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Showing posts sorted by relevance for query ODD. Sort by date Show all posts

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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Conduct Disorder in Children with High-Functioning Autism and Asperger's

"My 12 year old son is diagnosed with high functioning autism and conduct disorder (also the suspicion of ADHD). Any other parents out there with this combination in their child? Any advice for us? This has been a very difficult road - with no end in sight. My husband and I are feeling both the physical and mental effects of the stress we have to endure on a daily basis. We are desperate at this point."

Although several studies have suggested an association between violent crime and High-Functioning Autism, few have examined the underlying reasons. All kids display oppositional or aggressive behavior from time to time, especially when they are upset, tired, or hungry. Oppositional behavior (e.g., arguing, lying, and disobeying) is a normal part of development for kids and  teenagers. When this behavior is frequent or excessive, affects the youngster’s home or school life, or violates the rights of others, a conduct disorder may be present.

Conduct disorder (CD) is the most severe psychiatric disorder in childhood, and occurs more frequently in boys than in girls. According to the U.S. Department of Health and Human Services, the disorder affects an estimated 1-4 percent of teenagers between the ages of 9 and 17 years. Young people with this disorder repeatedly violate the rights of others, and display aggressive, destructive, and deceitful behavior. Identifying the signs and symptoms of CD, and beginning treatment as early in life as possible, is essential in order to prevent the disorder and prognosis from worsening.

==> Parenting System That Stops Meltdowns and Tantrums Before They Start

What is conduct disorder?

Children with CD repeatedly violate the personal or property rights of others and the basic expectations of society. A diagnosis of CD is likely when symptoms continue for 6 months or longer. CD is known as a "disruptive behavior disorder" because of its impact on kids and their families, neighbors, and schools.

Another disruptive behavior disorder, called Oppositional Defiant Disorder ODD), may be a precursor of CD. A youngster is diagnosed with ODD when he or she shows signs of being hostile and defiant for at least 6 months. ODD may start as early as the preschool years, while CD generally appears when kids are older. OCD and CD are not co-occurring conditions.




The Best Way To Help Oppositional Children with Asperger's and High-Functioning Autism:

 

What are the signs of conduct disorder?

Symptoms of conduct disorder include:
  • Aggressive behavior that harms or threatens other people or animals
  • Destructive behavior that damages or destroys property
  • Early tobacco, alcohol, and substance use and abuse
  • Lying or theft
  • Precocious sexual activity
  • Truancy or other serious violations of rules

Those with CD or ODD also may experience:
  • Academic difficulties
  • Difficulty staying in adoptive, foster, or group homes
  • Higher rates of depression, suicidal thoughts, suicide attempts, and suicide
  • Higher rates of injuries, school expulsions, and problems with the law
  • Poor relationships with peers or adults
  • Sexually transmitted diseases

How common is conduct disorder?

Conduct disorder affects 1 to 4 percent of 9- to 17-year-olds, depending on exactly how the disorder is defined (U.S. Department of Health and Human Services). The disorder appears to be more common in boys than in girls and more common in cities than in rural areas.

Who is at risk for conduct disorder?

Research shows that some cases of CD begin in early childhood, often by the preschool years. In fact, some infants who are especially "fussy" appear to be at risk for developing CD.  

Other factors that may make a youngster more likely to develop CD include:
  • Abuse or violence
  • Crowding
  • Early institutionalization
  • Early maternal rejection
  • Family neglect
  • Large family size
  • Parental marital discord
  • Parental mental illness
  • Poverty
  • Separation from parents, without an adequate alternative caregiver

What help is available for families?

Although CD is one of the most difficult behavior disorders to treat, young people often benefit from a range of services that include:
  • Community-based services that focus on the young person within the context of family and community influence
  • Family therapy
  • Training for parents on how to handle problematic behavior
  • Training in problem-solving skills for kids and teens on the autism spectrum


Some child and teenager behaviors are hard to change after they have become ingrained. Therefore, the earlier the CD is identified and treated, the better the chance for success. Most High-Functioning Autistic and Asperger's children/teens with CD are probably reacting to events and situations in their lives. Some recent studies have focused on promising ways to prevent CD among "at-risk" kids on the autism spectrum. In addition, more research is needed to determine if biology is a factor in CD.

Parents or other caregivers who notice signs of CD or ODD in a youngster or teenager should:
  • Find family network organizations.
  • Get accurate information from libraries, hotlines, or other sources.
  • If necessary, talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and teenager disorders.
  • Pay careful attention to the signs, try to understand the underlying reasons, and then try to improve the situation.
  • Talk to other families in their communities.

People who are not satisfied with the mental health services they receive should discuss their concerns with their provider, ask for more information, and/or seek help from other sources.


