Depression in Teenagers with Autism Spectrum Disorder [Level 1]

"How have some of you dealt with a depressed teenager? My autistic son is 16 (high functioning) and a loner. His self-esteem is shot, and we're worried. Any advice is greatly appreciated!!!"

Adolescents suffer from depression more often than any number of grown-ups who live their entire lives with it. Moms and dads are generally dismissive of their child’s low moods, because they think that ALL teenagers are simply moody, hormonal, or tired and cranky. 

 

This dismissive attitude generally results in teenagers being even more depressed, because they think their mother or father doesn’t care. Take that in combination with adolescents with High-Functioning Autism (HFA) or Asperger’s (AS) who have very little impulse control as it is, and you have a horrible combination.

Depression is a serious medical problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenage son or daughter thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although mood disorders like depression can occur at any time in life, symptoms are significantly more pronounced in adolescents than grown-ups. To make matters worse, the HFA/AS teen’s depressive symptoms are usually more pronounced than that of a “typical” teen.

Issues such as peer pressure, peer rejection, bullying, academic expectations and changing bodies can bring a lot of ups and downs for HFA and AS adolescents. But for some of these young people, the lows are more than just temporary feelings — they're a symptom of depression. Adolescent depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most HFA and AS adolescents, depression symptoms ease with treatment (e.g., medication and psychological counseling).

Adolescent depression signs and symptoms include changes in your HFA/AS adolescent's emotions and behavior, such as the examples below. Be alert for emotional and behavioral changes, such as:

• Agitation or restlessness (e.g., pacing, hand-wringing or an inability to sit still)
• Changes in appetite (e.g., decreased appetite and weight loss, or increased cravings for food and weight gain)
• Disruptive or risky behavior
• Extreme sensitivity to rejection or failure, and the need for excessive reassurance
• Feelings of sadness, which can include crying spells for no apparent reason
• Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism
• Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
• Frequent thoughts of death, dying or suicide
• Insomnia or sleeping too much
• Irritability, frustration or feelings of anger, even over small matters
• Loss of interest in, or conflict with, family and friends
• Loss of interest or pleasure in normal activities
• Neglected appearance (e.g., mismatched clothes and unkempt hair)
• Ongoing sense that life and the future are grim and bleak
• Poor school performance or frequent absences from school
• Self-harm (e.g., cutting, burning, or excessive piercing or tattooing)
• Slowed thinking, speaking or body movements
• Tiredness and loss of energy
• Trouble thinking, concentrating, making decisions and remembering things
• Use of alcohol or drugs

It can be difficult to tell the difference between (a) ups and downs that are just part of being a young person and (b) full-blown depression. Talk with your teenage son or daughter. Try to determine whether your youngster seems capable of managing challenging feelings, or if life seems overwhelming. If depression symptoms continue or begin to interfere in your HFA/AS adolescent's life, talk to a physician or a mental health professional trained to work with these teens. Your adolescent's family physician is a good place to start. Your adolescent's school may recommend someone as well.

If you suspect your “special needs” son or daughter is depressed, make a physician's appointment as soon as you can. Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed adolescents may be at risk of suicide, even if signs and symptoms don't appear to be severe.  If you're an adolescent and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your physician or school nurse. Share your concerns with a mother or father, a close friend, your pastor, a teacher or someone else you trust.

==> Discipline for Defiant Aspergers and HFA Teens

If your teenage son or daughter is having suicidal thoughts, get help right away. Take all talk of suicide seriously. Here are some steps you can take:

• Seek help from your physician, a mental health provider or other health care professional.
• Reach out to family members, friends or spiritual leaders for support as you seek treatment for your HFA/AS adolescent.
• Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your HFA/AS adolescent to do so.

If you think your teenage son or daughter is in immediate danger of self-harm or attempting suicide, make sure someone stays with her or him. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your HFA/AS adolescent to the nearest hospital emergency department.

It's not known exactly what causes depression. A variety of factors may be involved. These include:

• Learned patterns of negative thinking. Adolescent depression may be linked to learning to feel helpless — rather than learning to feel capable of finding solutions for life's challenges.
• Inherited traits. Depression is more common in individuals whose biological (blood) relatives also have the condition.
• Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
• Early childhood trauma. Traumatic events during childhood (e.g., physical or emotional abuse, loss of a mother or father, etc.) may cause changes in the brain that make a teenager more susceptible to depression.
• Biological chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. When these chemicals are out of balance, it may lead to depression symptoms.

Many factors increase the risk of developing or triggering adolescent depression, including:

• Abusing alcohol, nicotine or other drugs
• Being a female (depression occurs more often in females than in males)
• Being bullied or rejected by peers
• Being gay, lesbian, bisexual or transgender (becoming socially isolated or experiencing bullying may increase the risk of depression)
• Having a chronic medical illness (e.g., cancer, diabetes or asthma)
• Having been the victim or witness of violence (e.g., physical or sexual abuse)
• Having certain personality traits (e.g., low self-esteem or being overly dependent, self-critical or pessimistic)
• Having few friends or other personal relationships
• Having issues that negatively impact self-esteem (e.g., obesity, peer problems, long-term bullying or academic problems)
• Having other conditions (e.g., anxiety disorder, anorexia or bulimia, attention-deficit/hyperactivity disorder or learning disabilities)

Family history and issues with family or others may also increase your HFA/AS adolescent's risk of depression:

• Having a dysfunctional family and conflict
• Having a family member who committed suicide
• Having a mother or father, grandparent or other biological (blood) relative with autism, depression, bipolar disorder or alcoholism
• Having experienced recent stressful life events (e.g., parental divorce, parental military service or the death of a loved one)

Untreated depression can result in emotional, behavioral and health problems that affect every area of your HFA/AS adolescent's life. Complications related to adolescent depression can include:

• Academic problems
• Alcohol and drug abuse
• Family conflicts and relationship difficulties
• Involvement with the juvenile justice system
• Low self-esteem
• Social isolation
• Suicide

You may choose to start by contacting your HFA/AS adolescent's family physician. In some cases, you may be referred directly to a mental health professional, such as a psychiatrist or psychologist.

To the extent possible, involve your teenage son or daughter in preparing for the appointment. Then make a list of:

• Questions that you and your HFA/AS adolescent want to ask the physician
• Key personal information, including any major stresses or recent life changes your HFA/AS adolescent has experienced
• Any symptoms your adolescent has had, including any that may seem unrelated to the reason you scheduled the appointment
• All medications, vitamins, herbal remedies or supplements that your HFA/AS adolescent is taking

Basic questions to ask the physician include:

• Are there any possible side effects with the medications you're recommending?
• Are there any printed materials that we can take home?
• Are there any restrictions that my adolescent needs to follow?
• How will we monitor progress and effectiveness of the treatment?
• Is depression the most likely cause of my youngster's symptoms?
• Is there a generic alternative to the medicine you're prescribing?
• My adolescent has these other health conditions. Could they be linked to depression?
• Should my adolescent see a psychiatrist or other mental health provider?
• What are other possible causes for my youngster's symptoms or condition?
• What are the alternatives to the primary approach that you're suggesting?
• What kinds of tests will my youngster need?
• What treatment is likely to work best?
• What websites do you recommend?
• Will making changes in diet, exercise or other areas help ease depression?

