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Aggression in Teenagers with Autism Spectrum Disorder

"Is aggression typically a trait of teens with ASD? I'm a single parent and my 17 y.o. son is becoming more verbally and physically aggressive and I do not know if this will escalate to dangerous levels."
 
Adolescents with ASD (high-functioning autism) are often not found to be physically aggressive unless they feel threatened in some manner. 
 
For some young people on the spectrum, aggression may become quite common when reaching adolescence, and this may be clearly influenced by the parenting styles of the mother and/or father. 
 
Also, if your son is on the receiving end of teasing, bullying and peer-rejection at school, then aggression and shutdowns can be expected either at home or school (or both).
 
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 balance the discipline and aggression in life.

In many of today's families, it is not uncommon to find either a mother or father is absent from the teen's life. Because a teen's mental health is often greatly influenced by the presence of maternal nurturing and the balance of a father's discipline, when either of these are absent in the life of an ASD teenager, aggression can develop. 
 

If you are the parent of a child with ASD, it is important to provide this balance to your child-rearing efforts. If you are a single mother, and your youngster's father is not present (or still lives in the house - but is emotionally unavailable), you can expect your son's aggression may be present as you provide the maternal sensitivity he needs while also attempting to be the disciplinarian. 
 
Because kids on the spectrum 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 who can provide that discipline (i.e., guidance, not punishment) while you provide the maternal sensitivity will go a long way in your son's long-term development.

Conversely, if you are a father who is raising an ASD youngster alone, you will want to be sure that you find ways to be sensitive and nurturing to his or her needs. Because fathers are more likely to be the authoritarian, a woman's sensitivity will be important in your son's mental health. Often, this role can be filled by a woman who is an aunt or even a grandmother - and does not necessarily mean that a step-mother or step-parent is necessary.

ASD is a developmental disorder that affects many adolescents by resulting in abnormal social development. For moms and dads, 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 may lead to confusion in your child, and this may further exacerbate the ASD-related complications into adulthood.

Teens with ASD may display some – or all - of the following characteristics:
  • lack of appreciation that communication involves listening as well as talking (e.g., they may not allow their communication partner an opportunity to engage in the conversation)
  • narrow field of interests (e.g., a teen with ASD may focus on learning all there is to know about cars, trains or computers)
  • preference for playing alone
  • very literal understanding of what has been said
  • anger and aggression when things do not happen as they want
  • apparently good language skills, but difficulty with communication
  • language may be considered to be very advanced or ‘precocious’ when compared to their peers
  • the teen may be able to talk extensively on a topic of interest, but have difficulty with more practical tasks such as recounting the day’s events, telling a story, or understanding jokes and sarcasm
  • behavior varies from mildly unusual, eccentric or ‘odd’ to quite aggressive and difficult
  • difficulty in forming friendships
  • having rules and rituals that they insist all family members follow
  • inability to understand the rules of social behavior, the feelings of others and difficulty ‘reading’ body language (e.g., a teen with ASD may not understand that someone is showing that they are unhappy by frowning)
  • sensitivity to criticism

==> Discipline for Defiant ASD / High-Functioning Autistic Teens
By

Educating Students with ASD [Level 1]: Comprehensive Guidelines for Teachers and Parents

Children with ASD (high functioning autism) will respond quite well to specific classroom adaptations. Here are the recommended methods teachers can employ with their "special needs" students: 
  1. Implement Creative Programming - Through the student’s IEP, educators can develop class schedules which will be motivating and challenging to the student while addressing his/her needs.
  2. Intervene Early - The earlier intervention begins, the earlier children can learn the needed skills for adulthood and friendship.
  3. Obtain In-Depth Training - Learn the differences among the kids with ASD in elementary, middle school and high school.
  4. Recognize Children’ Strengths - Many children with ASD will go on to make great contributions to society. However, we must tap into their strengths and offer support so that they do not drop out of school because academic and social demands are too high.
  5. Understand How Social Impairments Impact Learning and Peer Relationships - Some children require weekly sessions with trained staff members who can help them “solve the puzzles” they encounter in everyday activities and help alleviate depression caused by perception of social failure. Provide ongoing social skill instruction to help children form relationships with peers.