4 Crucial Mistakes in Dealing with Oppositional Behavior:



How to Identify Conduct Disorder in Your High-Functioning Autistic or Asperger's Child—

Step 1—Learn about the risk factors for developing CD (e.g., having a parent with a mood disorder, ADHD, substance abuse disorder, or CD). A history of abuse or neglect, exposure to violence, inconsistent or excessively harsh discipline, poverty, and overcrowded living conditions are other risk factors for CD.

Step 2—Take note of any aggressive behavior (e.g., bullying, threatening, or intimidating others). Autistic kids with CD often initiate both verbal and physical fights, and have a history of violence and cruelty toward people and animals. More serious signs of aggressive behavior include the use of weapons and a history of sexual assault.

Step 3—Consider whether prior destructive acts were intentional or unintentional. While all kids have the potential to damage property due to carelessness or reckless play, kids with CD deliberately cause damage to the property of others.

Step 4—Watch carefully for other signs of CD (e.g., lying, theft, truancy, substance abuse, serious rule violations, and precocious sexual activity). High-Functioning Autistic and Asperger's kids with this disorder may also experience symptoms of depression, have poor relationships with family members and peers, and experience significant academic difficulties.

Step 5—Speak with your youngster’s teacher to get her opinion, and discuss your youngster’s symptoms with a mental health professional who specializes in disorders of childhood. Read all you can about the symptoms of CD so that you are better able to identify the symptoms in your youngster.


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


COMMENTS:

•    Anonymous said… 13 yr old with aspergers and adhd
•    Anonymous said… Having answers doesnt change your little fellows . He is the se boy . Find all the good traites to his syndrome and concentrate on intervention. I have a beautiful 8 yrs old boy and the stress i felt has lessoned as i can now get help . All the best.
•    Anonymous said… I feel your pain we have a 10 year old adopted daughter that we are lost with
•    Anonymous said… I'm there with you--my 10 year old son-who isn't CD but ADHD- is like a light switch--just a flip of the switch and he's like a different child--angry, 'mouthy', etc. But, like the light switch, can switch right back and be the calm, pleasant boy we know.
•    Anonymous said… It is a difficult road, but it will get better.
•    Anonymous said… It really does get better. Really, it does. I met my stepson 4 years ago and he has come such a long way. I went from having to pretty much follow him everywhere he went to make sure he was safe and not running away to now he can walk to school with the other kids. We still have our moments but they are so much easier to deal with. Consistancy is the key!
•    Anonymous said… Maturity does wonders, but we wouldn't have survived and made it in public school, until he was a junior, without medication. We treated the anxiety of Aspergers and later dealt with the ADD for school goals. He is a white food eater so any food approaches were not available to us. Early on we had many incidences of out of control emotion and frustration....Prozac and Abilify finally stabilized our son. Home school allowed us to remove the ADD meds...he works cooperatively at his pace. He is now 17....and has grown out of his control issues and reactive behavior.
•    Anonymous said… My 13 year old has Asperger's and ADHD, diagnosed when he was 10. Best advice I can give is keep a consistent schedule. Post checklists and schedules everywhere to keep everyone accountable. Limit computer/TV/game system time. We are also in weekly therapy for assistance with coping with anxiety, social groups, and on medication for the anxiety and ADHD, both at very low doses.
•    Anonymous said… My 7 year old daughter has just diagnoised with Adhd and aspergers. It is not easy we are still learning at this stage it is a hard journey and I am sure it is just the start. X
•    Anonymous said… My 8 year old son was diagnosed with ADHD and ODD at 5 years of age and has had a diagnosis of HFA. After working with Autism for 30 years. His diagnosis was no surprise. Unfortunately there is not a lot of support for our HFA kids. How ever sites like this makes you realise your not on your own. And you can pick up lots of information from parents in the same boat.
•    Anonymous said… My daughter turned 17 in sept, i also found out finally that she has ASD aswel xx we have our ups an downs, but I wouldn't changer her x
•    Anonymous said… My son 15 has exactly same condition. It's been few ups and down, but he is doing very well now. He is in mainstream high school. Message me in here, if you like to chat. It's helps to talk about it. We've been there. This journey will continue forever, however, not all bad
•    Anonymous said… My son has adhd asd language prossesing disorder.spd age 11
•    Anonymous said… My son has been dignosed with a regulatory disorder it where he acts out 7 different disorders which are aspergers adhd add and autism and sensory and other ones but the one he shows the most is aspergers and autism if anybody out there has any tips to get them to listen to you when needed I have tryed many different ways to get him to listen to me
•    Anonymous said… My son is 16. Undiagnosed as yet . Takes forever in UK. He probably has Asperger's. Is very bright. Model pupil at school. At home very uncommunicative. Doesn't eat with the family. Anything that upsets him leads to a retaliation. He has cut electric leads to my radio, thrown my clothes round my room, broken raw eggs including shells into cooked pasta, thrown an egg against granite splash back, poured a bottle of cooking oil down the sink. This morning went down to find he had thrown uncooked mince into the sink and broken off wooden trim in my kitchen. I have sought help by speaking to CAMHS , the mental health dept for kids, but he has refused to go to appointments and when someone came to the house he kicked off when they left. We are quite religious but never ask him to join us in prayer. We call him for meals and I try and make food he likes or stock up on pizza, quiche , cheese pasties....whatever. The trigger yesterday was that I forgot to get quiche. I have been told to talk to him that he has to learn to control his emotions. We all feel upset must learn not to act out our frustrations. My added problem is that my 2 year old has been diagnosed with a very rare muscle condition and needs a great deal of care equivalent to a baby of 6 months. I have 2 other kids aged 14 and 9 who are being squeezed out because of the needs of their siblings. So I try and make special time for them. Communication is the main problem with my eldest.
•    Anonymous said… My son is almost 12 so I've been there. It does get better. We used medication for about 2 years to help him clearly think. We used concerts because it had the least side effects and is out of the system in 12 hours. When we decided to homeschool we stopped the meds and started using essential oils. It is very important to have the same or close to the same routine every day. Don't surprise him with something last minute or it will cause a meltdown. We also did family therapy for a while to help him realize getting so angry was his choice not something we were doing to him. He still has some ego issues and if he feels he is right there is no telling him he is wrong. He totally compares with Sheldon off the big band theory. It does get better just keep you're head up and make sure you let him know when something isn't exceptable.
•    Anonymous said… Need more details! Do you mean following your instructions and directions? Or acknowledging your voice when you are simply trying to gain his focus? What does he do in those situations and what have you tried? Then I can share my insight with you, would love to help. Ty
•    Anonymous said… Pathological demand avoidance , conduct disorder call it what you want .... Life is miserable and tense!
•    Anonymous said… Same. My son is 7, but I hope he doesn't get conduct disorder. He's got some pretty serious angry outbursts.
•    Anonymous said… There is a clear link between aspergers, add, and odd and allergies Still trying to work out what it is
•    Anonymous said… Yes 2 out of 3 of my sons have autism. My 12 yr old has autism, he is verbal and high function. My 11 yr old has Aspergers and ADHD. It also is a daily struggle, but it has been a long road to get to this point. They do talk therapy , IEP'S and medications for anxiety, depression, hyperactivity and inattention. Overall with these interventions, love and support they are progressing daily...but it can be a daily struggle. Feel free to private message me if you would like any advice. Best wishes
•    Anonymous said… I am looking in to the option of homeschooling but many disagree.
•    Anonymous said… I often wonder if there aren’t so many more undiagnosed kids out there judging by the amount of children who are disruptive in certain ways & who also show signs of Aspergers.
•    Anonymous said… It depends. Everyone’s different, but my son works best one on one, full attention... work done on computer / tablet He so smart and knows it, but anxiety issues don’t let him get it all out until comfortable . Of course include times of socialization, time with peers( if you can) my son likes his alone time mostly. Advocate helped.
•    Anonymous said… My son 16 yr ASD ADHD + ODD. Always remember that your child is a complicated combination. Every specialist letter about our son starts with "Ben is a very complex boy..................". When attending therapies or looking for strategies to help your child remember, to consider each condition has an influence on your childs behaviour. Over all what we find with our boy is that the ASD (aspergers) makes him anxious, timid, routine driven and socially awkward at times. The ADHD overides this sometimes, he can be forward, busy, loud and in your face. The ODD makes him reluctant and suspicious to follow instructions blindly, he questions everything and clashes with peers and teachers. But all together he is funny, loving, smart, friendly, helpful, great with younger kids, I could go on and on. But as I said my advice is always keep in mind his multiple conditions because what works for one doesnt work for the other, you have to become a detective and work out what suits your child in particular.
•    Anonymous said… My son had a late diagnosis finally,after all the years of stress, problems at school,ect( too much to list) at12 yrs old. He is 14 now. We still have our days,he’s going into HS but home schooling works best. Getting an advocate was on of the best things we did. And having his 504 plan and IEP /ARD in order is key!!
•    Anonymous said… Not specifically, but I have a child diagnosed with ADHD and ODD (as well as a few other things) and is suspected of being on the spectrum, but they're not comfortable diagnosing, yet. I also have an Aspie who can be rather aggressive and mean and when he was 12, I had to give him more freedom through the day in order to have a calmer, more agreeable child in the home. What helped the first child (ADHD, ODD) was dietary changes. I took her to an integrative medicine doctor and got a full work up, as we'd been told for years that she had no allergies, etc, and I just couldn't believe she would behave those ways unless something was going on in her body. I was correct and we had to put her on a special diet. It's like night and day. She's so much gentler and kinder and cooperative now. Less hostile, less anxious (we also found out she has an anxiety problem, which the dietary changes also helped). Interestingly enough, my Aspie also has dietary issues. They both have bodies that find it hard to detox on a standard American diet, no matter how healthy it is. They need to mostly eat foods in their natural states or as close to it as possible. Ms. ADHD has confirmed methylation issues (possibly MTHFR mutation, but we haven't tested for that, yet...the integrative medicine doctor tested for methylation pathway blockages without needing to do a genetic test). I truly believe that behavioral issues in children are directly related to a biological cause, if we find it. I don't mean simply a different neurological type, but an actual biological cause (usually in the gut, check out info on the gut-brain connection). I hope something I shared helps. Good luck!
•    Anonymous said… One of our biggest struggles is the uneducated people who assume and judge, it’s sad. But my close family members rule!!!!!
•    Anonymous said… What I really want to say is, when my son doesn’t want to go, Cries, gets sick, has anxiety... goes to Nurse, misses class, teachers are not on board ..calls to come get him and it happens all the time. It’s What’s best.. homeschool.
•    Anonymous said… Yes, our son has both. The high functioning ASD proves to be more of a challenge to manage than ADHD. The only advice we have is that both parents doing the same things in terms of management & working together. We find one parent dealing with a problem/meltdown works-not both parents. We take it in turns so we give each other a break. We just take each day as it comes-cos we never know when our son may need extra support. We did buy ear defenders which have worked well for him. Look after yourselves too. And don't beat yourselves up if you get it wrong now & again-this is a constant learning curve & every child is different. Good Luck, but bet you're already doing great xx
•    Anonymous said… Yes. With those same challenges. Private violin lessons , art and Planned one on one with a friend. Also , school counseling, OT, He still has social challenges.  