To make the most of the time allotted, make sure your HFA/AS son or daughter is ready to answer questions from the physician, for example:

• Are you using any mood-altering substances, such as alcohol, marijuana or street drugs?
• Do you ever have suicidal thoughts when you're feeling down?
• Do you generally always feel down, or does your mood change?
• Do you have a history of significant weight gain or loss?
• Do you have any biological (blood) relatives — such as a mother or father or grandparent — with depression or another mood disorder?
• Does your mood ever swing from feeling down to feeling extremely happy and full of energy?
• How long have you felt depressed?
• How much do you sleep at night? Does the amount change over time?
• How severe are your symptoms? Do they interfere with school, relationships or other day-to-day activities?
• What is your diet like?
• What other mental or physical health conditions do you have?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• When did family members or friends first notice your symptoms of depression?

When adolescent depression is suspected, the physician will generally do these exams and tests:

• Lab tests. For example, your HFA/AS adolescent's physician may do a blood test called a complete blood count, or test your teen’s thyroid to make sure it's functioning properly.
• Physical exam. The physician may do a physical exam and ask in-depth questions about your HFA/AS adolescent's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem.
• Psychological evaluation. This evaluation will include a discussion with your son or daughter about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications.

To be diagnosed with depression, your teenage son or daughter must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Symptoms can be based on your HFA/AS adolescent's feelings or on the observations of someone else. For a diagnosis of major depression, the following symptoms must occur most of the day, nearly every day, during at least a two-week period, and be a change or worsening in the adolescent's usual attitude and behavior.

Your adolescent must have at least one of the following:

• Diminished interest or feeling no pleasure in any or most activities
• Depressed mood, such as feeling sad, empty or tearful (in adolescence, depressed mood can appear as constant irritability)

Your adolescent must also have four or more of the following:

• Fatigue or loss of energy
• Feelings of worthlessness, or excessive or inappropriate guilt
• Insomnia or increased desire to sleep
• Recurrent thoughts of death or suicide, making a suicide plan or a suicide attempt
• Restlessness or slowed behavior that can be observed by others
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in adolescence, failure to gain weight as expected can be a sign of depression)
• Trouble making decisions, thinking or concentrating

To be considered major depression:

• Symptoms are not caused by grieving (e.g., temporary sadness after the loss of a loved one)
• Symptoms are not due to the direct effects of something else (e.g., drug abuse, taking a medication or having a medical condition such as hypothyroidism)
• Symptoms aren't due to a mixed episode, which is mania along with depression that sometimes occurs as a symptom of bipolar disorder
• Symptoms must be severe enough to cause noticeable problems in day-to-day activities (e.g., school, social activities or relationships with others)

Other types of major depression include:

• Psychotic depression. This is severe depression accompanied by psychotic symptoms, such as delusions or hallucinations.
• Dysthymia. Dysthymia is a less severe, but more long-term form of depression. While it's usually not disabling, dysthymia can prevent your teenage son or daughter from functioning normally in a daily routine and from living life to the fullest.
• Atypical depression. In this type of depression, key signs and symptoms include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.

 ==> Discipline for Defiant Aspergers and HFA Teens

There are several other conditions with symptoms that can include depression. It's important to get an accurate diagnosis so that your HFA/AS adolescent gets appropriate treatment. Your physician or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of the following conditions:

• Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect feelings, thoughts and behavior.
• Bipolar disorder. Bipolar disorder is characterized by mood swings that range from the highs of mania to the lows of depression. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's important to get an accurate diagnosis because treatment for bipolar disorder is different from that for other types of depression.
• Cyclothymia. Cyclothymia, or cyclothymic disorder, is a milder form of bipolar disorder.
• Schizoaffective disorder. Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder such as depression.
• Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.

Many types of treatment are available. In some cases, a primary care physician can prescribe medications that relieve depression symptoms. However, many adolescents need to see a psychiatrist or psychologist or other mental health counselor. A combination of medications and psychotherapy is very effective for most HFA/AS adolescents with depression.

If your teenage son or daughter has severe depression or is in danger of self-harm, she or he may need a hospital stay or may need to participate in an outpatient treatment program until symptoms improve.

Antidepressants and increased suicide risk— Although antidepressants are generally safe when taken asdirected, the FDA requires that all antidepressants carry "black box" warnings, the strictest warnings for prescriptions. In some cases, kids, teens and young people under the age of 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. So, individuals in these age groups must be closely monitored by parents and health care providers.  If your son or daughter has suicidal thoughts while taking an antidepressant, immediately contact your physician or get emergency help.  For most HFA/AS adolescents, the benefits of taking an antidepressant generally outweigh any possible risks. In the long run, antidepressants are likely to reduce suicidal thinking or behavior.

Antidepressants and pregnancy— If your teenage daughter is pregnant or breast-feeding, some antidepressants may pose an increased health risk to her unborn or nursing youngster. If your daughter becomes pregnant, make certain she talks to her physician about antidepressant medications and managing depression during pregnancy.

Finding the right medication— Everyone's different, so finding the right medication or dose for your HFA/AS son or daughter may take some trial and error. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as the body adjusts.  If your adolescent has bothersome side effects, she or he shouldn't stop taking an antidepressant without talking to the physician first. Some antidepressants can cause withdrawal symptoms unless the dose is slowly tapered off — quitting suddenly may cause a sudden worsening of depression. Encourage your adolescent not to give up. If antidepressant treatment doesn't seem to be working, your adolescent's physician may recommend a blood test called cytochrome P450 (CYP450) to check for specific genes that affect how the body processes antidepressants. This may help identify which antidepressant might be a good choice. However, these genetic tests have limitations and may not be widely available.

Hospitalization and other treatment programs— In some HFA and AS adolescents, depression is so severe that a hospital stay is needed, especially if your son or daughter is in danger of self-harm or hurting someone else. Getting psychiatric treatment at a hospital can help keep your adolescent calm and safe until symptoms are better managed. Day treatment programs also may help. These programs provide the support and counseling needed while your adolescent gets depression symptoms under control.

Managing medications— Carefully monitor your HFA/AS adolescent's use of medications. To work properly, antidepressants need to be taken consistently at the prescribed dose. Because overdose can be a risk for adolescents with depression, your adolescent's physician may prescribe only small supplies of pills at a time, or recommend that you dole out medication so that your son or daughter does not have a large amount of pills available at once.

Medications— Because studies on the effects of antidepressants in HFA and AS adolescents are limited, physicians rely mainly on adult research when prescribing medications. The Food and Drug Administration (FDA) has approved two medications for adolescent depression — fluoxetine (Prozac) and escitalopram (Lexapro). However, as with grown-ups, other medications may be prescribed at the physician's discretion (off label), depending on your HFA/AS adolescent's needs. Talk with your adolescent's physician and pharmacist about possible side effects, weighing the benefits and risks. In some cases, side effects may go away as the body adjusts to the medication.

Psychotherapy— Psychotherapy is a general term for treating depression by talking about depression and related issues with a mental health provider. Psychotherapy may be done one-on-one, with family members, or in a group.  Through these regular sessions, your teenage son or daughter can:

• explore relationships and experiences
• find better ways to cope and solve problems
• learn how to identify and make changes in unhealthy behaviors or thoughts
• learn about the causes of depression
• set realistic goals

Psychotherapy can help your son or daughter regain a sense of happiness and control, and help ease depression symptoms like hopelessness and anger. It may also help your HFA/AS adolescent adjust to a crisis or other current difficulty.

