“Is it common for aspergers teenagers to retaliate (sometimes violently) when they feel that they are being mistreated by siblings, peers, etc.?”
Common? No. Does it happen? Yes.
Most juveniles with Asperger’s (AS) and High-Functioning Autism (HFA) have strict codes of behavior that often include a dislike or even hatred of violence. Even among them, however, aggression can be a problem when the juvenile or young adult becomes frustrated, feels unfairly treated, or feels excluded. Juveniles with AS and HFA can persuade themselves that aggression is justified in these circumstances. Aggression toward younger siblings may be a problem, as may aggression at school, but the usual arena is at home.
This kind of aggression may be explosive, in which case there is often a sharp onset and a sharp offset. The AS or HFA juvenile may be even more unaware of the impact of his aggression than others who have tantrums. Parents often say something like this: “He calmed down quickly, long before we could feel calm. He just seems to want to carry on as if nothing had happened. If we try to talk about the tantrum, we might set him off again.”
Aggression of this kind may begin at an early age, and moms and dads find it difficult to deal with. Counter-violence makes matters worse, but it is a solution that often appeals to fathers. Withdrawal during the tantrum, and then discussing how it felt to be on the receiving end of it, are often useful. But living with this level of aggression can be one of the most difficult aspects of raising a child on the autism spectrum.
These juveniles have a lively sense of self-preservation. They may therefore suppress an aggressive response to a bully or another aggressor, but turn the aggression on to a more vulnerable person later, who may have had nothing to do with the situation. The target of aggression is most likely to be a juvenile's mother, or later in life, a spouse.
Emotional processing is difficult for AS and HFA juveniles. They can’t tell themselves to “just forget it” or “life's too short to worry so much.” They want answers – and they want justice. Incidents that have happened in the past (sometimes many years before) may linger in the mind of an adult with AS and may resurface at regular intervals (called “rumination”). When they do, it is as if the individual is re-experiencing the episode over again, and he may become suddenly and unexpectedly aggressive.
"Any suggestions for my 4 year old high functioning boy that hits and bites his playmates when he’s mad?"
Unfortunately, many youngsters with Asperger’s (AS) and High-Functioning Autism (HFA) are often physically aggressive …they hit, bite and scratch others. These behaviors are fairly common and often appear by the youngster's first birthday. Moms and dads often struggle over how to manage their youngster's aggressive and/or destructive behavior.
While some biting can occur during normal development, persistent biting can be a sign that a youngster has emotional or behavioral problems. While many AS and HFA kids occasionally fight with or hit others, frequent and/or severe physical aggression may mean that a youngster is having serious emotional or behavioral problems that require professional evaluation and intervention. Persistent fighting or biting when a youngster is in daycare or preschool can be a serious problem. At this age, AS and HFA kids have much more contact with peers and are expected to be able to make friends and get along.
BITING—
Many AS and HFA kids start aggressive biting between one and three years of age. Biting can be a way for a youngster to test his power or to get attention. Some AS and HFA kids bite because they are unhappy, anxious or jealous. Sometimes biting may result from excessive or harsh discipline or exposure to physical violence. Moms and dads should remember that kids on the autism spectrum who are teething might also bite. Biting is the most common reason these young people get expelled from day care.
What to do:
Obviously, don’t bite a youngster to show how biting feels. This models aggressive behavior.
For a toddler (1-2 years), firmly hold the youngster, or put the youngster down.
For a young boy or girl (2-3 years) say, "Biting is not okay because it hurts people."
If biting persists, try a negative consequence (e.g., don’t hold or play with a youngster for five minutes after she bites).
Say "no" immediately in a calm but firm and disapproving tone.
If these techniques or interventions are not effective, moms and dads should talk to their family physician.
HITTING—
Toddlers and preschool age kids on the spectrum often fight over toys. Sometimes these kids are unintentionally rewarded for aggressive behavior. For instance, one boy may push another boy down and take away a toy. If the youngster cries and walks away, the aggressive youngster feels successful since he got the toy. It is important to identify whether this pattern is occurring in AS and HFA kids who are aggressive.
What to do:
Obviously, don’t hit a youngster if she is hitting others. This teaches her to use aggressive behavior.
If a youngster hits a playmate, immediately separate the kids. Then try to comfort and attend to the “victim.” This models empathy for the offender!
It’s better to intervene before a youngster starts hitting (e.g., intervene as soon as you see the youngster is very frustrated or getting upset).
Moms and dads should not ignore or down play fighting between siblings.
When young AS and HFA kids fight a lot, supervise them more closely.
For a toddler (1-2 years) say, "No hitting. Hitting hurts."
For a young boy or girl (2-3 years) say, "I know you are angry, but don't hit. Hitting hurts." This begins to teach empathy to your youngster.
When hitting or fighting is frequent, it may be a sign that a youngster has other problems (e.g., he may be sad or upset, have problems controlling anger, have witnessed violence or may have been the victim of abuse at day care, school, or home).
Research has shown that AS and HFA kids who are physically aggressive at a younger age are more likely to continue this behavior when they are older. Studies have also shown that young people who are repeatedly exposed to violence and aggression on TV, videos and movies act more aggressively.
If your son or daughter has a persistent problem with fighting and biting or aggressive behavior, seek professional assistance from a child and adolescent psychiatrist or other mental health professional who specializes in the evaluation and treatment of behavior problems in AS and HFA kids.
Navigating the tumultuous waters of adolescence is challenging for any teenager, but it can be particularly daunting for those with Autism Spectrum Disorder (ASD). Aggressive behaviors may surface during this critical developmental phase for a variety of reasons, including difficulties in communication, sensory overload, significant changes in routine, and struggles with emotional regulation.
Understanding the roots of these aggressive tendencies and developing practical strategies to manage them can create a more harmonious environment for both teens and their families. Below is a comprehensive guide designed to assist parents, caregivers, and educators in addressing aggression in teens with ASD.
Understanding the Roots of Aggression: The Key to Empowerment
To effectively address aggressive outbursts, it’s crucial to identify and understand their underlying triggers:
1. **Communication Barriers**: Teens with ASD often experience challenges in articulating their feelings or needs verbally. This communication gap can lead to intense frustration and, ultimately, aggressive outbursts when they feel unheard or misunderstood.
2. **Sensory Sensitivities**: Many individuals on the autism spectrum possess heightened sensitivity to sensory stimuli. For instance, overwhelming lights, loud noises, or crowded settings can lead to sensory overload, pushing them to react aggressively as a means of coping with discomfort.
3. **Changes in Routine**: Adolescents with ASD typically thrive on predictability and routine; thus, unexpected changes—like a switch in school schedules, family dynamics, or even meal times—can provoke anxiety and lead to aggressive behaviors as a reaction to confusion or insecurity.
4. **Emotional Regulation**: Many teens on the spectrum find it challenging to recognize, interpret, and manage their emotions effectively. This difficulty often results in intense emotional responses in situations perceived as threatening or distressing.