Role of Inclusion—

1. Carefully structure seating arrangements and group work. Kids with ASD should not be seated near class bullies or aggressive children. Rather, sit them next to children who can serve as a “peer buddy.” See where the youngster works most effectively; near the teacher or near a quiet open space. Avoid self-selection when children are being assigned to a group. Teach children how to function as a team and accept all members.

2. Connect with Each Other, Parents, Internet, and Other Support Groups. To avoid the feelings of many educators and families who feel isolated in their attempts to support children with ASD, create regular communication through meetings, telephone or e-mail among inclusion and special education educators and parents. Create a Home School Coordination- Improve the behavior of this student by combining school and home effort. Work on goals that the youngster should meet. Then send home a note indicating if the youngster has met that goal. If s/he has done so, reward him/her (in school and at home if the appropriate behavior is being exhibited there as well). 
 

3. Don’t Take it Personally. Don’t be insulted by the student who interrupts, speaks too loudly or misses your jokes. Separate the youngster from the syndrome (be perturbed with the behavior, but support the youngster) and try to imagine the world as viewed through his eyes. Model warmth and acceptance. Refrain from impatience and irritation so peers will too.

4. Help Your Classroom Become a Caring Environment. Create and maintain your classroom as a safe, supportive and accepting community by expecting and ensuring that all children respect, support and take responsibility for each other. Help create a strong sense of belonging among all the diverse children in your classroom.

5. Prepare for Changes in the Routine. Since most children with ASD thrive on clear expectations and routines there are many different methods a teacher can use to help create smooth transitions. Write class schedules and time frames on the blackboard, or use a picture schedule for younger kids. Designate classroom jobs, space and time with certain activities (e.g., computer). Explain changes in the routine well in advance (e.g., “On Thursday, we will have an assembly. That means you go straight from your second period class to the auditorium.”).

6. Promote Positive Peer Interactions. Create ways to connect the student with empathic peers in order to promote social acceptance and friendships. Use role playing and games - Try the program “Magic Circle” where children are seated in a circle and are encouraged to share their feelings and listen to others. This type of activity helps promote active listening skills and recognition of each individual. Help the student engage in successful conversations and reflection by using comic strips, since the pictures, words and symbols identify what the people say and do and emphasize what people may be thinking. Social stories which describe typical social situations and explain the meaning of various comments and identify appropriate responses are also good. Direct the youngster to participate in activities or clubs in which their abilities might neutralize their social deficiencies (e.g., math groups). Make sure they are not involved in groups that are frequented by bullies. Identify the student’s special gifts and teach him/her to share those gifts through tutoring, class presentations, or community service.

7. Provide a Safe Haven. Children with ASD can become overwhelmed by noise, crowds, chaos or trying to engage in social interactions (e.g., an assembly, recess time), which can lead to anxiety and stress. Offer an alternative to attending these events. Try earplugs or headphones to assist in screening out troubling noise. Make sure the youngster has a trusted contact person with whom they feel comfortable with (e.g., special education teacher, school psychologist, guidance counselor or principal, older responsible pupil). Give access to a quiet, private place (e.g., school library, tutoring room, empty classroom or office) where the student can spend lunchtime, study hall or any other free time alone, can rest and refresh themselves to alleviate the stress that accompanies the constant effort to fit in. 
 

8. Use Available Resources/ Make Needed Accommodations. Children with ASD often respond well to visuals, graphic models and technology. They often have impaired gross or fine motor skills. Encourage the use of computers for written assignments and exams. Allow for extra time or quiet space if needed. When significant amounts of notes need to be taken, pair the student with ASD with a buddy in order that the student can photocopy the notes missed. Allow time on the Internet. The effort and anxiety associated with interpersonal connections is greatly reduced because then children only have to deal with the written word. However, limit the amount of time on the computer in order that a potential obsession does not develop and that the computer does not become a substitute for human contact.