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The Difference Between Asperger's and Autism

"What is the real difference between Asperger's Syndrome and Autism? When I tell people that my daughter has Asperger's, they usually ask me, 'What is Asperger's exactly?' And I say, 'It's a form of Autism.' But that doesn't really help them to understand Asperger's since there is supposedly a big difference between the two disorders."

There is a great deal of confusion when it comes to the differences between Aspergers (high functioning autism) and Autistic Disorder. It seems that even medical professionals have difficulty determining a clear line between the two disorders. Often, it boils down to simply categorizing children according to the specific traits they exhibit, such as how they use language. However, there are some professionals who assert that Aspergers and Autism are actually the same disorder and should both fall under the heading of Autism.

Click here for more information on the new criteria for Autism as described in the DSM 5.

It's important to understand Pervasive Developmental Disorders (PDDs) when trying to determine the differences (or lack thereof) between Aspergers and Autism. PDDs are neurobiological disorders that include a wide spectrum of conditions, including Aspergers and Autism. PDDS are marked by much delayed or significantly lacking social and language skills. A child with a PDD will usually have problems communicating with others and understanding language. Often, children with these conditions ignore or fail to understand facial expressions, and they may not make eye contact as most people expect in social situations.

Autism is the most well known of the disorders classified as PDDs. Autistic kids look just like everyone else. It is their behavior that is different, and they appear withdrawn and often resist to change. They tend to throw tantrums, shake, flap or move their bodies in odd ways, and laugh or cry for what seems like no reason.

Kids with Autism may play in a way that it considered odd and exhibit obsessive attachments to certain objects. They may act as if they are deaf, ignore verbal cues, repeat certain words over and over again, or be entirely non-verbal. In those who are verbal, a lack of ability to start a conversation is often evident.

Aspergers is often considered within the spectrum of Autism. A child with Aspergers may exhibit odd or abnormal verbal communication skills. He may also avoid peer relationships, lack interest in others, fail to return emotional feelings, form obsessive attachments to subjects of interest, and have repetitive behaviors. He may exhibit repetitive movements, such as flapping or twisting. Interestingly, children with Aspergers generally do not experience delays in language or cognitive development, and they are often very curious about their environment.

It is important to note that not all children with Aspergers and Autism lack the ability to function normally. Some are considered highly-functioning and are capable of caring for themselves and interacting socially. However, these young people are usually seen as odd or eccentric because they still have behaviors that don't mesh with what most people consider normal.

Since Aspergers and Autism are seen as so similar, some people draw a line between the two at language development and social awareness. It seems that those with Aspergers typically have more normal language development, though many still have disordered language and communication skills. Kids and teens with Aspergers also tend to be more interested in - and aware of - social interactions than those with Autism. However, social skills must be taught and even practiced, as they generally don't come naturally to young people with this disorder.

