISORDER. Exogenous factors such as prenatal exposure to toxins, alcohol, and poor nutrition all seem to have effects, but findings are inconsistent. Studies have implicated abnormalities in the prefrontal cortex; altered neurotransmitter function in the serotonergic, noradrenergic, and dopaminergic systems; and low cortisol and elevated testosterone levels.

Clinical Course—

In Aspergers toddlers, temperamental factors, such as irritability, impulsivity, and intensity of reactions to negative stimuli, may contribute to the development of a pattern of oppositional and defiant behaviors in later childhood. Family instability, including economic stress, parental mental illness, harshly punitive behaviors, inconsistent parenting practices, multiple moves, and divorce, may also contribute to the development of oppositional and defiant behaviors.

The interactions of an Aspergers youngster who has a difficult temperament and irritable behavior with moms and dads who are harsh, punitive, and inconsistent usually lead to a coercive, negative cycle of behavior in the family. In this pattern, the youngster's defiant behavior tends to intensify the parents' harsh reactions. The moms and dads respond to misbehavior with threats of punishment that are inconsistently applied. When the parent punishes the youngster, the youngster learns to respond to threats. When the parent fails to punish the youngster, the youngster learns that he or she does not have to comply. Research indicates that these patterns are established early, in the youngster's preschool years; left untreated, pattern development accelerates, and patterns worsen.

Developmentally, the presenting problems change with the Aspergers youngster's age. For example, younger kids are more likely to engage in oppositional and defiant behavior, whereas older kids are more likely to engage in more covert behavior such as stealing.

By the time they are school aged, Aspergers kids with patterns of oppositional behavior tend to express their defiance with teachers and other adults and exhibit aggression toward their peers. As kids with oppositional defiant disorder (ODD) progress in school, they experience increasing peer rejection due to their poor social skills and aggression. These kids may be more likely to misinterpret their peers' behavior as hostile, and they lack the skills to solve social conflicts. In problem situations, kids with OPPOSITIONAL DEFIANT DISORDER are more likely to resort to aggressive physical actions rather than verbal responses. Kids with OPPOSITIONAL DEFIANT DISORDER and poor social skills often do not recognize their role in peer conflicts; they blame their peers (e.g., "He made me hit him.") and usually fail to take responsibility for their own actions.

The following 3 classes of behavior are hallmarks of both oppositional and conduct problems:

1. emotional overreaction to life events, no matter how small
2. failure to take responsibility for one's own actions
3. noncompliance with commands

When behavioral difficulties are present beginning in the preschool period, teachers and families may overlook significant deficiencies in the youngster's learning and academic performance. When many Aspergers kids with behavioral problems and academic problems are placed in the same classroom, the risk for continued behavioral and academic problems increases. OPPOSITIONAL DEFIANT DISORDER behavior may escalate and result in serious antisocial actions that, when sufficiently frequent and severe, become criteria to change the diagnosis to conduct disorder. Milder forms of OPPOSITIONAL DEFIANT DISORDER in some kids spontaneously remit over time. More severe forms of OPPOSITIONAL DEFIANT DISORDER, in which many symptoms are present in the toddler years and continually worsen after the youngster is aged 5 years, may evolve into conduct disorder in older kids and adolescents.

Treatment—

Given the high probability that oppositional defiant disorder (ODD) occurs alongside attention disorders, learning disorders, and conduct disturbances, an evaluation for these disorders is indicated for comprehensive treatment. Pharmacologic treatment (e.g., stimulant medication) for ADHD may be beneficial once this is diagnosed. Aspergers kids with oppositional behavior in the school setting should undergo necessary screening testing in school to evaluate for possible learning disabilities. With the multifaceted nature of associated problems in OPPOSITIONAL DEFIANT DISORDER, comprehensive treatment may include medication, parenting and family therapy, and consultation with the school staff. If kids with OPPOSITIONAL DEFIANT DISORDER are found to have ADHD as well, appropriate treatment of ADHD may help them to restore their focus and attention and decrease their impulsivity; such treatment may enable their social and behavioral interventions to be more effective.