Characteristics of ASD—
  • Cognitive abilities which are average or above average (they are often known as “little professors”)
  • Depression, frequent school absences, low school motivation due to being socially vulnerable and easy targets for teasing and bullying
  • Difficulties with subjects that require inferential reasoning, abstract concepts, problem solving, extensive calculations or social judgments
  • Fine motor problems which lead to poor penmanship and low writing motivation
  • Friends and new acquaintances may be acknowledged with tight and enthusiastic hugs instead of formal greetings like “Hi, how are you?”
  • Gross motor clumsiness which leads to poor skills in competitive sports and physical activities
  • Hypersensitivity to noises or smells
  • Lack of emotional reciprocity or empathy
  • May begin to talk about the latest topic of concern which is of interest only to themselves (e.g., train schedules), may be age inappropriate or boring but the person does not pick up on looks of disinterest or snickers from the group
  • May move into the personal space of others, not recognizing body language, facial and verbal cues that he/she has transgressed
  • May not make direct eye contact
  • Persistent preoccupation with parts of objects
  • Rigid and inflexible adherence to specific routines or rituals
  • Speech and language peculiarities such as: stilted and formal language, voice too loud or monotone or hyperverbal.
  • Stereotyped and repetitive motor movements
   
The Complete Guide to Teaching Students with High-Functioning Autism
 
 
Personal Challenges for Children with Autism Spectrum Disorder—

Listed below are behaviors that a youngster on the Autistic Spectrum might encounter on a daily basis...

Social Interactions:

• inappropriate use of eye contact, avoidance or extended staring
• little sense of other people’s boundaries
• not accepting hugging, cuddling or touching unless self initiated
• poor use of nonverbal gestures
• trouble with back and forth social interactions
• wanting to be left alone at times

Interest and Activities:

• defensive to touch which isn’t self initiated
• difficulty waiting
• history of eating problems
• lack of fear or real danger
• lining up and or/ ordering objects
• pacing or running back and forth, round and round
• repeatedly watching videos or video segments
• resisting change
• strong attachment to inanimate objects
• very sensitive to sounds

Qualitative Impairments in Communication:

• difficulty understanding abstract concepts
• problem understanding jokes
• problem with getting the order of words in sentences correct
• problems answering questions
• problems using speed, tone and volume appropriately
• problems with reciprocal conversations

Learning Characteristics:

• delayed response time
• good visual skills
• hyperactivity
• needs help to problem solve
• problems organizing
• short attention span to some activities and not others
• well developed long term memory

Observable Problems Behaviors:

• aggression- biting, hitting, kicking, pinching
• low motivation
• temper tantrums
• toileting problems

Motor Problems:

• balance
• clumsiness
• motor planning- can’t make body do what it needs to do
• stiffness
• tired easily

 
Environmental Challenges that Lower Ability to Function Competently—

Personal:

- not being understood
- not understanding
- not having choices
- making a mistake
- being touched

Major Changes:

- alterations in school, work, home, community
- time changes
- staff or teacher absent
- cancellation of event or activity
- having to wait too long

Environmental Confusion:

- crowds
- noise
- not having enough space
- losing things of value
- surrounded by too much movement
- surrounded by too much visual stimuli

Relationships:

- being corrected
- being denied
- being late
- being ignored
- being left out
- being teased
- being scolded

Sensory Challenges—

Sound/ Auditory:

- reacts to unexpected sound
- fears some noises
- making self induced noises
- confused about direction of sound
- distracted by certain sounds

Sight/Vision:

- has been diagnosed as having a visual problem
- is sensitive to light
- has difficulty tracking
- upset by things looking different
- closely examines objects or hands

Smell/Olfactory:

- sensitive to smells
- explores environment by smelling
- reacts strongly to some smells
- ignores strong odors

Touch/Tactile:

- defensive about being touched
- prefers deep touching rather than soft
- dislikes feel of certain clothing
- over or under dresses for temperature
- upset by sticky, gooey hands

Taste:

- has an eating problem
- dislikes certain textures or foods
- tastes non-edibles