5. **Social Interaction Challenges**: Misinterpretations in social situations can lead to feelings of exclusion or irritation. A misunderstanding on the playground or in the classroom can escalate quickly into aggressive actions stemming from frustration or anxiety about social interactions.
#### Strategies for Prevention and Management
1. **Create a Predictable Environment**: - **Establish Consistent Routines**: Implement daily schedules that are consistent and predictable. Utilize visual schedules with clear timeframes and activities to help the teen anticipate what comes next, reducing anxiety and uncertainty. - **Prepare for Changes**: When changes are unavoidable, take the time to prepare the teen. Use social stories—short narratives that describe a situation and appropriate responses—to help them understand and anticipate the adjustments.
2. **Enhance Communication Skills**: - **Alternative Communication Tools**: Invest in communication aids such as picture exchange communication systems (PECS) or mobile applications designed for non-verbal communication, which can empower the teen to express needs and feelings more effectively. - **Teach Emotion Recognition**: Utilize tools like emotion wheels or feelings charts to help the teen identify and name their emotions. Engage in role-playing scenarios to practice expressing these emotions in a safe and constructive manner.
3. **Develop Coping Strategies**: - **Introduce Relaxation Techniques**: Teach the teen various stress-relief practices, such as deep breathing exercises, guided imagery, or progressive muscle relaxation, which can help them calm down when they feel frustration mounting. - **Designate a Calming Space**: Create a "calm-down corner" equipped with sensory-friendly items like fidget toys, noise-canceling headphones, and weighted blankets. This designated space should be a safe retreat where the teen can go to de-escalate their feelings.
4. **Implement Positive Behavior Supports**: - **Reinforce Positive Behavior**: Focus on and encourage appropriate behavior by utilizing positive reinforcement techniques. For instance, a token economy system that rewards positive actions can significantly motivate a teen to adhere to expected behaviors. - **Establish Clear Expectations and Consequences**: Clearly lay out what behaviors are expected and what the consequences will be for aggressive actions. Consistency in applying these guidelines will help the teen understand boundaries.
5. **Teach Problem-Solving Skills**: - **Engage in Role-Playing Exercises**: Conduct role-playing exercises to practice responses to potential triggers or frustrating situations, giving the teen tools to handle conflicts more effectively. - **Create a “Calm-Down” Plan**: Collaboratively develop a personalized plan with the teen that outlines specific steps to take when they feel overwhelmed, including identifying preferred coping strategies they can turn to.
6. **Seek Professional Guidance**: - **Consider Behavioral Therapy**: Engaging a therapist who specializes in ASD can provide tailored strategies to help manage aggression. Therapeutic approaches like Applied Behavior Analysis (ABA) can be particularly effective. - **Consult for Medication if Necessary**: For cases where anxiety or mood disorders severely impact behavior, consult with a psychiatrist experienced with ASD. Medication might support better emotional regulation, thus reducing aggressive episodes.
7. **Engage in Family Support**: - **Participate in Parent Training Programs**: Enroll in programs designed to educate parents on effective management strategies for challenging behaviors associated with ASD, equipping them with coping mechanisms. - **Join Support Groups**: Connecting with support groups can provide valuable opportunities for sharing experiences, offering insights, and fostering a sense of community among families facing similar struggles.
8. **Foster Social Skills Development**: - **Enroll in Social Skills Training**: Enrich the teen's social competence by introducing them to social skills groups where they can practice interactions in a structured environment, promoting effective communication and relationship-building. - **Facilitate Peer Relationships**: Encourage the formation of friendships by organizing activities that allow the teen to interact with peers who share similar interests, ensuring these experiences are positive and constructive.
#### When Aggression Occurs
In the unfortunate event of an aggressive outburst, it is essential to respond appropriately, keeping both the teen and others safe:
- **Stay Calm**: Your composure can significantly influence the situation. Use a soothing tone and body language to reassure the teen while maintaining a calm demeanor. - **Ensure Safety**: Assess the environment to ensure everyone’s safety, removing any objects that could be used to cause harm during the outburst. - **De-Escalate the Situation**: Implement de-escalation techniques, such as creating physical distance if needed, softly redirecting their focus, or guiding them to their calming area to promote tranquility. - **Reflect Post-Incident**: After the situation has calmed down, engage the teen in a discussion about what triggered the aggressive behavior. Focus on identifying key triggers and brainstorming effective responses or coping mechanisms for the future.
Managing aggressive behaviors in teens with Autism Spectrum Disorder requires a thoughtful, multifaceted approach grounded in empathy, understanding, and structured support strategies. By enhancing communication, creating predictable environments, and teaching effective coping mechanisms, parents and caregivers can empower their teens to navigate the complexities of adolescence with greater confidence and resilience.
Education and ongoing support are invaluable—not only for the individuals with ASD but also for their families. Through the implementation of these strategies, challenging behaviors can be transformed into profound opportunities for personal growth, emotional connections, and understanding.
Resources for parents of children and teens on the autism spectrum:
More articles for parents of children and teens on the autism spectrum:
Social rejection has devastating effects in many areas of functioning.
Because the ASD child tends to internalize how others treat him,
rejection damages self-esteem and often causes anxiety and depression.
As the child feels worse about himself and becomes more anxious and
depressed – he performs worse, socially and intellectually.
Meltdowns are not a pretty sight. They are somewhat like overblown
temper tantrums, but unlike tantrums, meltdowns can last anywhere from
ten minutes to over an hour. When it starts, the Asperger's or HFA child
is totally out-of-control. When it ends, both you and your child are
totally exhausted. But... don’t breathe a sigh of relief yet. At the
least provocation, for the remainder of that day -- and sometimes into
the next - the meltdown can return in full force.
Although Aspergers [high-functioning autism] is at the milder end of the
autism spectrum, the challenges parents face when disciplining a
teenager on the spectrum are more difficult than they would be with an
average teen. Complicated by defiant behavior, the teen is at risk for
even greater difficulties on multiple levels – unless the parents’
disciplinary techniques are tailored to their child's special needs.
Your older teenager or young “adult child” isn’t sure what to do, and
he is asking you for money every few days. How do you cut the purse
strings and teach him to be independent? Parents of teens with ASD face
many problems that other parents do not. Time is running out for
teaching their adolescent how to become an independent adult. As one
mother put it, "There's so little time, yet so much left to do." Click here to read the full article…
Two traits often found in kids with High-Functioning Autism are
“mind-blindness” (i.e., the inability to predict the beliefs and
intentions of others) and “alexithymia” (i.e., the inability to
identify and interpret emotional signals in others). These two traits
reduce the youngster’s ability to empathize with peers. As a result, he
or she may be perceived by adults and other children as selfish,
insensitive and uncaring. Click here to read the full article...
Become an expert in helping your child cope with his or her
“out-of-control” emotions, inability to make and keep friends, stress,
anger, thinking errors, and resistance to change.
A child with High-Functioning Autism (HFA) can have
difficulty in school because, since he fits in so well, many adults
may miss the fact that he has a diagnosis. When these children display
symptoms of their disorder, they may be seen as defiant or disruptive.