Parent management training (PMT) is recommended for families of Aspergers kids with OPPOSITIONAL DEFIANT DISORDER because it has been demonstrated to affect negative interactions that repeatedly occur between the kids and their moms and dads. PMT consists of procedures in which parents are trained to change their own behaviors and thereby alter their youngster's problem behavior in the home. PMT is based on 35 years of well-developed research showing that oppositional and defiant patterns arise from maladaptive parent-child interactions that start in early childhood.

These patterns develop when moms and dads inadvertently reinforce disruptive and deviant behaviors in a youngster by giving those behaviors a significant amount of negative attention. At the same time, the parents, who are often exhausted by the struggle to obtain compliance with simple requests, usually fail to provide positive attention; often, the moms and dads have infrequent positive interactions with their kids. The pattern of negative interactions evolves quickly as the result of repeated, ineffective, emotionally expressed commands and comments; ineffective harsh punishments; and insufficient attention and modeling of appropriate behaviors.

PMT alters the pattern by encouraging the parent to pay attention to prosocial behavior and to use effective, brief, non-aversive punishments. Treatment is conducted primarily with the moms and dads; the therapist demonstrates specific procedures to modify parental interactions with their youngster. Moms and dads are first trained to simply have periods of positive play interaction with their youngster. They then receive further training to identify the youngster's positive behaviors and to reinforce these behaviors. At that point, parents are trained in the use of brief negative consequences for misbehavior. Treatment sessions provide the moms and dads with opportunities to practice and refine the techniques.

Follow-up studies of operational PMT techniques in which moms and dads successfully modified their behavior showed continued improvements for years after the treatment was finished. Treatment effects have been stronger with younger kids, especially in those with less severe problems. Recent research suggests that less severe problems, rather than a younger patient age, is predictive of treatment success. Approximately 65% of families show significant clinical benefit from well-designed parent management programs.

Regardless of the Aspergers youngster's age, intervention early in the developing pattern of oppositional behavior is likely to be more effective than waiting for the youngster to grow out of it. These kids can benefit from group treatment. The process of modeling behaviors and reactions within group settings creates a real-life adaptation process. In younger kids, combined treatment in which moms and dads attend a PMT group while the kids go to a social skills group has consistently resulted in the best outcome. The efficacy of group treatment of adolescents with oppositional behaviors has been debated. Group therapy for adolescents with OPPOSITIONAL DEFIANT DISORDER is most beneficial when it is structured and focused on developing the skills of listening, empathy, and effective problem solving.

Obstacles to Treatment—

Oppositional defiant disorder (ODD), and other conduct problems, can be intractable. Despite advances in treatment, many Aspergers kids continue to have long-term negative sequelae. PMT requires parental cooperation and effort for success. Existing psychiatric conditions in the moms and dads can be a major obstacle to effective treatment. Depression in a parent, particularly the mother, can prevent successful intervention with the youngster and become worse if the youngster's behavior is out of control. Substance abuse and other more severe psychiatric conditions can adversely affect parenting skills, and these conditions are particularly problematic for the moms and dads of a youngster with OPPOSITIONAL DEFIANT DISORDER.

In situations in which the moms and dads lack the resources to effectively manage their Aspergers youngster, services can be obtained through schools or county mental health agencies. Many states have effective "wrap around" services, which include a full-day school program and home-based therapy services to maintain progress in the home setting. Thus, effective treatment can include resources from several agencies, and coordination is critical. If county mental health or school special education services are involved, one person is usually designated to coordinate services in those systems.


My Aspergers Child: Parent Management Training (PMT) for Parents with Defiant Aspergers Children


Keywords—
• Aspergers and ADHD
• Aspergers and antisocial actions
• Aspergers and attention-deficit/hyperactivity disorder
• Aspergers and conduct disorder
• Aspergers and defiant behavior
• Aspergers and defiant disorder
• Aspergers and disruptive behavior
• Aspergers and harshly punitive behaviors
• Aspergers and hostile behavior
• Aspergers and impulsivity
• Aspergers and irritability
• Aspergers and learning disorders
• Aspergers and maladaptive parent-child interactions
• Aspergers and noncompliance with commands
• Aspergers and ODD
• Aspergers and oppositional defiant disorder
• Aspergers and overreaction to life events
• Aspergers and parent management training
• Aspergers and peer rejection
• Aspergers and stubbornness
• Aspergers defiant disorder
• Aspergers negativistic behavior

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Are there any medications or techniques to address the zoning out??