You are your adolescent's best advocate to help her or him succeed. Here are some steps you and your “special needs” child can take that may help:

• Encourage communication with your HFA/AS adolescent. Talk to your son or daughter about the changes you're observing and emphasize your unconditional support. Create an environment where your youngster can share concerns while you listen.
• Help the HFA/AS adolescent avoid alcohol and other drugs. Your son or daughter may feel like alcohol or drugs lessen depression symptoms, but in the long run they worsen symptoms and make depression harder to treat.
• Learn about depression. Education can empower your teenage son or daughter and motivate her or him to stick to a treatment plan. It can also benefit you and other loved ones to learn about your adolescent's depression and understand that it's a treatable condition.
• Make sure your HFA/AS adolescent adopts healthy habits. Even light physical activity can help reduce depression symptoms. Sleeping well is important for all adolescents, especially those with depression. If your teenage son or daughter is having trouble sleeping, ask the physician for advice.
• Pay attention to warning signs. Work with your HFA/AS adolescent's physician or therapist to learn what might trigger depression symptoms. Make a plan so that you and your child know what to do if symptoms get worse. Ask family members or friends to help watch for warning signs.
• Stick to the treatment plan. Make sure your HFA/AS son or daughter attends appointments, even if he or she doesn't feel like going. Even if your adolescent is feeling well, make sure he or she continues to take medications as prescribed. If your child stops taking medications, depression symptoms may come back. Quitting suddenly may cause withdrawal-like symptoms.

Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for professional care. But some mind-body therapies may help.

Complementary and alternative medicine practitioners believe the mind and body must be in harmony to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

• Acupuncture
• Guided imagery
• Massage therapy
• Meditation
• Music or art therapy
• Relaxation techniques
• Spirituality
• Yoga or tai chi

Relying solely on these therapies is generally not enough to treat depression. But they may be helpful when used in addition to medication and psychotherapy.

Showing interest and the desire to understand your HFA/AS adolescent's feelings lets her or him know you care. You may not understand why your adolescent feels hopeless or why she or he has a sense of loss or failure. Listen to your “special needs” child without judging and try to put yourself in his or her position. Help build your child’s self-esteem by recognizing small successes and offering praise about his or her competence.

Encourage your HFA/AS adolescent to:

• Ask for help. Adolescents may be reluctant to seek support when life seems overwhelming. Encourage your son or daughter to talk to a family member or other trusted adult whenever needed.
• Connect with other adolescents who struggle with depression. Talking with other adolescents facing similar challenges can help your son or daughter cope. So can learning skills to manage life's challenges. Local support groups for depression are available in many communities. And support groups for depression are offered online (but check them out to make sure they're credible and trustworthy sites).
• Encourage your HFA/AS adolescent to keep a private journal. Journaling may help improve mood by allowing your child to express and work through pain, anger, fear or other emotions.
• Have realistic expectations. Many adolescents judge themselves when they aren't able to live up to unrealistic standards (e.g., academically, in athletics, in appearance, etc.). Let your teenage son or daughter know that it's OK not to be perfect.
• Make and keep healthy friendships. Positive relationships can help boost your HFA/AS adolescent's confidence and stay connected with others. Encourage her or him to avoid relationships with peers whose attitudes or behaviors could make depression worse.
• Simplify life. Encourage your son or daughter to carefully choose obligations and commitments, and set reasonable goals. Let your child know that it's OK to do less when she or he feels down.
• Stay active. Participation in sports, school activities or a job can help keep your teenage son or daughter focused on positive things, rather than negative feelings or behaviors.
• Stay healthy. Do your part to make sure your child eats regular, healthy meals, gets regular exercise and gets plenty of sleep.
• Structure time. Help your child plan activities by making lists or using a planner to stay organized.

There's no sure way to prevent depression. However, these strategies may help. Encourage your HFA/AS adolescent to:

• Boost low self-esteem by recognizing small steps toward getting better.
• Get treatment at the earliest sign of a problem to help prevent depression from worsening.
• Maintain ongoing treatment, if recommended, even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.
• Reach out for friendship and social support, especially in times of crisis.
• Take steps to control stress, for example, not committing to too many obligations at once.

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

==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder

==> Parenting Children and Teens with High-Functioning Autism: Parents' Comprehensive Handbook

==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book

==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism

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

Parenting Difficult Teenagers on the Autism Spectrum

If you are a mother or father of a teenager with Asperger’s (AS) or High-Functioning Autism (HFA), you undoubtedly have bigger challenges to overcome than you ever thought possible. There may be days where you feel all alone in your trials and tribulations. Maybe you've been so busy taking care of your teen's needs that you have not had the opportunity to seek support from those who have traveled a similar road.

As a parent of a teen on the autism spectrum, you are most likely aware that he somehow always finds a way to get under your skin.  There are so many changes going on with your teen – emotionally, psychologically, and biologically – that it’s almost impossible to understand him at times. Furthermore, his meltdowns, unpredictable temper, and natural instinct of reclusiveness may make communication nearly impossible.  If this is a challenge that you are facing, the tips listed below will help you positively parent your “special needs” adolescent. Good luck on your journey!

Tips for Parenting Difficult Teens with Asperger’s and High-Functioning Autism:

1. Accept that your AS or HFA adolescent will spend more time alone and away from family members compared to a “typical” teen.

2. Allow your adolescent to express her frustration. It’s hard enough just getting through adolescence – but for AS and HFA teens, the job is even more difficult.

3. Ask for advice from other parents of teens on the autism spectrum.

4. Assign tasks that your teen is capable of doing on his own. In this way, he will feel like he is a contributing member of the family, which is a great morale booster.

5. Be consistent with discipline. If you are not consistent with consequences, your AS or HFA adolescent will become confused about what is - and is not - acceptable. Also, when you're angry, it can be easy to make rash judgments and get carried away with loud demands or threats. Instead, wait until you are calm to set a consequence (e.g., count to 10 before responding to rude or annoying teen-behavior).

==> Discipline for Defiant Asperger's and HFA Teens

6. Don't go overboard with consequences or try to ground for weeks. If you do, your discipline will lose its effectiveness and your adolescent will look for ways to get around it.

7. Focus on the behavior, not your child’s personality. For example, say things like "It's not acceptable to lie about where you've been" instead of "You're a liar." Also, disregard the attitude and focus on the actions.

8. Be exceedingly patient. Parenting an AS or HFA teen takes extra patience with a strong dose of inner strength.  Problematic situations require a deep breath and that extra ounce of strength you really didn’t think you had. Sometimes you can find your patience and strength in a quick memory, a supporting hand, friendly advice, or even just sharing the difficult moments. 

9. Be realistic about “completion time” of chores and homework. Many AS and HFA teens need to do things “step-wise.” In other words, they have to finish what they’re currently doing before they can comfortably move on to the next task. Also, praise efforts – not just results.

10. Be your teen’s parent – not her “buddy.” Your responsibility is to ensure the well-being and safety of your “special needs” teenager. Intervening in a dangerous situation (e.g., involving drugs, abuse or truancy) might make your teenager dislike you, but it will also save her life. Don't just “go along just to get along.”

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11. Pick your battles carefully. Your adolescent will feel more resistant to what you have to say if you lecture him about every perceived transgression. Decide what's really important, and focus your efforts on those behaviors. Just address one issue at a time!

12. Encourage friendships. Loneliness is one of the main causes for challenging behavior among AS and HFA teenagers. Try to encourage opportunities for socializing and making friends.