A large body of research has documented the difficulties associated with being bullied – and with bullying other kids. Young people who are bullied suffer more anxiety, depression, loneliness, post-traumatic stress – and have a heightened risk of suicide. Kids who bully are more likely than other youngsters to experience peer-rejection, conduct problems, anxiety, academic difficulties, and engage in rule-breaking behavior.
Recent research has shown that a substantial number of kids with Asperger’s (AS) and High-Functioning Autism (HFA) who have been a victim of bullying become bullies themselves at some point. A distinguishing feature of AS and HFA children is that they struggle to control their emotions. For example, they may unintentionally prompt kids to bully them again by reacting very emotionally to teasing, threats or physical aggression, and may have similar problems controlling feelings of anger and frustration, predisposing them to retaliatory aggression.
Given that these young people experience a broader range of behavioral and emotional difficulties than do “typical” kids, it is not surprising that AS and HFA victims of bullying experience anxiety, depression, peer-rejection, a lack of close friendships, and the cognitive and social difficulties often apparent in bullies themselves (e.g., a greater acceptance of rule-breaking behavior, hyperactivity, a tendency toward reactive aggression, etc.).
In addition, these victims are at greater risk for psychiatric disorders and criminal offenses in young adulthood than are kids dealing with only one of these problems. Also, they have proven to be less responsive to a comprehensive school-based program for kids with severe emotional disturbances. As a result, it is of the utmost importance that they receive support and services that address the full spectrum of their needs.
Programs designed to address emotional and behavioral problems associated with being bullied:
1. Self-control techniques have been used in the treatment of both aggressive and anxious kids with AS and HFA. Given the difficulty these children have controlling their emotions, it is advisable to make this deficit a key target of interventions. “Special needs” kids develop better self-control over their emotions by learning to recognize the physical signs of anxiety or anger (e.g., muscle tension) by practicing positive self-talk (e.g., “I should stop, take a few deep breaths, and think before I act”) and utilizing relaxation techniques (e.g., muscle relaxation, deep breathing) to reduce emotional arousal and delay an immediate response to a stressful situation. This will provide careful reflection (e.g., problem solving, cognitive restructuring) prior to taking retaliatory action.
2. Problem-solving skills training is another strategy common to programs targeting behavioral or emotional problems. AS and HFA kids are helped to think of several possible solutions to a given problem, and to reflect on the positive and negative consequences of each in order to choose the technique that will maximize positive consequences in both the short- and long-term. Kids who are bullied – and then bully others in return – rely too heavily on aggressive solutions, whereas anxious or depressed youngsters often default to avoiding their difficulties.
Problem-solving skills training can be used in either case to broaden the repertoire of constructive coping techniques and enhance decision-making. Decreasing depression and anxiety related to being bullied would be helpful in itself for victims, but it may have the added benefit of reducing negative moods that render AS and HFA kids vulnerable to engaging in explosive, emotional and reactive aggression.
3. Cognitive restructuring has been used to deal with aggression, anxiety, and depression in AS and HFA children. The central feature of this technique is to identify thoughts that increase anger, anxiety or sadness, challenge their accuracy, and replace them with thoughts that are more realistic and less destructive. For example, a child may learn to recognize that his anxiety rises when he assumes that all of his peers would “think he is dumb” if he were to give an incorrect answer in class. Instead, he may be encouraged to take a more realistic view, recognizing that everyone makes mistakes, and that when other people make mistakes, he does not usually think badly of them. To reinforce this concept, the child may use some positive self-talk (e.g., “It’s OK to make mistakes, because it’s how we all learn”).
Applied to behavioral difficulties, cognitive restructuring techniques are often used to emphasize that there is more than one way to explain the actions of other kids. For example, since kids who are bullied – and then subsequently become bullies themselves – do not often give their peers the benefit of the doubt. They may be inclined to see teasing as cruel, which would increase anger and the likelihood of an aggressive response. However, it is equally likely that teasing may be good-natured, and in teaching AS and HFA kids to be open to this possibility, the number of peer conflicts that result in episodes of bully-like behavior may be reduced.
As a therapist who has worked with families affected by autism spectrum disorders over the years, what I see most often is that many AS and HFA kids who have been bullied by peers in elementary and middle school tend to become bullies themselves around the high school years. But, they usually do not bully their peers at school, rather they find easier targets to misplace their aggression. This is usually parents (especially single mothers) and younger siblings. In other words, they bring their frustration and aggression home with them and take it out on family members.
AS and HFA children who are victims or bullying face a complicated array of social and emotional challenges, and it is crucial that concerned moms and dads, educators, and mental health providers recognize the full extent of their difficulties, and tailor interventions to match their complex needs. More research is needed to create and evaluate programs that integrate cognitive-behavioral techniques for the treatment of both behavioral and emotional problems associated with bullying. Until that happens, parents, educators and clinicians can broaden the focus of existing school-based and clinic-based interventions by applying the strategies listed above.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
“My son is 9 years old and he is being very aggressive at home, but mostly in school [before the coronavirus break] - especially with teachers and personnel that intervene with him. I know they don’t put in practice his IEP goals, and he expresses to me how awful the school is for him. Now they are telling me that he has EBD [emotional behavior disorder] and they have been destroying his student record. My son is a great kid and I am learning everyday about high functioning autism, but I am suspecting his school is [was] doing a lot of damage to him. Please help!”
The incidence of aggressive behavior among kids and teens with High-Functioning Autism (HFA) and Asperger’s is of great concern. This complex issue needs to be carefully understood by both parents and educators. Parents who witness this behavior are obviously concerned, but they often hope that their child will "grow out of it." However, it should not be quickly dismissed as "just a phase” the child going through. Unless some underlying issues are addressed, aggressive behavior is likely to continue – and worsen.
Faced with a world in which they find it difficult to interact socially, communicate clearly, and control their own behavior, kids on the autism spectrum sometimes respond with aggression. This behavior can include a wide range of behaviors (e.g., use of weapons, throwing objects, threats to hurt others, homicidal thoughts, spitting, pushing, kicking, hitting, explosive temper tantrums, destroying public or personal property, etc.). On the surface, these behaviors may appear to be pure oppositional defiance. But, on closer inspection, it is often discovered that they have more to do with impulsiveness, anxiety-reduction, and low-frustration tolerance – traits that coexist with the disorder.
To be effective, treatment approaches for violent and aggressive behavior in autistic children need to take the following factors into account:
• Due to difficulties with empathizing, many kids with HFA don't recognize the suffering of others. So, when the attack another person, they may not be able to fully comprehend the damage they inflict (i.e., imagine how the victim feels).
• After just a few years of classroom experience, many children on the spectrum think of themselves as victims due to the fact that they may have been teased, ostracized from the peer-group, bullied, and misunderstood (and perhaps unfairly treated) by teachers. As a result, they may believe that their aggressive behavior is totally justified.