Movement/Vestibular:

- seems fearful in space
- arches back when held or moved
- likes rocking, swinging, spinning
- avoids balancing activities

Perceptual/Perceptual Motor:

- has difficulty with time perception
- problems with use of some tools
- difficulty with body in space
- relies on knowing location of furniture

Social Skills which may be Personal Challenges—

Personal Management/Self Control:

- waiting
- finishing work
- taking care of belongings
- turning in assignments on time
- changing activities
- accepting correction

Reciprocal Interactions:

- imitating
- sharing
- taking turns
- offering help, comfort
- inviting others to join
- asking for a favor
- letting someone know you are hurt or sick

Reciprocating Social Interactions Appropriately:

- listening
- commenting on a topic
- answering questions
- accepting help
- responding to teasing
- making a choice
- giving eye contact appropriately

Manner of Interaction:

- being polite
- being kind
- being considerate
- being honest
- not walking away when someone is talking

Abstract Social Concepts:

- being good
- timing
- fairness
- friendship
- caring
- lying
- humor

Group Behaviors:

- come when called to a group
- stay in certain places
- participate with group
- follow group rules
- winning and losing
- pick up, clean up, straighten up

 
Effective Behavior Interventions of Problem Behaviors–

What makes kids on the spectrum do what we do?
  • Biological Influences
  • Instructional/ Reinforcement History
  • Setting /Events
  • Stimulus Events

In order to create an effective intervention for problem behaviors, educators (and parents) need to take into consideration a variety of aspects.

1. Hypothesize the function of the behavior

• Social Attention
• Escape/ avoidance
• Wants tangible item or activity
• Sensory Feedback

2. Gather Information

a. Antecedent : Does the behavior occur……

- When you are attending to other people in the room?
- Following a request to perform a difficult task?
- When a request for an item or activity is denied?
- Repeatedly, in the same way, for long periods of time, even when no on is around?

b. Consequence: When the behavior occurs, do others….

- Attend to the student?
- Leave the student alone?
- Negotiate or give the desired item/activity
- Allow the student to engage in inappropriate behavior? 

3. Plan an Intervention

a. Based on information gathered, are environmental changes needed?

- Move student closer to teacher.
- Limit materials available to student.
- Remove distracters.

b. Based on information gathered, determine how people should react to the challenging behavior each time it occurs.

- Plan to ignore.
- Plan to attend.
- Plan to remove privileges.
- Plan to redirect.

4. Identify a Replacement Behavior

a. What appropriate behavior is “functionally equivalent” to the challenging behavior?

- Manipulating a stress ball or twist pen to replace inappropriate hand movements
- Teaching the student to ask if he can use the computer later to replace tantrum behavior
- Teaching student to raise his hand to replace attention-seeking behaviors
- Teaching the student to communicate his wants appropriately to replace escape/ avoidance behaviors

b. Complete replacement behavior planning guide with team…

- Which behavior is the team going to target for replacement?
- What functionally equivalent behavior is the team going to train in place of the problem behavior?
- In what situations will training occur?
- Who will be responsible for conducting the training sessions?
- What motivation system will be implemented during training?
- Describe how the team will evaluate if and how the student uses the new response.

 
Promoting Positive Classroom Behavior of Children—

The suggestions written below can be used to help kids with ASD but can be used in any classroom to help promote a positive atmosphere.

a) Rules - Establish, teach and enforce classroom rules. Rules should be positively stated and identify the specific behaviors you wish to see displayed

b) Premack Principle - Method of maintaining and increasing compliance with rules through the use of positive reinforcement. A desired activity is available to children on the completion of an undesired activity (e.g., a student who stays in their seat for a period of time can earn an opportunity to work on the computer).

c) Contingency Contracts - Children and educators formalize agreements concerning specific behavior for the exchange of reinforcers by writing an agreement. It outlines the behaviors and consequences of a specific behavior management system. (See the link on this site titled "Contracts")

d) Self-Recording - The student monitors his or her own behaviors by using a data collection system. Children can be taught to increase their on task behavior during a class by placing a + in a box when they are paying attention for several minutes and a -–if they are off task.

e) Self-Evaluation - A self-management system that has been used to promote appropriate behavior in many general education programs. Children are taught to evaluate their in class behavior using a rating scale. For example, a student can rate his on task and disruptive behaviors using a 0-5 point rating scale ("unacceptable" to "excellent"). The student earns points (which can be exchanged for reinforcers) based on both student behavior and the accuracy of his ratings. 
 