Question

"I have a 9 year old son who was mildly diagnosed with Autism [level 1] when he was in second grade. He is very social, likes to tell jokes, is involved in a swimming team at the YMCA and has lots of play dates. His main problem is in school and doing homework... he tends to be in this "low arousal state" where he appears to be "zoning out". He has a para which basically helps him to stay focused. He is about 5 reading levels behind grade level. He has trouble with inference and thinking outside the box. Math word problems are difficult. He doesn't exhibit any depression, hyperactivity, temper tantrums, or stemming. He is very pleasant to people and makes eye contact. Are there any medications or techniques to address the zoning out?? I know he's paying attention since when presented with a question, he usually answers correctly. Again, this only occurs during school and homework. He also has been heavily stuttering out of nowhere for over a year. He receives speech 3x's to 2x's and adaptive phy.ed. Any information would be great."

Answer

One of the unusual abilities that high-functioning autistic kids have is “hyper-focus”. Like all ASD traits, hyper-focus is a double-edged sword. On the one hand, when combined with the special interest and ASD long-term memory, it is responsible for the genius label as it applies to autistic children. On the other, it's responsible for many learning and obedience issues.

Hyper-focus is commonly found in ASD kids who also have the ADD/ADHD. In recent years, the definitions of ADHD (Attention Deficit Hyperactive Disorder) and ADD (Attention Deficit Disorder) have merged in the medical sense under the banner of ADHD. Personally, I'm not keen on this merging of diagnosis because while the two share similar definitions, there are some fundamental differences between them. 
 
While both ADHD and ADD kids have, by definition, attention issues, the hyperactive youngster is more likely to have attention problems due to hyperactivity itself while the ADD youngster is more likely to have a hyper-focus problem.
 

Consider the differences between the two:

1. A youngster who does not respond when his name is called because he is distracted or is shouting and jumping from chair to chair.

2. A youngster who is intently starring at a spinning wheel, or playing with some lego bricks and does not respond when his name is repeatedly called.

Hyper-focus is possibly the cause of the problem only in the second case.

One of the basic tenants of positive parenting and positive schooling is that the obedient youngster should be rewarded. In school for example, a youngster who is obviously paying attention will receive a reward while one who is not may be rebuked or simply ignored. This technique is generally quite effective with "typical" kids.

Unfortunately, this technique does not work with hyper-focused kids who go into daydream state - or "zone out" - automatically. Zoning out is not disobedience. This youngster is not trying to be naughty - they just happen to go into that state automatically.

The best remedy for these kids is for the teacher to work more closely with them and for more one-on-one time to be allocated. In schools, this isn't always practical and hyper-focused kids can often miss out on necessary attention and can fall behind. Often, such kids are labeled "slow" and are put into remedial classes simply because they lack the ability to remain "on-task".

Hyper-focus has a lot of advantages. It allows one to think more abstractly and with greater complexity. It is a particularly useful skill to have when you need to be able to model complex systems or think in an extremely logical manner (for computer programming). In the adult world, hyper-focus allows people with autism to deal with excessive levels of detail while still retaining a top-down approach.
 

Autistic kids tend to hyper-focus mainly on their special interests and they are able to take in and process large amounts of related information as a result.

The best way to make use of hyper-focus in primary school kids is to attempt to line their work up with their special interests whenever possible.

For example, if your youngster's special interest is trains, then giving them sentences to write about trains or mathematics problems regarding carriages, train sizes or weights, or giving them scientific projects on the use of electricity or steam in trains will allow the youngster to use their special interest to further their normal learning.
 
Resources for parents of children and teens on the autism spectrum:
 
 
 
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.

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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."

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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.

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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.

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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.

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The Distinction Between Meltdowns and Tantrums in Children with Autism Spectrum Disorder (ASD)

Children diagnosed with Autism Spectrum Disorder (ASD) often communicate their internal experiences and emotional states in ways that may di...