13. Establish clear rules and guidelines for your adolescent to help her understand what behavior is acceptable. Don't just wait until she does something you don't like and then discipline her. Make sure the rules are clear from the start. Also, involve your adolescent in establishing the house rules so that if she breaks the rules, you can remind her that she played a role in setting them. Furthermore, be very specific and keep the rules simple (e.g., "In this house, we speak kindly to one another" or "Everyone must pitch in by completing their assigned house chores").

14. Look at your teen’s history. Negative events that happened during the pre-school and elementary school years help to shape a teen’s personality. By the time these kids become adolescents, many have been living with the resulting pain for most of their lives (e.g., due to peer-rejection, teasing, bullying, etc.). AS and HFA teens may feel pain and anger, but they lack the ability to act on those emotions. However, they are able to act on those emotions with more lasting and harmful consequences.

15. Expect gradual improvement, not immediate results. Your AS or HFA teen is emotionally immature compared to her same-age peers.

16. Foster independence. It’s so easy to do everything for your “special needs” teen (e.g., making all the decisions for her).  Give her the chance to do more herself and to make decisions on her own.

17. Get a dog. According to research, owning a dog can transform an AS or HFA teen’s life. Bringing a pet into your home is great for all teenagers, but can become a real friend for those with developmental disabilities. Having a pet reduces stress, can help your teen learn responsibility, improve social skills, and reduce feelings of isolation. Research has shown that dogs can calm and comfort “special needs” teenagers and help them develop the confidence to try new tasks.

18. Get a punching bag and some boxing gloves. My grandson’s behavior became very problematic when he started middle school. I found that a punching bag helped him to unwind. He used to scream at it while punching it! It was also great exercise to get rid of some of the stress and anger that accrued through his school day. Using the punching bag was his “home from school” routine each day through the week.

19. Record your moments of success and failure in a journal. Keeping a journal and recording incidents can help you to look back and see if there are any patterns or contributing factors to problematic behavior. The journal may be a good thing to look through with your teen, talking about both the positives and negatives. Also, be sure to log and monitor medications (don’t forget, medications can have side-effects that contribute to problematic behavior).

20. Try to look at your adolescent’s situation from a different perspective. In this shift of perspective, answers are often revealed and insight into what is triggering your adolescents' behavior comes into focus. Sometimes moms and dads can get un-stuck simply by looking at a situation with new eyes, which is usually followed by acting or thinking about things differently. When the parent responds in different ways, there is no choice for the adolescent but to act differently too.

==> Discipline for Defiant Asperger's and HFA Teens

21. Provide lots of structure. Write down routines as sequences of tasks (2-5 items only), and post where easily visible. AS and HFA teenagers respond well to structure and routines because it helps to nurture self-discipline and provides a sense of security.  These “special needs” teens are typically afraid of the “unknown” – and as a mother or father, it is your job to guide your teenager through his many “unknowns.”  Growth and change are unavoidable, and these teens need the security of routines to counteract their constantly changing worlds. Structure and routines help them grow to understand and learn to positively control change and their surroundings. The security of small routines actually enables them to handle change and growth with less fear and more independence.

22. When confronting misbehavior, relax your facial muscles and keep your voice down. When faced with an angry teen who is aggressive and shouting, keep your face neutral and lower the volume and pitch of your own voice. Nine times out of ten, your teen will quieten down to hear what you are saying. Also, stay calm – but be assertive. Take some deep breaths if you feel yourself beginning to get aggravated. Calm, assertive instructions and body language are important assets when dealing with challenging behavior.  Any more emotion into an already emotional situation only clouds judgments, causes greater confusion, and launches your teen closer to meltdown.

23. Try to be prepared. If you know you are going to do something with your teenager or ask him to do something that may trigger a tantrum or meltdown, anticipate and prepare for his response. Preparation often relieves some of the stress that rings your “patience buzzer.” Also, always visualize your response before acting on it.

24. Understand when professional help is needed. Most AS and HFA adolescents benefit from some type of professional help in identifying the underlying reasons for their problems and assistance in dealing with them. Getting help for your “special needs” adolescent when she first starts having difficulties is usually far more successful than waiting until problems get worse. For some moms and dads, this can be a difficult step to take. Many parents fear that “reaching out for help” is a sign of weakness – but nothing could be further from the truth. The advantages of seeking professional help for your adolescent include: (a) experienced help in figuring out the reasons your adolescent is acting out, (b) expertise in identifying what clinical interventions are most likely to be effective, and (c) support in helping your adolescent, yourself and your family get through challenging times.

25. AS and HFA adolescents may not know how to express themselves well, causing them to act out – and parents may take the behavior to heart, causing them to lose patience and to speak in anger. Thus, talk with your adolescent about how to express himself in a more appropriate way, helping him to better handle his anger and frustration. Role-play specific situations. Play your adolescent first so you can model appropriate responses, and then let your adolescent give it a try.


Why Your Teen with Asperger's or High-Functioning Autism Prefers To Be Alone 

Additional ideas for parenting your “special needs” adolescent include the following:

• Compliment your AS or HFA adolescent and celebrate his efforts and accomplishments.
• Encourage your adolescent to develop solutions to problems or conflicts. Help her learn to make good decisions. Create opportunities for her to use her own judgment, and be available for advice and support.
• Encourage your adolescent to get enough sleep and exercise, and to eat healthy, balanced meals.
• Encourage your adolescent to volunteer and become involved in civic activities in her community.
• If your adolescent engages in interactive internet media (e.g., games, chat rooms, and instant messaging), encourage him to make good decisions about what he posts and the amount of time he spends on these activities.
• Respect your adolescent’s need for privacy.
• Respect your adolescent’s opinion. Listen to her without playing down her concerns.
• Show affection for your adolescent. Spend time together doing things you enjoy.
• Show interest in your adolescent’s school and extracurricular interests and activities and encourage him to become involved in various activities (e.g., sports, music, theater, and art).
• Talk with your adolescent about her concerns, and pay attention to any changes in her behavior. Ask her if she has had suicidal thoughts, particularly if she seems sad or depressed. Asking about suicidal thoughts will not cause her to have these thoughts, but it will let her know that you care about how she feels. Seek professional help if necessary.
• Talk with your adolescent and help him plan ahead for difficult or uncomfortable situations. Discuss what he can do if he is in a group and someone is using drugs or under pressure to have sex, or is offered a ride by someone who has been drinking.

Asperger’s and High-Functioning Autism are “developmental disabilities,” which are some of the most overwhelming for parents to deal with, changing visions of the future and providing immediate difficulties in caring for and educating their teen. AS and HFA teens with behavioral issues don't respond well to traditional discipline. Instead, they require specialized techniques that are tailored to their specific abilities and challenges. If those techniques are not developed and used, these young people often throw their families into chaos – and are seriously at risk for school-related problems. Thus, parents will do well to take most of the ideas listed above to heart. Use them wisely and frequently.

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

==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder

==> Parenting Children and Teens with High-Functioning Autism: Parents' Comprehensive Handbook

==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book

Coping Skills for Aspergers and HFA Teens: 40 Tips for Parents

Teens with Aspergers and High Functioning Autism (HFA) have core neurologically-based deficits in social-emotional and communication skills. Without specialized help with these skills, even the brightest teenager may end up unable to make and keep friends or hold down a job. I have worked with numerous Aspergers and HFA teens that made really good grades in high school – but simply could not hold down a job (e.g., working in a fast food restaurant, grocery store, etc.).