Ways to Decrease Inappropriate Classroom Behaviors –

Listed below are various ways to decrease inappropriate behaviors and increase appropriate ones for kids with ASD.

- Redirection - Introduce a novel stimulus to recapture the student’s attention by delivering verbal and nonverbal cues to the student to stop misbehavior, offering assistance with a task, engaging him/her in conversation, reminding him/her to focus attention on the task, or modeling calm and controlled behavior.

- Interspersed Requests - Used to motivate children to perform a difficult or unpleasant task by initially asking them to perform several easier tasks, which they can complete successfully in a short amount of time. This helps promote “behavioral momentum”.

- Differential Reinforcement - Techniques used to decrease inappropriate behaviors by reinforcing the occurrence of positive behaviors, which cannot coexist with the appropriate behavior. (See the link on this site titled "Differential Reinforcement")

- Extinction - A strategy in which the positive reinforcers maintaining a behavior are withheld or terminated, resulting in the reduction in the behavior. (See the link on this site titled "What is ABA" ---then read about 'Ignoring')

- Checklists and Schedules - Provide visual structure and motivation needed to complete assignments and remain on task by checking off assignments and activities upon their completion.

Adaptation of Oral Presentations/Lectures for Children—

Some children require modifications to be made in order for them to understand what is being taught. There are various types of adaptations. Listed below are a few which can be used to help any student achieve to their highest potential:

Pausing - to help children retain lecture content pause for 2 minutes every 5-7 consecutive minutes of lecturing. During the pause children can discuss and review content, ask questions or engage in visual imagery.

Visual Aids - Visual supports such as charts, graphs, lists and pictures can be used to highlight main points, maintain attention, promote eye contact and address the needs of visual learners.

Guided Notes - Outlined and guided notes in which the student fills in the blanks provide a foundation for note taking, and promotes on task behavior. Since many kids with ASD have difficulty with fine motor skills such as writing, this is a method that can be implemented to help them throughout lectures.

Active Student Responding (To encourage active participation) choral responding- in which children answer simultaneously on a cue from a teacher during fast paced lessons.

Response Cards - cards are simultaneously held up by all children to display their responses to questions or problems presented by the teacher

Cooperative Learning Groups/ Peer Tutoring - helps with social interaction

Other Strategies—
  • Use repetition by asking children to answer the same questions several times during a class period.
  • Reinforce correct responses and appropriate behavior with descriptive statements that identify what made the answer "right".
  • Group student with peers who participate and attend.
  • Select children randomly to respond and remind them that they may be called on next
  • Change activities frequently
  • Vary the presentation and response modes of instructional activities.
  • Decrease the complexity and syntax of statements.

Affective Education Strategies to Implement in Any Classroom—

Rapport - Maintaining rapport with children can help establish a positive classroom environment. Educators can establish rapport by talking to children about topics in which they are interested, sharing their own interests, providing opportunities for children to perform activities in which they excel, and complimenting children.

Humor - Good-natured joking helps develop a good relationships and a positive classroom atmosphere. Humor helps children see a situation from another perspective and decreases the likelihood of conflicts.

Dialoguing - Dialoging involves meeting with the children to assist them in identifying the problem, discovering their perspective on that problem, phrase it in their words, and discussing solutions for resolving the problem. It helps children understand their behaviors and problem solve alternatives to inappropriate behaviors.

The Complete Guide to Teaching Students with High-Functioning Autism
 
By

Kids with Autism Spectrum Disorder and the Associated Relationship Problems

"Is it common for children with ASD to have a great deal of difficulty relating to their peers in a proper manner? My son tends to burn bridges (so to speak) rather quickly with his friends."
 