My Aspergers Child: How to Prevent Meltdowns and Tantrums


 COMMENTS:

•    Anonymous said... According to the DSMV, there is no difference. It's now High Functioning Autism at level 1 -2.
•    Anonymous said... Going thru the same situation with my 16 year old son and his school. They wont acknowledge his aspergers diagnisis.
•    Anonymous said... I don't bother getting into a lot of details, I just say "In her case, her main struggles are _______, but others may have different difficulties" With the school, teachers etc I go into more detail.
•    Anonymous said... i think its hard for people to understand autism and talking... they hear autistic and think oh well how cause she can talk and look at me and has friends... i just tell people she has high functioning and still struggles with a lot of the same things as a severe autistic child but in a less severe form... most people tend to understand that.
•    Anonymous said... It is on the Autism spectrum and is high functioning autism.
•    Anonymous said... It's a social delay. The way in which they relate to others. That's what I tell my son about himself. Then I give him examples of his behavior and he understands it. He can't control it yet, but, I'm giving him awareness of it so he can be mindful of his actions.
•    Anonymous said... It's not hfa. Hfa usually involves speech issues, meaning not talking. Not unable to talk just introverted in a way. Aspies generally talk, and quite well. From my experience anyway:)
•    Anonymous said... People seem to get Autism for the most part. I just tell them my son has high functioning Autism and it affects things like his social skills, eye contact and coordination.
•    Anonymous said... That's a good question. I have a 9 year old with Asperger's and go through the same thing. It's hard to explain to someone who doesn't understand Autism at all.
•    Anonymous said... The individual is their own unique self, and their needs are their needs, just like anyone else. It really doesn't matter what anyone wants to call it. The only real usefulness for either label is as an indicator that says, "we need to keep looking".
•    Anonymous said... With the dx coding changes I just say he's HFA now. It's easier for most to understand that and the school works with it easier

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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
By

Raising Aspergers Children: Symptoms and Parenting Strategies

Aspergers (high functioning autism) is a developmental disorder falling within the autistic spectrum affecting two-way social interaction, verbal and nonverbal communication and a reluctance to accept change, inflexibility of thought and to have all absorbing narrow areas of interest. Individuals are usually extremely good on rote memory skills (facts, figures, dates, times etc.) many excel in math and science. There is a range of severity of symptoms within the syndrome, the very mildly affected youngster often goes undiagnosed and may just appear odd or eccentric.

While Aspergers is much more common than Autism it is still a rare condition and few people, including professionals, will know about it much less have experience of it. It seems to affect more boys than girls. In general terms they find making friends difficult, not understanding the subtle clues needed to do so. They often use language in a slightly odd way and take literal meanings from what is read or heard. They are happiest with routines and a structured environment, finding it difficult to decide what to do they fall back on to their preferred activities. They love praise, winning and being first, but find loosing, imperfection and criticism very difficult to take. Bad behavior often stems from an inability to communicate their frustrations and anxieties. They need love, tenderness, care, patience and understanding. Within this framework they seem to flourish.

Kids with Aspergers are for the most part bright, happy and loving kids. If we can help break through to their 'own little world' we can help them to cope a little better in society. They have a need to finish tasks they have started. Strategies can be developed to reduce the stress they experience at such times. Warnings that an activity is to finish in x minutes can help with older kids. With younger kids attempts to 'save' the task help - videoing a program, mark in a book etc.

As the kids mature some problems will get easier, but like all other kids new problems will emerge. Some teenagers can feel the lack of friendships difficult to cope with as they try hard to make friends in their own way but find it hard to keep them. This is not always the case, many have friends who act as 'buddies' for long periods of time. Social skills will have to be taught in an effort for them to find a place in the world ... so take all opportunities to explain situations time and time again ..... and one day.......it may work!

Please bear in mind that booklets such as this do tend to detail all the problems which can be found within a syndrome but that does not mean every youngster will have all of them. Each youngster will also have different levels of achievements and difficulties. They are after all just as the others ... individuals!

Is Aspergers The Same As Autism?

The debate on this question still continues, some experts say that Aspergers should be classified separately, others argue that the core difficulties are the same, only the degree to which they are seen in the kids actually makes the difference. One expert - Uta Frith - has referred to Aspergers kids as 'Having a dash of Autism'.

Autism is often interpreted as a withdrawal from normal life - to live in the persons own fantasy world. This is no longer the real meaning of Autism. The severity of the impairments is much greater than in Aspergers, and often the youngster will have little or no language. Learning problems are more common in classic Autism. In Aspergers speech is usual and intelligence (cognitive ability) is usually average or even above average.