One of the main reasons for this dilemma is that the teenager has trouble relating to other people on the job. He may say or do things that come across as socially awkward – or downright rude (e.g., ignoring co-workers when they say hello, talking about his own pursuits with no apparent interest in what the other person may have to say, making negative comments about other people's work/appearance/habits, etc.). To make matters worse, after being fired, the Aspergers employee often never understands the real reasons why he lost the job.

Aspergers and HFA teens generally have a lot of trouble understanding the unspoken rules that govern how they must act around other people in order to get along socially. They often end up with no close friends, and with slim chances of finding a girlfriend. This happens because of problems with social-emotional understanding. Aspergers teens can have a great deal of trouble understanding feelings (including their own), and as a result, they may appear to be detached and uncaring – or at the other extreme, out of control of their feelings. So a young man with Aspergers figures that since he told his girlfriend on their first date that he really likes being with her, he doesn't need to say it again. Or he has just won the school math contest, jumps up and down with happiness one minute, and then yells and sobs the next minute, because any kind of strong feelings – positive or negative – overwhelm him.

Aspergers teens also have a hard time reading other people's non-verbal cues (e.g., body language, facial expression, tone of voice, etc.), which make up about 70-80% of what we communicate (words only count for about 20%-30% of what we communicate). People need to read non-verbal cues in order to make accurate assessments about what other people are thinking, feeling, and intending. If one can't read non-verbal cues and doesn’t understand or predict other people's thoughts/feelings/intentions, he will repeatedly be “off the page” in interactions with others.

The Good News—

Aspergers teens typically have many talents that can make them highly valuable as friends, lovers, and employees:

• many “Aspies” are superior in their loyalty, honesty, and logical thinking
• many of our major advances in literature, the arts, computer technology, mathematics, and other sciences were achieved by “Aspies”
• their ability to focus can lead to achievements that help the rest of us enjoy an enriched quality of life and a better understanding of the universe in which we live
• their memories for facts can be mind-boggling
• their sense of humor can be magnificent
• they can have an extraordinary ability to focus on one isolated topic without getting distracted by other, unrelated input into their brains

So, how can you help your Aspergers or HFA teen to survive and THRIVE?

Here are 40 tips for parents:

1. A regular bed time at a reasonable hour is more important than ever, if you can put/keep it in place. Regular routines of all kinds—familiar foods, rituals, vacations—are reassuring when the adolescent’s body, biochemistry, and social scene are changing so fast.

2. Although some adolescents with Aspergers are more docile and youngster-like, be prepared to tolerate/ignore considerable distancing, surliness, or acting out, knowing that it won’t last forever. At the same time, set some firm limits, and keep a close eye on the youngster/adolescent’s welfare.

3. Be patient. Remember that kids and adolescents with Aspergers are relatively immature, socially and emotionally, compared to non-Aspergers kids of the same chronological age. Imagine sending a 10 year old off to high school (even if she has a chronological age of 14), or putting a 14 year old boy behind the wheel of car (even if he has a chronological age of 18)—or sending that 14 year old off to college or the army. We need to adjust our expectations for adolescents with Aspergers -- and make sure they still have appropriate supports.

4. Boys may need to spend increased amounts of time with their fathers, and/or other male role models, as they undertake to become men. If Dad has taken a back seat, let him know his son really needs his attention now. If you are a single mother, look especially hard for male mentors at your son’s school or in the wider community.

5. Build and use any support networks you can: extended family, close friends, church/synagogue groups, and understanding school staff. If you don’t have a good network, consider individual or family therapy for a little support during a stormy, demanding life passage. When you have a demanding adolescent, it’s good to be reminded once a week that your needs and feelings are valid and important, too!

6. Consider delaying graduation in order to ensure that transition services are actually provided under DOE. It may be hard to convince an academically gifted, college bound student to accept this route. However, it may be very helpful for students who will need a lot of help with independent living skills and employment issues. Services need not be delivered within high school walls. Community college courses, adaptive driving lessons, and employment internships are just a few alternatives to consider.

7. A simple, low key, consistent approach is more important than ever, as adolescents become taller and stronger—not that physical restraint was ever very useful with our children. Pick your battles. Set and enforce only your bottom line rules and expectations—matters of safety and respect. Write them down. Make sure both moms and dads/all involved adults agree on the rules. Give choices when possible, but not too many. Engage your adolescent in problem-solving; what does s/he think would work?

8. Encourage your adolescent to carry a wallet disclosure card to show if stopped by a police officer or other first responder. A lot of adolescents with Aspergers like to walk at night to unwind, and police may view their behavior as suspicious. You may want to introduce your adolescent to your local police community relations officer, and explain a little about Aspergers.

9. Establish verbal codes or gestures to convey that one or both parties need a time out: a chance to cool down before continuing a difficult discussion at a later time.

10. Even for a previously well-adjusted youngster, multiple stressors during the adolescent years may bring on anxiety and even depression. Stressors seem to include increased academic/abstract thinking and social demands at school, peer pressure, increased social awareness, and fears of the future. Highly anxious adolescents who do not get help may be at risk for hospitalizations, school failure, acting out (including alcohol and substance abuse), or even suicide attempts.

11. Forgive yourself for being an imperfect parent, and for not loving your youngster “enough.” Forgive yourself for sometimes losing your temper, yelling, or handling a tense situation awkwardly. Forgive yourself for getting your adolescent diagnosed “late”—there are still plenty of years in which to help your youngster. Forgive yourself for not arranging play dates, or sports, or tutoring, the way other moms and dads may be doing.

12. Go with the flow of your youngster’s nature. Simplify schedules and routines, streamline possessions and furnishings. If your adolescent only likes plain T shirts without collars or buttons, buy plain T shirts. If your kid likes familiar foods, or has a favorite restaurant, indulge her.

13. Have realistic, modest goals for what the adolescent or the family can accomplish in a give time period. You may need to postpone some plans for career goals, trips, culture or recreation.

14. If both moms and dads can largely agree about an adolescent’s diagnosis, treatment, and rules, it will save a lot of family wear and tear. To get your partner on the same page, attend Aspergers conferences or classes together. When you hear the same information, you can discuss it and decide what will work best for your adolescent and in your family. As you learn more about Aspergers, you may also come to better appreciate each other’s contributions to your youngster’s welfare. Attend team meetings at the school together, or alternate which parent attends. Seeing your youngster’s therapist together (possibly without the youngster), or seeing a couples or family therapist, may help you weather a tough time together.

15. If you can afford it, you may prefer to pay private school tuition rather than paying a lawyer to negotiate with a financially strapped or resistant school system. However, a private school may not be the best choice. Some families move to a community with a better high school.

16. If you have not talked to your adolescent about Aspergers, you or someone else should do so—to the extent that the adolescent is ready to hear it. It’s tricky for adolescents—they so much want to be “normal” and strong and successful. A diagnosis can seem threatening or even totally unacceptable. In truth, however, the adults with Aspergers who do best are those who know themselves well—both their own strengths, which point them toward finding their niche in the world, and their own blind spots: where they need to learn new skills or seek out specific kinds of help.

17. If you have not yet made a will and set up a special needs trust, do it now. Ask the lawyer about powers of attorney or other documents you may need once your adolescent is no longer a minor. Few moms and dads assume guardianship of a young adult 18 or older, but it may be necessary and appropriate in some situations.