ASD level 1 (high-functioning autism) often leads to problems in social interaction with peers. These problems can be severe or mild depending on the individual. Kids with ASD are often the target of bullying at school due to their idiosyncratic behavior, precise language, unusual interests, and impaired ability to perceive and respond in socially expected ways to nonverbal cues, particularly in interpersonal conflict. 
 
Kids on the autism spectrum may be overly literal, and may have difficulty interpreting and responding to sarcasm, banter, or metaphorical speech. Difficulties with social interaction may also be manifest in a lack of play with other kids.

The above problems can even arise in the family. Given an unfavorable family environment, the youngster may be subject to emotional abuse. A youngster or teen with ASD is often puzzled by this mistreatment, unaware of what has been done incorrectly. Most kids on the spectrum want to be social, but fail to socialize successfully, which can lead to later withdrawal and asocial behavior, especially in adolescence. 
 
 
At this stage of life especially, they risk being drawn into unsuitable and inappropriate friendships and social groups. People with ASD often interact better with those considerably older or younger than themselves, rather than those within their own age group.

Young people with ASD often display advanced abilities for their age in language, reading, mathematics, spatial skills, and/or music—sometimes into the "gifted" range—but this may be counterbalanced by considerable delays in other developmental areas. This combination of traits can lead to problems with teachers and other authority figures. A youngster with ASD might be regarded by teachers as a "problem kid" or a "poor performer." 
 
The youngster’s extremely low tolerance for what they perceive to be ordinary and mediocre tasks, such as typical homework assignments, can easily become frustrating; a teacher may well consider the youngster arrogant, spiteful, and insubordinate. Lack of support and understanding, in combination with the youngster's anxieties, can result in problematic behavior (such as severe tantrums, violent and angry outbursts, and withdrawal).

Two traits sometimes found in individuals on the spectrum 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 oneself or others), which reduce the ability to be empathetically attuned to others. Alexithymia in ASD functions as an independent variable relying on different neural networks than those implicated in theory of mind. In fact, lack of Theory of Mind may be a result of a lack of information available to the mind due to the operation of the alexithymic deficit.

A second issue related to alexithymia involves the inability to identify and modulate strong emotions such as sadness or anger, which leaves the individual prone to “sudden affective outbursts such as crying or rage.” The inability to express feelings using words may also predispose the individual to use physical acts to articulate the mood and release the emotional energy.

People with ASD report a feeling of being unwillingly detached from the world around them. They may have difficulty finding a life partner or getting married due to poor social skills. The intense focus and tendency to work things out logically often grants people with ASD a high level of ability in their field of interest. When these special interests coincide with a materially or socially useful task, the person on the spectrum can lead a profitable career and a fulfilled life. The youngster obsessed with a specific area may succeed in employment related to that area. 
 

What is ASD like?
  • It affects individuals all of their lives, but as individuals get older they get better at social and coping skills.
  • Many great scientists, writers and artists are thought to have had Aspergers, including many Nobel Prize winners.
  • Individuals with ASD can do well when others understand the effects of the syndrome on their behavior and learning, and provide a supportive environment.
  • They find it hard to relate to other individuals.
  • Some individuals who are said to be eccentric loners may have ASD.
  • The effects of autism can vary from slightly unusual behavior to quite aggressive and anti-social behavior.
  • They have trouble understanding the feelings of other individuals and they do not seem able to read body language. For example, a person with ASD may not realize when they have hurt someone's feelings, or when someone doesn't want to listen to them.
  • They like everything to be the same, and everything to be in the right place. They can get very upset if something is done 'the wrong way'.
  • They may talk a lot about their own interests, but have problems getting the message across or giving others the chance to talk.