• Due to certain traits associated with the disorder (e.g., mind-blindness, sensory sensitivities, literal thinking, social skills deficits, etc.), many kids with HFA view the world as a cold and hostile place. They may develop a “habit of thought” that attributes hostile intentions to others. This attitude leaves them little choice but to defend themselves (or shutdown and retreat). For example, if another student bumps up against them in the hallway, they may immediately take offense, certain that they were bullied (again). They may have a hard time imagining that perhaps the bumping was just clumsiness on the other student's part. In other words, these “special needs” kids may see the world as an unsafe place in which there are only victims and victimizers, so they may (unconsciously) choose to be one of the latter.
What can parents and teachers do to help? Here are some specific techniques to employ that may reduce or eliminate violence and aggression in the HFA child:
1. Many moms and dads are afraid to discipline an unruly autistic youngster for fear that he (a) is too “fragile,” (b) will hate them for being “unfair,” (c) will have a meltdown, or (d) is simply unable to follow instructions to behave in a certain manner. Your youngster doesn't have to like you – or even love you – but he does have to respect the parent-child relationship and realize that there will be consequences for poor choices. You don't have to be your youngster's friend, but you do have to be his parent.
2. Arrange furniture in a sensible way so that your HFA child can easily maneuver through rooms. If he often tries to escape through a certain door, change the path of the room so that he is unlikely to go near that door. Keep surfaces clear, taking special care to place breakables and dangerous or messy items out of reach. Organize and structure your youngster's living space to minimize frustration. Labels can help him understand where things belong and make him less likely to become overwhelmed or anxious. Also, restrict access to items that tend to cause power struggles.
3. Sometimes stress over not being able to verbalize frustration causes aggressive behavior. For example, if your youngster is angry that he can't button his coat, but is unable to describe how he feels about lacking that skill, he could act out inappropriately. Examining the root problem and addressing it may help to curb angry behavior. Calm reactions on the part of the parent or teacher are important here.
4. Many times, mothers and fathers are quick to make evaluations of their HFA youngster’s unruly behavior (e.g., viewing aggression as nothing more than a childish tantrum). Parents need to revisit their evaluations, because an HFA youngster's violence may be stemming from other issues (e.g., anxiety and/or depression). Don't make judgments until you get to the root of the problem.
5. Sometimes an aggressive youngster knows that if she engages in "divide and conquer" tactics with her parents, she will be able to get her way. However, if mom and dad maintain a united front, then there's strength in numbers, therefore disallowing the child to play one parent against the other.
6. Sometimes violent outbursts are predictable. For example, due to sensory sensitivities, the child may become upset when wearing a warm winter sweater. Maybe the fabric feels uncomfortable against his skin, or the smell of the drier sheet is offensive to him. Examine every component of a situation that seems to trigger aggressive actions and make the necessary adjustments.
7. Be sure to learn the difference between tantrums and meltdowns. A tantrum is very straightforward and has several qualities that distinguishes it from a meltdown. Unlike a meltdown, when the troubling situation is resolved, a tantrum will end as suddenly as it began. A tantrum is thrown to achieve a specific goal, and once the goal is met, things return to normal, whereas a meltdown will usually continue as though it is moving under its own power and wind down very slowly.
8. There's not a youngster born that doesn't have currency, whether it's toys, clothes, games, or television. Access to this "currency" needs to be contingent upon proper behavior (e.g., if your youngster throws a tantrum in a crowded store, he should not be rewarded with a toy or a coloring book). She needs to (a) understand the consequences of his behavior, (b) be able to predict the consequences of his actions with 100% accuracy.
9. If aggressive behavior has developed suddenly or has gotten worse over time, then investigate to see if your youngster has an allergy. Seasonal or food allergies can cause discomfort that the youngster can't describe, leading to extreme behavior. Other factors to consider are environmental conditions, change in medication, or a change in the home or school setting. In addition, some drugs cause aggression.
10. Be sure that your child’s Individual Education Plan (IEP) has all the proper stipulations. Not all IEPs are created equally; they need to be tailored to the child’s specific needs. There is probably no process as frustrating for parents and teachers alike as the IEP process. If you feel that your child’s IEP is fairly worthless and that school staff is mostly ignoring it, then some significant changes need to be made immediately. There are several common mistakes parents and teachers make when creating an IEP (or going through the IEP process), for example:
The IEP contains goals that can’t be measured. This is the most common mistake made when creating IEPs. It is easy to make - and accept - overly generalized goals and achievement objectives and believe they are acceptable. Many IEPs contain goals and objectives like, "...will improve letter recognition." This is a vague goal which can be claimed as "achieved" with very little progress actually having been made. A better goal would be something like, "...will recognize 9 out of 10 random letters shown, 4 out of 5 times." This is specific and measureable.
The parent signs the IEP when she doesn't totally agree with it. Never sign an IEP at the meeting, especially if you don't agree with it. A verbal commitment that "we will work out the fine details later" is not binding, but your signature is. Remember that you have three days to review the IEP before signing it. It is always a good idea to take the IEP home and review it one more time, even if you think that everything is fine. Never feel pressured into signing an IEP! All schools have a due process procedure you can follow that will progressively escalate any complaints you have through the appeals process. If you can’t agree on your IEP, the school should provide you the information and steps you need to begin the due process procedure.
The short-term goals will not meet long-term goals. If a specific long-term goal is agreed upon, make sure that the short-term goals adequately support progress towards the long-term goal.
The parent fails to review a preliminary IEP. Without a preliminary look at what is being proposed for your HFA youngster, your first opportunity to see the IEP is in the IEP meeting where you are expected to agree to - and sign - the IEP. This puts you in an unfavorable position, because you can feel pressured to agree to items without having time to really think through their implications. Always ask for a preliminary copy prior to the IEP meeting, and never feel like you have to sign at the meeting.
11. When the youngster with a “disorder” is acting out, the family may blame him for the family's dysfunction. Sometimes, parents will bring their disruptive autistic youngster in for treatment. This is the sacrificial lamb for the family's toxicity. Parents need to examine their own behavior, and if need be, the entire family should seek counseling. One child – even one with “special needs” – can’t be responsible for all the problems in the household.
12. Lastly, medication may be needed – especially if the youngster's behavior is hazardous to him or those around him. Medications are frequently used in the management of aggression, and current psychopharmacologic treatment strategies involve treating aggression as part of each particular syndrome. Before prescribing medication for aggression, the clinician should ensure that the child has a medical evaluation to rule out contraindications to treatment and to determine whether the aggressive symptoms might improve without the use of drugs (e.g., cognitive-behavioral therapy).
Here are a few suggestions specifically for teachers of students with HFA and Asperger’s:
1. Work from the HFA student’s strengths and interests. Find out how he feels about the subject matter, and what his expectations are. Then try to devise examples, case studies, or assignments that relate the subject matter to his interests and experiences.
2. When possible, let the HFA student have some say in choosing what will be studied. Give her options on term papers or other assignments (but not on tests). Let her select which topics to explore in greater depth.