For the moment it is taken that the similarities are enough for both Autism and Aspergers to be considered within the same 'spectrum' of developmental disorders. Whilst a clear diagnosis is essential, it can change through life. The autistic traits seen in young kids can often seem less severe as the youngster matures and learns strategies to cope with his/her difficulties.

Key Features—

The main areas affected by Aspergers are:

• Communication
• Narrow Interests / Preoccupation's
• Repetitive routines / rituals, inflexibility
• Social interaction

Social Interaction—

Kids with Aspergers have poor social skills. They cannot read the social cues and, therefore, they don't give the right social and emotional responses. They can lack the desire to share information and experiences with others. These problems are less noticeable with moms and dads and adults, but it leads to an inability to make age appropriate friends. This in turn can lead to frustration and subsequent behavior problems. They find the world a confusing place. They are often alone, some are happy like this, others are not. They are more noticeably different among peer groups in unstructured settings i.e. playgrounds. Their naiveté can cause them to be bullied and teased unless care is taken by assistants or buddies to integrate and help protect them. They can often focus on small details and fail to see the overall picture of what is happening in any situation.

Communication—

Both verbal and nonverbal communications pose problems. Spoken language is often not entirely understood, so it should be kept simple, to a level they can understand. Take care to be precise. Metaphor s (non-literal expressions - 'food for thought') and similes (figures of speech - 'as fit as a fiddle') have to be explained as kids with Aspergers tend to make literal and concrete interpretations. Language acquisition - learning to speak - in some cases can be delayed. They make much use of phrases they have memorized, although they may not be used in the right context. A certain amount of translation may be needed in order to understand what they are trying to say.

Spoken language can sometimes be odd, perhaps they don't have the local accent or they are too loud for a situation or overly formal or speak in a monotonous tone. If the youngster with Aspergers has a good level of spoken language you must not assume their understanding is at the same level. Some talk incessantly (hyper verbal) often on a topic of interest only to themselves without knowing the boredom of the listener.

Difficulties in using the right words or forming conversations are part of semantic-pragmatic difficulties. They appear often to talk 'at' rather than 'to' you, giving information rather that holding proper conversations. Body language and facial expressions of a youngster with Aspergers can appear odd (stiff eye gaze rather than eye contact) and find 'reading' these things in others gives rise to further difficulties. Early age is known as Hyperlexia. Some kids have remarkable reading abilities although you should check if they also understand the text. The ability to read fluently without understanding the meaning is known as Hyperlexia.

Narrow Interests / Pre-occupations—

One of the hallmarks of Aspergers is the youngster's preoccupation (or obsession) with certain topics, often on themes of transport - trains in particular-or computers, dinosaurs, maps etc. These pre-occupations, usually in intellectual areas change over time but not in intensity, and maybe pursued to the exclusion of other activities.

Repetitive Routines / Inflexibility—

Kids often impose rigid routine on themselves and those around them, from how they want things done, to what they will eat etc. It can be very frustrating for all concerned. Routines will change from time to time, as they mature they are perhaps a little easier to reason with. This inflexibility shows itself in other ways too, giving rise to difficulties with imaginative and creative thinking. The youngster tends to like the same old thing done in the same old way over and over again!. They often can't see the point of a story or the connection between starting a task and what will be the result. They usually excel at rote memory - learning information without understanding, but it can still be an asset. Attempts should always be made to explain everything in a way they can understand. Don't assume because they parrot information back that they know what they are talking about.

Education—

If the youngster with Aspergers is to be educated in a mainstream school it is important that the correct amount of support is made available. In order to get the correct support a Statement of Special Educational Needs should be drawn up from the various advice supplied by you and the specialists. This procedure, when it begins, can take 6 months and be a very stressful and confusing time - don't be afraid to contact people who can help, this need not be a professional it may just be someone who has done it all before.

It is beneficial if the school of your choice is willing to learn about the difficulties that they and the youngster will face, some schools are better than other on this score. Looking at several schools will give a better picture of exactly what is available. The support currently offered in mainstream school is by Special Support Assistants (SSA) for a certain number of hours each week based on the youngster's needs in order to help the youngster access the curriculum and develop in a social setting. A support teacher with specialist knowledge of Autism should support the youngster, SSA, teacher and school in understanding and teaching the youngster. Other professional input may also be required such as speech and language therapy to help develop skills.

The home/school link is vital, a diary can prove invaluable giving two way communication on achievements and problems on a regular basis.

Parenting Strategies—

Parenting your youngster with symptoms of Aspergers can be a daunting task. You may have just discovered that your youngster has a diagnosis of AS and you are thinking “What now?” Or you may have a youngster who you know is different and/or a health professional has said that he or she has some attributes of Aspergers or Mild Aspergers but is still considered in the normal range. You are probably feeling a little overwhelmed and it might seem like you are the only person or family going through these issues. We know because that’s exactly how we felt.