18. If your adolescent seems like a good candidate for college, take him or her to visit colleges during the spring vacation weeks of the junior year of high school, or during the summers before junior and senior year. Visits reveal a lot about what environment the adolescent will prefer. Purchase a large college guide to browse.

19. Impersonal, written communication is easier for the adolescent to absorb: lists of routines and rules, notes, charts, or calendars. E-mail may become a new option.

20. In so far as you can, keep your cool—they can’t handle our upset feelings. Walk away if you need to.

21. Instill the essential habit of a daily shower and clean clothes: peers, teachers, and future potential employers are very put off by poor hygiene. If possible, put your adolescent’s clothes on a well-organized shelf in the bathroom, near the clothes hamper.

22. Children still need structure, down time, soothing activities, and preparation for transitions.

23. Children with Aspergers can be difficult to parent and to love even when they are young. Often, our children neither accept nor express love or other positive feelings in ways a non-Aspergers parent expects or finds most comfortable. Children’ behavior can be trying or embarrassing for us. Adding adolescence to the mix can make this dilemma even more painful.

24. Look for opportunities for a sheltered, successful overnight stay away from home with no parent. Examples: long weekend visits to relatives, a week or two of a carefully chosen sleep-away camp, taking a course on a college campus.

25. Look for volunteer activities or part time jobs at the high school or in the community. Be persistent in asking the school to provide help in the areas of career assessment, job readiness skills, and internships or volunteer opportunities. They probably have such services for intellectually challenged adolescents—but may not realize our children need that help, too. They may also not know how to adapt existing programs to meet our children’ needs.

26. Make sure thorough neuropsych re-evaluations are performed every three years. This information and documentation may be critical in securing appropriate services, alternative school placements, a good transition plan; choosing an appropriate college or other post secondary program; proving eligibility for services and benefits as an adult.

27. Not all adolescents are ready for a residential college experience right after high school. To decide, use the evidence of how the adolescent did at sleep-away camp or similar samplings of independence, and look carefully at executive function skills (organizational skills). As an alternative, community colleges offer a lot of flexibility: easy admission, low cost, remedial courses if necessary, the option of a light course load, and the security of living at home. Some college disability offices are more successful than others at providing effective, individualized support. However, if the adolescent is living at home, you may be able more easily to sense trouble, step in with help, or secure supports your young adult needs to succeed.

28. Residential schools may be worth considering for some. The right fit can build tremendous confidence for the adolescent, give the moms and dads a break, and prepare everyone for the independence of the post high school years.

29. Schedule regular monthly educational team meetings to monitor your adolescent’s progress, to ensure that the IEP is being faithfully carried out, and to modify it if necessary. Because adolescents can be so volatile or fragile, and because so many important things must be accomplished in four short years of high school, these meetings are critical. If an adolescent is doing very well, the team can agree to skip a month—but be sure to reconvene to plan the transition to the following year.

30. Seek out activity-based, practical social skills groups designed especially for adolescents. Participating in such a group, being accepted by group leaders and peers, is probably the most powerful way to allay an adolescent’s potential despair at not fitting in socially and not having any friends. The positive social experiences and new skills they learn will be assets for the rest of their lives.

31. Side by side conversations (walking, in the car) may be more comfortable for the adolescent than talking face to face.

32. Some adolescents adjust o.k. to middle/high school with appropriate supports and accommodations. Others, however, just cannot handle a large, impersonal high school. You may need to hire an advocate or lawyer to negotiate with your school system to pay for an alternative school placement, tuition, and transportation.

33. Special interests may change, but whatever the current one is, it remains an important font of motivation, pleasure, relaxation, and reassurance for the adolescent.

34. Teach laundry and other self-care/home care skills by small steps over time. Try to get the adolescent to take an elective such as cooking or personal finance at the high school.

35. Adolescents need to learn when to ask for help, from whom, and how. It’s very helpful to have someone such as a trusted guidance counselor whose door is always open, and who can coach the adolescent in problem solving.

36. Adolescents with Aspergers are less prepared than non-Aspergers adolescents for the new challenges of sexuality and romance. Some are oblivious; others want a girl or boy friend, but are clueless about how to form and maintain a relationship. Boys especially may be at risk for accusations of harassment, and girls especially at risk for becoming victims. Teach appropriate rules, or see that another adult does. Look for supervised activities in which boys and girls can socialize safely together, supervised by a staff person who know Aspergers and can coach appropriate social skills.

37. What kind of living situation, employment, and transportation fit your adolescent’s picture of his/her future at age 18 or 25? Once the goals are set, where can the adolescent learn the necessary skills? Consider academic courses, electives, extracurricular activities, and additional services within and outside the high school (e.g. community college, adaptive driving school).

38. With or without Aspergers, most adolescents become less willing to take a parent’s word or advice; so we need to hook them up with other trustworthy adults. If you want your adolescent to learn or try or do something, arrange for the suggestion or information to come from a trusted adult other than a parent. E.g.: Handpick your adolescent’s guidance counselor. Look for other good mentors: Uncle? Scout or youth group leader? Psychologist, social worker, peer mentor, “Big Brother,” social skills group leader? Weight room coach or martial arts teacher?

39. Adolescents continue to grow and develop. You may get some nice surprises along the way, as you see the adolescent take an unexpected giant step toward maturity. I think of it as their neurons maturing on the vine! Maybe it’s just that they figure some things out, and get used to the feel of their new body chemistry.

40. You want input and ownership from the adolescent as far as is possible, but moms and dads can and should have input. You may need to have team meetings when the adolescent is absent, so you can speak frankly about your concerns, without fear that the adolescent may feel you lack respect for or faith in her/him.

My Aspergers Teen: Discipline for Defiant Aspergers Teens

Teaching Interpersonal Relationship Skills to Teens on the Spectrum

"My son (high functioning, 15 years old) has a hard time learning from past 'social mistakes' and usually reacts without thinking through to the likely outcomes as he interacts with his peers. Is there a way to help him be a bit more insightful, that is, be able to generalize from one situation to the next and identify cause-and-effect re: the things he says and does around friends and classmates?"

Having positive peer relationships is important for all adolescents. Unfortunately, many teens with Asperger’s (AS) and High-Functioning Autism (HFA) have a hard time making and keeping friends and being accepted within the larger peer group. The perceived “odd behavior” associated with AS and HFA can wreak havoc in an adolescent's attempts to connect with classmates in positive ways.

Not being accepted by others, feeling isolated, different, unlikeable and alone – this is probably the most painful aspect of having AS and HFA. These negative experiences carry long-lasting effects. Positive connections with others are so important. Though teens with AS and HFA desperately want to make friends and be liked by the group, they often just don't know how. The good news is that parents can help their adolescent develop social skills and competencies.

Here are some important tips on how parents can help their “special needs” teenager to develop much needed social skills:

1. Adolescents with AS and HFA tend to have a hard time learning from past experiences. They often react without thinking through consequences. One way to help these young people is to provide immediate and frequent feedback about inappropriate behavior or social miscues. Role-playing can be very helpful to teach, model, and practice positive social skills, as well as ways to respond to challenging situations like bullying.

2. An after-school or weekend job can let a teenager practice some social skills and gain self-confidence. Many AS/HFA teens feel they are doomed to social isolation until they, for example, land a job at McDonald’s. In this case, the teen just might begin talking to classmates who work at – or come into – the restaurant, and then get to know many of them outside of work.