Secondary School—
  • It can seem as though they are really bright because they know a huge amount about something they are interested in, but they might have trouble keeping up with other subjects.
  • Other students get better at interpersonal relationships as they grow older, but it can become more difficult for a student with ASD to be involved in friendship groups. However, they may enjoy groups which follow their special interest (e.g., science clubs).
  • Secondary school can be very stressful for students with ASD because they have a different timetable each day, several different teachers, and have to move between classrooms. These changes can be really stressful for someone who likes everything to be the same.

Teenagers with ASD are usually able to manage stressors better than younger kids, and behavior problems at school may be less of an issue at secondary school. However a teenager on the spectrum  may be so worn out after 'holding it together' all day at school that he or she may 'fall apart' at home.
  • It may be possible to negotiate with teachers to reduce the amount of homework or extend tasks over a longer time.
  • Feeling tired after school is often a problem, and facing up to homework at the end of the day can be very stressful for someone who has already had a stressful day.
  • A school counselor can help to work out strategies for dealing with problems, which might include a place to work alone if things get too hard sometimes.

 
Adult Life—
  • If partners and kids are able to learn more about ASD, they are often more able to understand the behavior and live more comfortably with the person who has autism.
  • Individuals with ASD also need to understand relationships better and learn more about how their behavior and emotions can affect others.
  • Most individuals on the spectrum can form strong bonds with a few friends, marry and have kids.
  • Peer support groups can also be helpful for partners and kids. Check on the internet to see if there are support groups in your area.
  • Their anxieties and difficulties with the subtleties of relationships can be confusing and upsetting to partners and their kids.

Problems for Brothers and Sisters—

It can be difficult if you have a brother or sister with ASD.
  • Parents often have to spend a lot more time with the youngster who has autism, so that you can feel you are missing out.
  • Their behavior can be difficult to live with because they don't relate to others well.
  • They may have frequent tantrums when things don't go their way, and this can be embarrassing to you, especially if your friends are around.
  • You may have to watch out more for your brother or sister to protect them from others, such as protecting them from being bullied.

Understanding more about Autism Spectrum Disorder may help you interact more successfully with your brother or sister.
By

Sleep Problems in Teens on the Autism Spectrum

Question

I'm a single mother and don't know how to deal with my 13 yr old anymore. He doesn't want to go anywhere or do anything which is hard when you have to, and I am now homeschooling him due to trouble going to school. A big problem right now is sleep issues… he is so active at night and tired during the day. At the moment he is not falling asleep till about 1 or 2 am, and I've tried waking him up earlier to reset his body clock but I can't get him out of bed. I don't know how to get him back into a healthy sleep routine.

Answer

Studies find that approximately 73% of kids with ASD level 1 (high-functioning autism) experience sleep problems, and these problems tend to last longer in this group than they do for kids without ASD. For example, kids on the spectrum are more likely to be sluggish and disoriented after waking. Laboratory research has begun to describe the unique physiological presentation associated with sleep problems in kids with ASD, including disruptions in the sleep stage most associated with cognitive functioning (i.e., REM or Rapid Eye Movement sleep). In addition to physiological differences, some of the sleep difficulties in this population may be related to anxiety.

The impact of poor sleep is unequivocal. Poor sleep negatively impacts mood and exacerbates selective attention problems commonly found in kids with ASD, as well as impairing other aspects of cognitive function.
 

There is no one panacea to manage sleep problems in autistic kids. However, there are many interventions that are likely to be helpful. In general, moms and dads need to understand and be prepared for resistance to change that these kids often show. Moms and dads should also be prepared for problems to get worse before they get better as kids often initially challenge but then gradually become accustomed to new routines.

A good place to start an intervention targeted at improving sleep is changing lifestyle behaviors and environmental conditions that can influence sleep/wake patterns. These include exercise, napping, diet, and aspects of the bedroom and sleep routine.

Exercise & Activity—

The goal is decreasing arousal as bedtime approaches. To achieve this it may be useful to have a scheduled period before bedtime (approximately 30-45 minutes) in which the aim is calmness and relaxation. During that period, media such as television, computers, electronic games, and music should be limited as they can stimulate the youngster through activity, sound, and light. 
 