Like you, we are moms and dads who would like nothing more than for all of our kids to reach their maximum potential. Because they only match some of the assessment criteria needed for an Aspergers diagnosis, we have had to find help for our kids ourselves. And we have found this help in some of the most unexpected places. This makes us uniquely positioned to show you how to get help from a variety of sources for your “normal” youngster or kids.

I wonder, do your youngster’s specific behavioral problems seem worse after lunch or a party? He or she may be intolerant to certain types of food. We can give you information about food intolerances and share with you our expertise of what we have learned. While there is not much scientific evidence that foods affect AS, we can show you information that you may want to look into.

Have you noticed that your youngster doesn’t like loud noises, bright lights, tight or loose fitting clothes and reacts inappropriately to any of these particular things? Does your youngster crave fast movement or are they almost impossible to get moving in the morning? The good news is there is an answer. They may have Sensory Integration Disorder (SID). There is growing evidence that links SID and Aspergers. Sensory Integration Disorder is easily manageable with techniques you can learn and do at home.

Do you find routines hard to establish and maintain? Using Visual Aids for your Aspergers youngster might just benefit you and your youngster as it has benefited us.

Moving Forward—

All this might seem a little daunting at the moment. However, with experience and help, including ours, you can teach your youngster to rule their Aspergers rather than have their Aspergers rule them.

On the pages of this site, you will find reference to many useful books and resources that help us and our kids cope with life. The books include those on AS as well as Sensory Integration and Food intolerances. You will also find information and links to other sites that provide information on other disorders related to Aspergers.

There are many things you can do to help your youngster better understand the world and in doing so make everyone's lives a little easier. The ideas below are only suggestions which you may or may not find helpful:
  • Begin early to teach the difference between private and public places and actions, so that they can develop ways of coping with more complex social rules later in life.
  • Don't always expect them to 'act their age' they are usually immature and you should make some allowances for this.
  • Explain why they should look at you when you speak to them.... encourage them, give lots of praise for any achievement - especially when they use a social skill without prompting.
  • Find a way of coping with behavior problems - perhaps trying to ignore it if it's not too bad or hugging sometimes can help.
  • In some young kids who appear not to listen - the act of 'singing' your words can have a beneficial effect.
  • Keep all your speech simple - to a level they understand.
  • Keep instructions simple ... for complicated jobs use lists or pictures.
  • Let them know that you love them - wart's an' all' - and that you are proud of them. It can be very easy with a youngster who rarely speaks not to tell them all the things you feel inside.
  • Limit any choices to two or three items.
  • Limit their 'special interest' time to set amounts of time each day if you can.
  • Pre-warn them of any changes, and give warning prompts if you want them to finish a task... 'when you have colored that in we are going shopping'.
  • Promises and threats you make will have to be kept - so try not to make them too lightly.
  • Teach them some strategies for coping - telling people who are teasing perhaps to 'go away' or to breathe deeply and count to 20 if they feel the urge to cry in public.
  • Try to build in some flexibility in their routine, if they learn early that things do change and often without warning - it can help.
  • Try to get confirmation that they understand what you are talking about/or asking - don't rely on a stock yes or no - that they like to answer with.
  • Try to identify stress triggers - avoid them if possible -be ready to distract with some alternative 'come and see this...' etc.
  • Use turn taking activities as much as possible, not only in games but at home too.

Remember, they are kids just like the rest, they have their own personalities, abilities, likes and dislikes - they just need extra support, patience and understanding from everyone around them.


Children with Aspergers: Tips for Teachers and Parents

Children with Aspergers are unique, and they can affect the learning environment in both positive and negative ways. In the classroom, the Aspergers child can present a challenge for the most experienced teacher. These children can also contribute a lot to the classroom because they can be extremely creative and see things and execute various tasks in different ways. Teachers can learn a lot when they have a child with Aspergers in their class, but the teacher may experience some very challenging days too.

Here are some tips for teachers and parents to consider:

Aspergers children and showing work: Many teachers require children to "show their work"; in other words, illustrate how they got the answer to a problem."Showing work" is a demand that usually accompanies math homework. This may not be the best strategy with the Aspergers child, and may in fact lead to a big disagreement with the child. Since many Aspergers children are visual learners, they picture how to solve the problem in their heads. To make them write out how they got they answer seems quite illogical to them. Why would you waste your time writing out something you can see in your head? The requirement of "showing work" simply does not make any sense to them, and it may not be worth the time it would take to convince them to do the requirement anyway.