3. Try to promote appropriate social interactions and help the youngster “fit-in” better. Formal, didactic social-skills training can take place both in the classroom and in more individualized settings. Approaches that have been most successful utilize direct modeling and role playing at a concrete level. By rehearsing and practicing how to handle various social situations, the HFA youngster can learn to generalize the skills to naturalistic settings.
4. Try to insure that school staff outside of the classroom (e.g., physical education teacher, bus driver, school nurse, cafeteria monitor, librarian, etc.) are (a) familiar with the HFA youngster's style and needs and (b) have been given adequate training in management approaches. Those less structured settings where the routines and expectations are less clear tend to be difficult for the HFA youngster.
5. There will be specific situations where medication can occasionally be useful. Educators should be alert to the potential for mood problems (e.g., anxiety or depression), significant compulsive symptoms or ritualistic behaviors, and problems with inattention. Occasionally, medication may be needed to address more severe behavior problems that have not responded to non-medical, behavioral interventions.
6. The use of a "buddy system" can be very useful since HFA students relate best 1-1. Careful selection of a peer-buddy for the HFA youngster can be a tool to help build social skills, encourage friendships, and reduce stigmatization.
7. The school counselor or social worker can provide direct social skills training, as well as general emotional support.
8. Realize that the HFA youngster has an inherent developmental disorder which causes her to behave and respond in a different way compared to other students. Oftentimes, behaviors in the HFA student are interpreted as "manipulative" or some other term that misses the point that she responds differently to environmental stimuli. Thus, school staff must carefully individualize their approach for this “special needs” child. It will likely be counterproductive to treat her just the same as her peers.
9. Put as many details as possible into an Individual Educational Plan so that progress can be monitored and carried over from year to year. It can sometimes be helpful to enlist the aid of outside consultants familiar with the management of young people on the autism spectrum (e.g., psychologists, psychiatrists, etc.).
10. Most students with HFA respond well to the use of visuals (e.g., schedules, charts, lists, pictures, etc.).
11. Know that the HFA student usually shows a surprising sensitivity to the personality of the educator. He can be taught, but only by those who give him true understanding and affection. The educator’s underlying emotional attitude influences (involuntarily and unconsciously) the mood and behavior of this “special needs” youngster.
12. Keep teaching fairly concrete. Avoid language that may be misunderstood by the HFA youngster (e.g., sarcasm, confusing figurative speech, idioms, etc.) Try to simplify more abstract language and concepts.
13. It is very helpful if the HFA youngster can be given opportunities to help other students at times.
14. It is often helpful for the educator and parent to work closely together, because the parent is most familiar with what has worked in the past for the HFA youngster.
15. If motor clumsiness is significant, the school Occupational Therapist can provide helpful input.
16. If learning problems are present, resource room or tutoring can be helpful to provide individualized explanation and review.
17. Hold high – but realistic – expectations for the HFA child. Research has shown that a teacher's expectations have a powerful effect on a student's performance. If you act as though you expect your “special needs” student to be motivated, hardworking, and interested in the subject matter, he is more likely to be so. Set realistic expectations when you make assignments, give presentations, conduct discussions, and grade examinations. "Realistic" in this context means that your standards are high enough to motivate the HFA child to do his best work, but not so high that he will inevitably be frustrated in trying to meet those expectations. To develop the drive to achieve, the child needs to believe that achievement is possible.
18. HFA students with very high-management needs may benefit from assistance from a classroom aide assigned to them.
19. HFA students can be fairly rigid about following "rules" quite literally. While clearly expressed rules and guidelines (preferably written down) are helpful, they should be applied with some flexibility. The rules don’t automatically have to be exactly the same for the HFA youngster as for the other students, because their needs and abilities are different.
20. Help the HFA student set achievable goals for himself. Failure to attain unrealistic goals can disappoint and frustrate him. Encourage him to focus on his continued improvement, not just on his grade on any one test or assignment. Also, help the child evaluate his progress by encouraging him to critique his own work, analyze his strengths, and work on his weaknesses.
21. Give the HFA student feedback as quickly as possible. Return tests and papers promptly, and reward success publicly and immediately. Give her some indication of how well she has done and how to improve. Rewards can be as simple as saying her response was good, with an indication of why it was good.
22. Efforts should be made to help classmates arrive at a better understanding of the HFA youngster in a way that will promote tolerance and acceptance.
23. Educators should take full advantage of the HFA youngster's areas of special interest when teaching. The youngster will learn best when an area of high personal interest is on the agenda. Educators can also use access to the special interests as a reward to the youngster for successful completion of other tasks, adherence to rules, and meeting behavioral expectations.
24. Educators can take advantage of the strong academic skills that many HFA students have in order to help them gain acceptance with their classmates.
25. Direct speech services may not be needed, but the speech and language clinician at school can be useful as a consultant to the other staff regarding ways to address problems in areas such as pragmatic language.
26. Classroom routines should be kept as consistent, structured and predictable as possible. Students with HFA usually don't like surprises. They should be prepared in advance for changes and transitions (e.g., schedule breaks, vacation days, etc.).
27. Care should be taken to protect the HFA youngster from teasing and bullying – both in and out of the classroom.
28. Be specific when giving negative feedback. Negative feedback is very powerful and can lead to a negative class atmosphere. Whenever you identify your “special need” student's weakness, make it clear that your comments relate to a particular task or performance, not to the student as a person. Try to cushion negative comments with a compliment about aspects of the task in which the student succeeded.
29. Avoid escalating power struggles. HFA students often don’t understand rigid displays of authority – and will themselves become more rigid and stubborn if forcefully confronted. Their behavior can then get rapidly out of control, and at that point, it is often better for the educator to back-off and let things cool down. When possible, anticipate such situations and take preventative measures to avoid the confrontation through presentation of choices, negotiation, and diversion of attention elsewhere.
30. If you have tried numerous strategies to address aggression in your HFA student to no avail, ask the parent to consider taking the child to a professional for a psychiatric evaluation to determine whether depression, anxiety, or other problems are present. Treatment of these conditions often result in reduced symptoms of aggression.
It is inevitable that you will have the opportunity of working with students on the autism spectrum in your classroom. You will need to make accommodations for some, and modifications for others. Providing for the needs of these young people will certainly be one of your greatest challenges as a teacher. Consider the tips listed above to make the learning process run as smoothly as possible.