3. As an adolescent reaches young adulthood, friendships are often more complicated, but it is equally important for you to continue to be involved and to facilitate positive peer interactions. The middle school and high school years can be brutal for an adolescent who struggles socially. Even if an adolescent remains unaccepted by the peer group at large, having at least one good friend during these years can often protect him or her from the most damaging effects of ostracism by the peer group.

4. AS and HFA teenagers need planned activities. Although you, as the parent, no longer plan and supervise your teenager as closely as you did back in the day, church organizations, scout groups, and other after-school or community activities can provide structure for the teenager who can’t find a crowd on his or her own. The grown-ups who run such groups are generally committed to involving all the teens. They’ll take the time to talk to a teenager standing on the edge of the group and encourage him or her to join in.

5. Clearly identify and give information to your adolescent about social rules and the behaviors you want to see. Practice these prosocial skills again and again and again. Shape positive behaviors with immediate rewards.

6. Communicate with the school, coaches, and neighborhood parents, so that you know what is going on with your adolescent and with whom your adolescent is spending time. An adolescent's peer group and the characteristics of this group have a strong influence on the young people within the group. A middle or high school age adolescent who has experienced social isolation and repeated rejection and simply wants to "belong" somewhere is often more vulnerable to moving into any peer group that will be accepting – even when that group is a negative influence.

7. Collaborate with your adolescent's school to make sure the classroom environment is as "AS/HFA-friendly" as possible so that your adolescent is better able to manage his or her symptoms. Work together with the school staff on effective behavior management approaches and social skills training.

8. Focus on one or two areas that are most difficult for your adolescent so that (a) the learning process doesn't become too overwhelming and (b) your adolescent is more likely to experience successes. Keep in mind that many teens with AS and HFA have difficulty with the basics like starting and maintaining a conversation or interacting with another individual in a reciprocal manner (e.g., listening, asking about the other person’s ideas or feelings, taking turns in the conversation, showing interest in his or her peer, etc.), negotiating and resolving conflicts as they arise, sharing, maintaining personal space, and even speaking in a normal tone of voice that isn't too monotone.

9. High schools are usually much larger than elementary and middle schools – and the school-wide social scene can be daunting to navigate for AS/HFA teens. Conversation and friendship come more easily among teenagers who have a shared interest. Encourage your teen to sign up for clubs or activities that will put him or her in touch with like-minded peers. An outing with the Spanish club may spark conversation with a peer in a different class.

10. If a teenager is seriously struggling on the social front, his or her "jump start" might be a formal group designed to teach social skills. Such groups are generally led by a psychologist or therapist, and may be sponsored by schools or community centers. The format may involve structured tasks or be an open forum for conversation, with feedback coming from both group leaders and peers.

11. Once an adolescent is labeled by his or her peer group in a negative way because of social skills deficits, it can be very hard to dispel this reputation. In fact, having a negative reputation is perhaps one of the largest obstacles your adolescent may have to overcome socially. Studies have found that the negative peer status of adolescents with AS and HFA is often already established by early-to-middle elementary school years, and this reputation can stick with the adolescent even as he or she begins to make positive changes in social skills. For this reason, it can be helpful for moms and dads to work with their adolescent's teachers, coaches, etc. to try to address these reputational effects.

12. Get involved in groups that foster positive peer relationships and social skills development (e.g., Boy Scouts, Indian Guides, Girl Scouts, Girls on the Run, sports teams, etc.). Make sure the group leaders or coaches are familiar with AS and HFA and can create a supportive and positive environment for learning prosocial skills.

13. Research finds that adolescents with AS and HFA tend to be extremely poor monitors of their own social behavior. They often do not have a clear understanding or awareness about social situations and the reactions they provoke in others. For example, they may feel that an interaction with a classmate went well – when it clearly did not. AS and HFA-related difficulties can result in weaknesses in this ability to accurately assess or "read" a social situation, self-evaluate, self-monitor, and adjust as necessary. These skills must be taught directly to your adolescent.

14. Some AS/HFA teenagers do best in smaller groups with some parental monitoring. Although moms and dads are generally viewed as "not cool" to most teenagers, your presence is acceptable in certain situations. A teenager that is reluctant to call a friend to "hang out" might be persuaded to invite a friend or two to a sporting event, if mom gets a few tickets.

15. Establish a positive working relationship with your adolescent's teacher. Share about your adolescent's areas of strength and interests, as well as areas of weaknesses – and strategies you have found to be most helpful in minimizing those weaknesses.

Cultivating friendships during adolescence can be an awesome task for the teenager with AS and HFA. Cliques are hard to break into, and delayed maturity is a roadblock to social success. While some AS/HFA adolescents win friends with their enthusiasm and off-beat humor, others find themselves ostracized, seen by their peers as over-bearing or immature. Parents can NOT structure their teen’s social life as they did through elementary and middle school, but by using the suggestions above, they CAN give the little push that can get their teen started on the path to effective interpersonal relationships.

Tips for teachers with AS/HFA students:

1. Adolescent students often look to their teachers when forming social preferences about their peers. A teacher's warmth, patience, acceptance, and gentle redirection can serve as a model for the peer group and have some effect on a “special needs” student’s social status.

2. Pairing the “special needs” student up with a compassionate "buddy" within the classroom can help facilitate social acceptance.

3. When a “special needs” student has experienced failures at school, it becomes even more important for the student’s teacher to consciously find ways to draw positive attention to him or her. One way to do this is to assign the student special tasks and responsibilities in the presence of the other students in the classroom. Make sure these are responsibilities in which your student can experience success and develop better feelings of self-worth and acceptance within the classroom. Doing this also provides opportunities for the peer group to view your “special needs” student in a positive light and may help to stop the group process of peer rejection.

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

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

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

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


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

Isolation and Loneliness in Teens on the Autism Spectrum

"What can we do as parents to get our teenager with high functioning autism to broaden his areas of interest and not hibernate in his room playing video games ALL DAY. He has very little contact with us and has virtually no friends?!"

Having little contact with family and peers is not uncommon among teenagers with Asperger’s (AS) or High Functioning Autism (HFA), but if your adolescent's isolation is becoming an issue and advancing into a troubling stage, you will want to quickly solve the problem in any way you can.

The adolescent years come with a host of issues for teens on the autism spectrum – much more so than for “typical” teens. Moms and dads often feel at a loss for how to help their “special needs” adolescent when he or she seems lonely, anxious, depressed or out of sorts.

Adolescents with AS and HFA may choose to isolate themselves, or it may happen as a result of bullying or exclusion by their peers. Other common reasons for isolation include the following:

• Isolation can be caused by the way these teens look, dress, act, or a combination thereof.
• Moodiness and erratic or volatile behavior can drive AS and HFA adolescents away from their peer group.
• Shyness can be a cause of social isolation.
• Some AS and HFA adolescents may be ostracized by peers due to their excelling academically or underachieving. “Fitting-in” is important to teens, and those that stand out may be pushed to the fringes of social groups.
• The AS or HFA adolescent may spend too much time on the internet or playing video games, and as a result, lose touch with their friends. They may replace genuine social interaction with online gaming where they converse with strangers.
• Depression is another prime cause of isolation for these young people. A depressed AS or HFA adolescent loses interest in everyday activities and drops out of social groups at school.