Aspergers children frequently are visual learners. Despite difficulties with eye contact, many Aspergers children are visual learners. Much of the information presented in classrooms is oral, and often children with Aspergers may have difficulty with processing language. Often they cannot take in oral language quickly, and presenting information visually may be more helpful. Many Aspergers children are "hands-on" learners.

Avoid demanding the child with Aspergers maintain eye contact with you. Eye contact is a form of communication in American culture; we assume a person is giving us their attention if they look at us. The Aspergers child experiences difficulty with eye contact; it is extremely hard for them to focus their eyes on a person for any extended period of time. Limited eye contact is a part of the disability. Don't demand an Aspergers child look you in the eye as you are talking to them--this is extremely difficult for them to do.

Don't assume the child with Aspergers is disrupting class or misbehaving to get attention. More often than not, children with Aspergers react to their environment, and sometimes the reaction can be negative. Sometimes the child may be reacting to a sensory issue, and other times the child may be reacting to a feeling of fear. The Aspergers child feels fear because of a lack of control over his/her response to the environment or because of a lack of predictability. The child with Aspergers does best with clear structure and routine. A visual schedule can be helpful for the child.

Every youngster with Aspergers is different. As a teacher you want to take the information you have acquired and apply it, but every Aspergers child is different, so it's difficult to take knowledge you have gained from one experience, and apply it to a situation with another child with Aspergers. Remember that each youngster with Aspergers is unique, and strategies that have worked with other children in the past may not work effectively with the Aspergers child because they perceive the world in a unique way, and they sometimes react to their environment in unpredictable ways.

If the child with Aspergers is staring off into space or doodling, don't assume they're not listening. Remember the Aspergers child may experience difficulty with communication, especially nonverbal communication. What appears to the teacher to be behavior illustrating a lack of attention on the part of the child may not be that at all. In fact, the Aspergers child who is doodling or staring off may actually be trying to focus him or herself through the act of doodling or staring. The child is unaware that nonverbally s/he is communicating to the teacher that "I'm not listening, or I'm bored." Doodling or staring may actually help the child with Aspergers focus more on what the teacher is presenting. You might simply ask the child a question to check if he or she is listening.

Sensory issues affect learning for the child with Aspergers. Often Aspergers children are distracted by something in the environment that they simply cannot control. To them, the ticking of the clock can seem like the beating of a drum, the breeze from an open window can feel like a tremendous gust, the smell of food from the cafeteria can overpower them and make them feel sick, the bright sunshine pouring through the windows may be almost blinding to them. This sensory overload the Aspergers child experiences may overwhelm them, so focusing can be difficult and frustration occurs. Frustration can then lead to disruptions from the child. To cope with frustration the child might choose to repeatedly tap a pencil on a desk (or another disruptive behavior) to focus themselves because s/he is experiencing sensory overload. What appears disruptive to the teacher and the rest of the class may actually be a way for the Aspergers child to cope with the sensory overload. Obviously, a teacher does not want disruptions in the classroom. Take time to evaluate the classroom in terms of sensory stimulation, and how the environment affects the child with Aspergers. Perhaps some modifications can be made, or the child can be taught some coping skills that are not disruptive to classmates, like squeezing a squishy ball in their hand or some similar activity.

Children with Aspergers experience difficulty with transitions. Often a child with Aspergers gets "stuck" and has difficulty moving from one activity to another. They may need to be coached through the transition, and if a typical school day is loaded with lots of transitions, the child faces increased anxiety. Moving from one activity to another is not a challenge for most children, but for the child with Aspergers transitions can be monumental tasks. Some possible strategies a teacher, paraprofessional, or parent can use: visual schedules, role-playing or preparing the child by discussing upcoming activities. Appropriate strategies are dependent on the age of the child and his/her abilities.

Children with Aspergers may experience difficulties with focusing as well as lack of focus. Focus involves attention. Sometimes Aspergers children focus all their attention on a particular object or subject; therefore, they fail to focus on what information the instructor is presenting. All their energy is directed toward a particular subject or object. Why? Because that object or subject is not overwhelming to them and they understand it. To overcome this problem, the teacher can try to establish some connection between the object or subject of interest and the area of study. For example, if a child is fascinated with skateboarding, the child could learn reading and writing skills through researching a famous skateboarder and writing a report. Math skills could be taught by looking at the statistics involving competitive skateboarders. The possibilities for instruction are endless, but it will take some time and creative planning on the part of the teacher.

As a teacher, paraprofessional or parent of a youngster with Aspergers, it's important to recognize the youngster's gifts as well as limitations. Children with Aspergers present a challenge for the people who work with them, but these kids also enrich our lives. So when you're feeling frazzled, take a deep breath and remember that tomorrow is another day. This youngster will grow up and make a contribution to our world in some way we can only imagine, and you can help this youngster.

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