Resources for parents of children and teens on the autism spectrum:
COMMENTS: • Anonymous said… After years of struggling, took my daughter out in grade 8, home schooled her for the year. Grade 9&10 she did online. She decided to go to high school grade 11&12. She is now in her final year of University graduating with a bachelor of science in Environmental science. I came to realize that school just wasn't as important as her mental well being. • Anonymous said… Ask the schools special education department to have him tested. The behavioral specialist is the one who usually does the testing n it should take at least 2 weeks BC the person observes the child as well. I'd call adminstration BC that specialist is the only one that can suggest a diagnosis n it has to be put in their report. • Anonymous said… Do you know why he is acting out? What are the triggers? Knowing these will help his behaviour as you can then implement things to help him cope or do some social stories etc. However I agree with everyone else I'd swap schools. Xx • Anonymous said… Encourging you to try another school. Did miracle-level wonders for my Aspergers teen & wish we'd done so sooner for him. Mine had an IEP from 2nd to 4th grade, had a good 4th grade year because older male teacher really appreciated his outside the box thinking & encouraged him while setting strict expectations and structure. The kind of teacher we all wish they all were, but unfortunately not. Even with my involvement and guidance, including written materials to enhance their knowledge of his needs, we had ignorant teachers unwilling to accomodate and absolute asshole bully peers & parents. Kids that know they can get away with rottenness toward him because they've been doing it for years. New environment with clean slate did wonders. Wish the same for you..best luck. Hang in there Momma • Anonymous said… get all of his records under freedom of information, keep your copies of all IEP's and gete to the head of education, sounds like he needs a change of education setting • Anonymous said… He has triggers, u need to watch for them. My sons 9 also n he's violent as well. A lot of times the generic word used is emotional behavior disorder BC not u til they have been seen for a long time • Anonymous said… Hire an advocate and force your County public school system to pay for your son to go to an ASD school. That's exactly what I did. A good advocate is well worth it. Believe me!! Best $2000 I could have ever spent on my son's future. My son will NEVER again have to deal with the uneducated and unskilled people within the public school system. YOU are the parent, don't ever let them forget it and try to back you in a corner. • Anonymous said… I know this journey all to well. Sometimes, we pray and hope for a better result as the child get older. You may have to seek behavior modification therapy. The teacher can become very exhausted as well. The school has to protect other student's from the violent behavior. You can discuss options with professional services. Perhaps, a smaller setting classroom. • Anonymous said… My son 13 has aspergers his school not doing well with his ehcp i feel like i am letting him down he doesnt want to move school and to be honest 8t would only make things worse for him change is not good when he in yr 8 nearly 9 but thats just my son . He is well behaved at school and home mostly just doesnt like to leave his xbox hates shopping lol • Anonymous said… Putting a child with special needs in the hands of those who do not understand or accommodate those needs is like sending a person who has a broken leg to an eye doctor. • Anonymous said… Same thing happened to me and my kid, I got involved really involved, got to do a meeting with the teachers, and talked to them about what he has , and what he needs, also got to set a plan with the teachers and all of this of course with my kid's Psychiatric psychologists and neurologist advice on paper. Now is not perfect but you can tell they are working on it.... Hard. • Anonymous said… They need to do a Functional Behavior Assessment (to find out what causes the behavior)then a Behavior Intervention Plan (to change the behavior). These are both added to the IEP. Ask questions like: What was happening before the behavior started? What did your son see? Was he trying to communicate? What would YOU do differently? • Anonymous said… Unfortunatly this is all too common. Not only did the schools insist my son had a behavior problem, one incident when a teacher bent down over him during a meltdown, he swung at her trying to defend himself after a different teacher sat on him. In doing so, he hit her breasts which was the closest thing to him and they tried to claim it was sexual assult..he was 8. I've since taken him out of school, did one year of "unschooling". He now does online school and the "behavior" has all but gone away. • Anonymous said… We changed schools and the phone calls to pick our son up stopped. Only calls I have had in the past 2 years was if he was hurt or sick. • Anonymous said… We ended up homeschooling and my only regret was not doing it sooner. Of course we are in a remote area with no other viable options. The school would not acknowledge psychiatric orders. • Anonymous said… We moved schools from a well meaning but hugely overcrowded and busy school to a very small rural school and he is doing a lot better. My son soaks up others stress and if he feels overwhelmed then the fight or flight instincts kick in. • Anonymous said… Yes, absolutely look around for a school that understand ASD, including knowing how to not let him use it to get out of school. That may sound harsh, but my co-parent and I have been through that. For a couple of years we got called easily two to three times a week to take our son home. He'd learned to use his outbursts to get sent home if he was bored or frustrated. Once we found a school that didn't always call us, he leaned really quickly he could no longer use it as a tool. This was in conjunction with some other improvements as well (imo, it's never just one thing, but multiple factors) that have him doing next, much better. He's now 10, so close in age to your little guy. I don't want anyone to think I believe ALL his outbursts were contrived, far from it. But in addition to real sensory overloads, he'd learned to manufacture them as well. High functioning is a different set of battles. Post your comment below...
“My teenage son is very aggressive and lacks any type of impulse control. He cannot be left alone with his siblings. Does you have any recommendations? I know he does not want to do these things, because when we talk about it, he says he loves his sister, etc., but he hurts her all the time. My poor daughter has to put up with his aggressions on a daily basis. I can't watch him every second he's awake. I also can't put either child in a protective bubble or send my son to his room and leave him there all day. I really don't know what to do with him and I'm not a big advocate of drug therapy.
He's starting to internalize his behavior, and now said to me this morning that he's a bad boy even though no one tells him that, not us, or his teacher. I worry about his self-esteem as he grows older. We praise him when he's good, but he gets a ton of negative feedback: “Don't do this… don't do that, etc… you need to go to your room for hitting your sister"… I constantly feel like I have to micromanage him. But he knows he's in time-out or in his room a lot, and I do that so he can calm down or to protect his siblings. Any advice would be helpful.”
Unfortunately, for some teens on the autism spectrum, aggression may become quite common when reaching adolescence, and this may be clearly influenced by the parenting styles of the teen's mother and father. In fact, one of the key factors in determining an ASD youngster's tendency to develop aggression later in life may involve the presence of a maternally sensitive woman who can also balance the discipline and aggression in life.
In many of today's American families, it is not uncommon to find that both the mother and father are relatively absent from the youngster's life (e.g., due to work-related issues). Because a youngster's mental health is often greatly influenced by (a) the presence of maternal nurturing and (b) the balance of a father's discipline, when either of these are absent in the life of a youngster on the autism spectrum, confusion abounds and aggression usually develops. If you are the parent of a teenager on the spectrum, it is important to provide this balance to your child-rearing efforts.
If you are a single mother, and your child's father is not present, you can expect your youngster's aggression will undoubtedly be present as you provide the maternal sensitivity your youngster needs while also attempting to be the disciplinarian.
Because ASD kids have trouble differentiating social cues, and are confused by discipline when expressed by their mother, the authoritarian type of parenting is often met with aggression. For this reason, having a male role model (e.g., uncle, grandfather) who can provide that discipline while you provide the maternal sensitivity will go a long way in your youngster's long-term development.
Conversely, if you are a father who is raising a child alone, you will want to be sure that you find ways to be sensitive and nurturing to your youngster's needs. Because fathers are more likely to be the authoritarian, a woman's sensitivity will be important in your youngster's mental health. Often, this role can be filled by a woman who is an aunt or grandmother, and does not necessarily mean that a step-mother has to be in the picture.
ASD is a developmental disorder that affects many kids by resulting in abnormal social development. For parents, offsetting the risk for development of aggression is most likely achieved by first identifying your parenting style - as either disciplinarian or nurturing - and then finding someone who can fulfill the role as the opposite parenting style.