Of the reasons listed above, I have found that the biggest reason AS and HFA teens isolate is because they have been bullied, teased and rejected by their peers. Due to their “odd” behavior, these young people are misunderstood and not heard by their peers. They are trying hard to be accepted, but they simply don’t know how to do it. When trying to cope with this rejection, their brain actually goes into survival mode, and they will either become hypo-aroused or hyper-aroused, which means that they will either hide (hypo) or act-out (hyper). These behaviors then can scare peers and parents. This is why it is so terribly important to look beneath the behavior and empathize with the adolescent's emotional state – and then listen to what he or she is saying.

Adolescents with AS and HFA may end up in a situation where they struggle to help themselves. If moms and dads see this happening, they should get involved and encourage their youngster to take positive action to overcome their social problems. Luckily, there are a few ways to encourage your adolescent to become a part of things once again.

==>  Discipline for Defiant Aspergers Teens

What moms and dads can do to help their AS and HFA teens to improve self-esteem, be more socially engaged, and experience less loneliness and depression:

1. Assist your adolescent with setting short-term and long-term goals for herself. Short-term goals (e.g., completing homework each day for a week, filling out two job applications per week, etc.) will help keep her focused. Long-term goals (e.g., getting a driver's license, saving up enough money to purchase a car, etc.) will give her something to look forward to. Reaching goals provides a sense of accomplishment and improves self-esteem.

2. Consider the treatment options for your adolescent's depression or anxiety if those have been diagnosed. Getting proper treatment for these conditions will help your adolescent to stop isolating himself so much from family and peers. Possible treatments may include counseling and/or medications.

3. Create opportunities for your adolescent to volunteer and help others. Providing assistance to others helps improve feelings of self-worth. There are many volunteer opportunities available for adolescents (e.g., visiting people in a nursing home, caring for animals at a local shelter, etc.).

4. Discuss your concerns with your child when she seems more relaxed. Be honest, telling her that you have noticed that she is spending more and more time on her own. Ask her if there is something troubling her. Be tactful and patient. Do not pressure her to talk, but encourage her by speaking softly and gently and by showing relaxed body language.

5. Encourage social activity by signing your teenager up for community sports, arts and crafts classes, or any other activities that he may enjoy that will help him to meet new friends and explore hobbies and other special interests.

6. Encourage your teenager to get some kind of exercise at least 3 to 4 times a week. Staying active can help improve mood.

7. Even if it doesn't always seem like it, your “special needs” adolescent craves your attention and approval. Spend time together doing an activity that you both enjoy, or let your adolescent choose how you spend your time together. Whether it's shopping, watching movies, or going for a hike, the most important thing is to be there and to get your adolescent out of her bedroom for a while.

8. Explore all aspects of your teen’s attempts to isolate himself by keeping a journal. A journal will contain valuable information for a therapist if your child receives counseling at some point in the future. The length of time “isolating behavior” has been going on is relevant. Also, look at your child’s personality. He may always have been a loner, or he may have previously been quite outgoing. Also, note any signs of a lowering or flattening in mood.

9. Get your support team together. There are school counselors and peer-support groups. There is also individual and family psychotherapy that is provided through local mental health agencies. You may also want to have your doctor check out the possibility of any medical conditions as a possibility for isolation or depression. If your teen is physically healthy, the next step will be to bring him or her to a mental health professional who specializes in autism spectrum disorders. The therapist will give your adolescent a screening for depression and guide you through treatment options. In addition, you can contact your local clergy for support. But always keep in mind that the most important relationship is the one between you and your teenager. The professionals can assist and guide, but you can influence your son or daughter in a positive way that will have a life-long impact on that parent-child relationship.

==>  Discipline for Defiant Aspergers Teens

10. Help your adolescent to find her talents. Encourage her to join a sport, play a musical instrument, or join a club until she finds something where she excels. Also, teach her that she does not have to be good at everything, but what she settles on should be enjoyable.

11. Help your teenager to stick to his usual sleep schedule and eat regular and healthy meals and snacks.

12. Increase your adolescent's self-esteem. Sadness and isolation can sometimes be linked to low self-esteem. Give your youngster lots of compliments and positive reinforcement for the things she does well, whether that's a good grade on a test, helping out with a younger sibling without being asked, or a beautiful drawing she created. Look for the good things about your adolescent and the positive things she does, and make a big deal about them! An adolescent who feels good about herself is more likely to want to get out of the house and enjoy life.

13. Intervene if you feel your child’s behavior is troubling. He may, for example, be spending increasing periods of time in his room with the door shut and locked. He may even be neglecting his diet, appearance or studies. The best way to intervene may be to sign your child up for a social-skills training group.

14. Model healthy self-esteem. Show your adolescent the importance of self-praise, and avoid becoming self-critical in his or her presence.

15. Open the line of communication. Without being overly pushy, let your teen know you are there if he needs to talk – no matter what the problem is. This may help you to find out if there are any reasons for his isolation (e.g., school-related stress).

16. Praise your adolescent for her efforts – even if she doesn’t reach her goals (e.g., acknowledgment of hard work in her sports attempts or academic efforts). Praise positive behaviors (e.g., making healthy choices, solving tough problems). Also, teach your adolescent how to respond to failure with a healthy attitude.

17. Stay in touch with their child’s teachers and coaches. Being aware of what she is doing and who she is friends with is very important. It also lets her know that she is important to you. Sure, she may complain about you being over-protective, but so what – you are the parent.

18. Suggest that your teenager keep a journal. Writing about her feelings, drawing, and writing poetry are some of the ways she can express herself. Sometimes she may be asked to do this by her therapist as well, and maybe share some of the entries. Often being able to identify and express feelings will improve how your teenager feels.

19. Teach your adolescent to recognize cognitive distortions and replace them with more realistic thoughts. AS and HFA teens with low self-esteem tend to have a distorted view of themselves and the world. Frequently, they expect things to turn out negatively (e.g., "Everyone is going to laugh at me when I give my presentation tomorrow in class”). Other distortions may include self-blame and becoming overly-critical of anything less than perfection.

20. While some moodiness and isolation is normal, it's important to be aware of signs of more serious problems (e.g., depression, suicidal thoughts). Symptoms of depression include frequent sulking, a change in eating or sleeping habits, lack of energy, and talking about death or suicide. If your adolescent shows any of these symptoms, seek help immediately. Call a therapist or your physician right away for instructions on what to do next if you suspect a serious problem.

Isolation increases an AS or HFA teen's risk of developing mental health problems (e.g., depression, chemical dependency). Thus, parents of these teens need to help them improve their self-esteem and social skills by encouraging them to change the way they think – and how they spend their time. This can be accomplished by using the steps listed above.

==>  Discipline for Defiant Aspergers Teens

Comments:

Steve Borgman said... What a great article. I liked the suggestion of getting one's teen in a volunteer activity, particularly in an activity s/he enjoys, such as something related to animals, if s/he loves animals. Also, I appreciate the suggestion of connecting with one's child when s/he is more relaxed.

D Marcotte said... Nice article. I would like to add a couple of suggestions. 1. If your teen is interacting with others online that should count as social interaction - i.e. chat rooms, websites or whatever. My daughter who is high functioning does very well online and has friends all around the world. 2. Introduce your teen to other teens on the spectrum - we have found this to be very helpful. They seem to really understand each other in a way NT people just don't. Their friendship may not look like what you expect, but that doesn't make it any less real. I would also like to mention a great website for families impacted by autism, www.asd-dr.com is designed to help families find the treatments, therapists and services they need in the local area. It also has a lot of links to online support through links to organizations, forums and other references.

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