Trying to manage both the motherly role and the fatherly role often leads to confusion in the youngster, which may exacerbate Autism-related complications in adolescence. Of course, it is not always possible to find a co-parent, but the ideal scenario would involve such an individual.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
"My son is very aggressive and lacks any type of impulse control. He cannot be left alone with his siblings. Does anyone have any recommendations? I know he does not want to do these things, because when we talk about it he says he loves his sister, etc, but he hurts her all the time. My poor daughter has to put up with his aggressions on a daily basis. I can't watch him every second he's awake. I also can't put either child in a protective bubble or send my son to his room and leave him there all day. I really don't know what to do with him and I'm not a big advocate of drug therapy. He's so young and I don't want to change his personality, only his behavior. Will this end soon? Will he gain control at 6, 7, or 8? I love my little boy, but I'm sad that he's so physical. He's starting to internalize his behavior and now said to me this morning that he's a bad boy even though no one tells him that, not us, or his teacher. I worry about his self-esteem as he grows older. We praise him when he's good, but he gets a ton of negative feedback. Don't do this, don't do that, etc. 'You need to go to your room for hitting your sister', I constantly feel like I have to micromanage him. But he knows he's in time out/ or his room a lot and I do that so he can calm down or to protect his siblings. Any advice would be helpful."
Aggressive behavior in the child with Aspergers occurs for a reason, just as it would with any other child. Inappropriate behavior, whether mild or severe, occurs in order to:
avoid something
because of pain
get something
to fulfill a sensory need
The first step in reducing or eliminating this behavior is to determine the need that it fulfills.
The second step is to teach them a replacement behavior (i.e., communicate what they want or don’t want). It may even involve using some of their obsessive or self-stimulating behaviors as a replacement. This is because it would be far less intrusive to others than aggressive behaviors, but still serve the same purpose.
This process takes time and initially, and depending on the behavior, you may not have time. If the behavior is severe, then you need to remove the child from whatever situation they are in at the time. Simply insisting that they stop the behavior and participate in whatever is occurring will not benefit the child or you, unless you remove them from the situation first.
Maintaining their routine will go a long way towards reducing the need for inappropriate or aggressive behavior in the first place.
A behavior analyst should be able to help you. He/she will work with you and your family to try to hash out the functions of the behaviors. Once that is determined you son will be taught replacement behaviors that he can use to meet the needs that his concerning behaviors are filling for him.
Try doing a web search for 'behavior analysis' or 'applied behavior analysis' in your state. That would be a good place to start.
Aspergers is one of the diagnostic subcategories of pervasive developmental disorders. It is characterized by a defect in reciprocal social interaction, lack of empathy for others and poor non-verbal communication. Antisocial acts, including aggression and sexual offense, are not considered to be uncommon in this disorder, but these symptoms are secondary to the diagnosis of Aspergers as a manifestation of difficulties with the "theory of mind" of others.
The usual treatment for Aspergers aggression includes:
• Art Therapy
• Behavioral contracts
• Cognitive behavior-modification
• Drama Therapy
• Language Therapy
• Music Therapy
• Occupational Therapy
• Osteopathy
• Physiotherapy
• Play Therapy
• Scripts and autopsies
• Social stories
• Speech Therapy
• Structuring the environment for social success
• Traditional behavioral consequences
"We have generally been against trying medication, even to treat the worst symptoms of our autistic child, but is there a point at which the advantages of some form of drug treatment outweigh the disadvantages?"
To answer this question, we will need to look at six clusters of symptoms. They are a convenient way of talking about drug treatments for the common kinds of behaviors that hinder the lives of children and teens who have Asperger’s (AS) and High-Functioning Autism (HFA).
These clusters are not comprehensive, but were chosen because they are common reasons to seek drug treatment for HFA:
1. Inflexibility and Behavioral Rigidity: Symptoms of inflexibility or behavioral rigidity are often difficult to quantify, and yet often introduce some of the most disruptive chronic behaviors exhibited by children with HFA. These can be manifest by minor differences in the environment (e.g., changes in location for certain activities), difficulties tolerating changes in routine, and changes to plans that have been previously laid out.
For some of these “special needs” kids, this inflexibility can lead to aggression, or to extremes of frustration and anxiety that thwart activities. Parents may find themselves “walking on eggshells” in an effort to circumvent any extreme reaction from their “fragile” child. Also, theHFA child himself may articulate his anxiety over fears that things will not go according to plan, or that he will be forced to make changes that he can’t handle. Sometimes these behaviors are identified as “obsessive-compulsive” because of the child’s need for ritualized order or nonfunctional routine.
It is not known whether these symptoms are produced by disturbances in the same cortico-striatal-thalamo-cortical circuitry that is believed to produce OCD. However, the model of obsessive-compulsive disorder has suggested that use of SRI agents can be useful in ameliorating this problem. Whether the effect of SRI medications on this symptom cluster is mediated by a general reduction in anxiety, or is specific for “needs for sameness” is not known. Reports from studies of alpha-adrenergic medications (e.g., clonidine, guanfacine) also suggest a decrease in these rigid behaviors.
2. Stereotypies and Perseveration: Stereotyped movements and repetitive behaviors are a common feature of HFA. As with behavioral rigidity and inflexibility, similar models for stereotypy and obsessive-compulsive disorder have been proposed. Stereotypy also may be closely related to tic disorders in which repetitive behaviors emerge from impairment in dopaminergic and glutamaturgic systems.
The treatments for stereotyped movements and perseveration closely parallel those for behavioral inflexibility, and the two clusters are often grouped together in studies of treatment effectiveness. Thus, serotonin reuptake inhibitors and alpha-adrenergic agonists may be helpful. Also, the hypothesis that dopamine may play a role suggests that dopaminergic blocking agents should be added to the possibilities. Reports from studies of olanzapine, risperidone, and ziprasidone suggest this is warranted.
3. Hyperactivity and Inattention: Hyperactivity and inattention are common in HFA kids, particularly in early childhood. Differential diagnostic considerations are vital, particularly in the context of AS and HFA. Hyperactivity and inattention are seen in a variety of other disorders (e.g., developmental receptive language disorders, anxiety, and depression). Therefore, the appearance of inattention or hyperactivity does not point exclusively to ADHD. The compatibility of the child and her school curriculum is particularly important when evaluating symptoms of hyperactivity and inattention. There is a risk that a school program that is poorly matched to the child's needs (e.g., by over-estimating or under-estimating her abilities) may be frustrating, boring, or unrewarding. If the verbal or social demands exceed what she can manage, they may produce anxiety or other problems that mimic inattention or induce hyperactivity.
Virtually every variety of medication has been tried to reduce hyperactive behavior and increase attention. The best evidence at this point supports dopamine blocking agents, stimulants, alpha-adrenergic agonists, and naltrexone.
4. Anxiety: Young people with HFA are particularly vulnerable to anxiety. This vulnerability may be an intrinsic feature of ASD through a breakdown in circuitry related to extinguishing fear responses, a secondary consequence of their inability to make social judgments, or specific neurotransmitter system defects.
The social limitations of HFA make it difficult for these “special needs” children to develop coping strategies for soothing themselves and containing difficult emotions. Limitations in their ability to grasp social cues and their highly rigid style act in concert to create repeated social errors. They are frequently victimized and teased by their peers and can’t mount effective socially adaptive responses.
Limitations in generalizing from one situation to another also contributes to repeating the same social mistakes. In addition, the lack of empathy severely limits skills for autonomous social problem-solving. For higher functioning kids on the autism spectrum, there is sufficient grasp of situations to recognize that others “get it” when they do not. For others, there is only the discomfort that comes from somatic responses that are disconnected from events and experience.
Several agents have been tried for treatment of anxiety. There is no reason to suspect that children with autism are less likely to respond to the medications used for anxiety in children without autism. Therefore, SRIs, buspirone, and alpha-adrenergic agonist medications (e.g., clonidine, guanfacine) all have been tried. The best evidence to date supports use of selective serotonin reuptake inhibitors. (Note: Kids with HFA may be more vulnerable to side effects and to exhibit unusual side effects.)
5. Depression: Depression seems to be common among teens and young adults with HFA. Many of the same deficits that produce anxiety may conspire to generate depression. There is also good evidence that serotonin functions may be impaired in young people with autism. The basic circuitry related to frontal lobe functions in depression may be affected. In addition, deficits in social relationships and responses that permit one to compensate for disappointment and frustration may fuel a vulnerability to depression. There is some genetic evidence suggesting that depression and social anxiety are more common among first-degree relatives of autistic kids, even when accounting for the subsequent effects of stress.
The medications that are useful for depression in “typical” kids and teens should be considered for those with HFA who display symptoms of depression. Since some features of depression and autism overlap, it is important to track that the changes in mood are a departure from baseline functioning. Therefore, the presence of social withdrawal in a child with HFA should not be considered a symptom of depression unless there is an acute decline from that child's baseline level of functioning.
The core symptoms of depression should arise together. Therefore, the simultaneous appearance of symptoms (e.g., decreased energy, further withdrawal from interactions, irritability, loss of pleasure in activities, sadness, self-deprecating statements, sleep and appetite changes, etc.) would point to depression.
Children and teens on the autism spectrum who display affective and vocal monotony are at higher risk for having their remarks minimized. They can make suicidal statements in a manner that suggests an off-hand remark without emotional impact. When comments are made this way, parents may underestimate them. In young people with HFA, the content of such comments may be more crucial than the emotional emphasis with which they are delivered.
Drugs that are useful for treatment of depression in children with HFA are serotonin reuptake inhibitors. There also may be indications for considering tricyclic agents with appropriate monitoring of ECG, pulse, and blood pressure. There are no medications that have been shown to be particularly more beneficial for depressive symptoms in children on the spectrum. Therefore, the decision as to which ones to use is determined by side effect profiles, previous experience, and responses to these medications in other family members.
6. Aggression: Aggression is seldom an isolated problem and is particularly complex in children with AS and HFA. It is important to understand that aggressive behavior is not always associated with just one condition and can have highly varied sources. An array of theoretic models has been proposed to understand aggressive behavior in kids on the spectrum. There are promising biologic models that suggest the behavior arises from alterations in dopaminergic reward mechanisms, and cognitive models suggesting that such acts are an outcome of conditioned learning. Tantrums and physical aggression are often responses to a variety of circumstances and occur in the context of diverse emotions.
It is useful to know the circumstances preceding and following aggressive outbursts before selecting a particular medication. For instance, when aggression is a response to anxiety or frustration, the most helpful interventions target those symptoms and the circumstances that produce them rather than exclusively focusing on aggressive behavior.
Unfortunately, the request for drug treatment typically follows a crisis, and the press for a rapid, effective end to the behavior problems may not permit the gathering of much data or discussion. Nonetheless, it is NOT appropriate to “always” begin with one agent or another. Moving to a more “reliable” medication too quickly may mean that the child takes on cardiovascular, endocrinologic, and/or cognitive risks that may be otherwise avoided.
There are reports in support of using serotonin reuptake inhibitors, alpha-adrenergic agonists, beta-blocking agents, mood stabilizers, and neuroleptics for aggressive behavior. When a doctor has the luxury of time, the support of family, and collaboration with staff where the child is attending school, then a drug that is safer, but perhaps takes a longer time to work or is a little less likely to help, can be tried.
In addition to cognitive and behavioral interventions, many children and teens on the autism spectrum are helped by medications (e.g., selective serotonin reuptake inhibitors, antipsychotics, stimulants, etc.) to treat the associated problems listed above. Experts agree that the earlier interventions are started, the better the outcome. With increased self-awareness and therapy, most kids and teens learn to cope with the challenges of AS and HFA.
Resources for parents of children and teens on the autism spectrum:
More articles for parents of children and teens on the autism spectrum:
Social rejection has devastating effects in many areas of functioning.
Because the ASD child tends to internalize how others treat him,
rejection damages self-esteem and often causes anxiety and depression.
As the child feels worse about himself and becomes more anxious and
depressed – he performs worse, socially and intellectually.
Meltdowns are not a pretty sight. They are somewhat like overblown
temper tantrums, but unlike tantrums, meltdowns can last anywhere from
ten minutes to over an hour. When it starts, the Asperger's or HFA child
is totally out-of-control. When it ends, both you and your child are
totally exhausted. But... don’t breathe a sigh of relief yet. At the
least provocation, for the remainder of that day -- and sometimes into
the next - the meltdown can return in full force.
Although Aspergers [high-functioning autism] is at the milder end of the
autism spectrum, the challenges parents face when disciplining a
teenager on the spectrum are more difficult than they would be with an
average teen. Complicated by defiant behavior, the teen is at risk for
even greater difficulties on multiple levels – unless the parents’
disciplinary techniques are tailored to their child's special needs.
Your older teenager or young “adult child” isn’t sure what to do, and
he is asking you for money every few days. How do you cut the purse
strings and teach him to be independent? Parents of teens with ASD face
many problems that other parents do not. Time is running out for
teaching their adolescent how to become an independent adult. As one
mother put it, "There's so little time, yet so much left to do." Click here to read the full article…
Two traits often found in kids with High-Functioning Autism are
“mind-blindness” (i.e., the inability to predict the beliefs and
intentions of others) and “alexithymia” (i.e., the inability to
identify and interpret emotional signals in others). These two traits
reduce the youngster’s ability to empathize with peers. As a result, he
or she may be perceived by adults and other children as selfish,
insensitive and uncaring. Click here to read the full article...
Become an expert in helping your child cope with his or her
“out-of-control” emotions, inability to make and keep friends, stress,
anger, thinking errors, and resistance to change.
A child with High-Functioning Autism (HFA) can have
difficulty in school because, since he fits in so well, many adults
may miss the fact that he has a diagnosis. When these children display
symptoms of their disorder, they may be seen as defiant or disruptive.