The availability of VCR and DVR technology makes it easier to control when kids can watch particular shows, thereby avoiding conflict over missing favorite programs that are shown in the late evening. The presence of televisions in kid’s bedrooms has been consistently associated with sleep problems and should be avoided at all costs. Likewise, computer access in a youngster’s bedroom is discouraged for sleep as well as for safety reasons.

In general, exercise during the day is associated with better sleep. However, exercise within 2-4 hours of bedtime can lead to difficulties in falling asleep, as it can disrupt the natural cooling process of the body that leads to rest at night. Having the youngster soak their body, particularly their head, in a calm bath that is as warm as can be tolerated 90 minutes before bedtime may be useful too. 
 
When the youngster gets out of the bath, core body temperature will drop rapidly; this is believed to help them to fall asleep faster. Using a waterproof pillow and avoiding the pulsation associated with showers is recommended. The use of progressive muscle relaxation, deep breathing and imagery exercises is the most widely researched treatment for insomnia in kids and may be useful for kids with autism as well.

Napping—

Controlled and limited (e.g., 20-30 minutes) napping is generally positive. However, longer daytime sleeping can be negative in that it makes it more difficult for the youngster to fall asleep at the ideal time in the evening. If the youngster’s sleep problems are associated with falling asleep, which is common for kids on the spectrum, it is advisable to avoid daytime napping.

Diet—

It is recommended that kids with sleep problems avoid all caffeine, alcohol, tobacco, high fat food, and monosodium glutamate (MSG). In contrast, food rich in protein may promote better sleep. Large meals within 2-3 hours of bedtime should also be avoided. A small carbohydrate/protein snack, such as whole wheat bread and low-fat cheese or milk before bedtime can be helpful to minimize nighttime hunger and stimulate the release of neuro-chemicals associated with falling asleep. For kids who often wake during the night to use the bathroom, and then have trouble falling back asleep, limited fluid intake in the 2 hours prior to bedtime is also recommended.

Melatonin is a natural brain hormone associated with sleep onset. There is some evidence that natural production of melatonin may be reduced in these young people on the spectrum. While melatonin supplements may be useful, a common side effect may be increased sluggishness in the morning. As discussed above, this is already a common problem for kids with autism. Use of melatonin and other alternative remedies should be discussed with a physician.
 

The Bedroom—

It is important that the bed and the bedroom are associated with sleep and are not associated with activity. When kids have sleep problems, it is highly recommended that their bed and bedroom activity be limited to sleep only. It is important to make sure that extreme changes in temperature are avoided during the night. 
 
Increasing light is associated with decreases in the release of the neuro-chemical melatonin which triggers sleep onset. Thus, it is important to get the sunlight flowing in the youngster’s room as soon as possible in the morning. Conversely, darkening the room at night is critical. When a youngster’s fear of the dark is an issue, behavioral psychotherapy may be necessary. We also recommend moving the clock so that the youngster is not watching the time while lying in bed.

Sleep Routine—

Setting and maintaining a regular time to sleep and wake may be critical. Moms and dads often make the mistake of allowing their kids to sleep much later on non-school days to “make up” for sleep. While this may be useful to a certain extent, allowing the youngster to sleep late in the day makes it difficult for them to fall asleep at an ideal time later in the evening. It is easier to wake a sleeping youngster then to force an alert youngster to go to sleep. Thus, we recommend that you keep your youngster on a regular schedule on non-school days and avoid drastic changes in the time that the youngster wakes. 
 
Likewise, having your kids go to bed when they are not tired conditions them to be awake in bed. It is recommended that you let your kids stay up until they are tired while maintaining their waking time in the morning. Then once they begin falling asleep within 10 minutes of going to bed, begin to move bed time earlier by 15 minutes at a time.

With carefully monitoring and patience, many moms and dads can make changes in a youngster’s life that promote better sleep. Improved sleep supports better mood, sustained attention and general health. However, for many families professional consultation is often necessary to design or maintain the appropriate intervention. When you need help, speak with other moms and dads of special needs kids about their experiences and ask your primary care doctor for referrals to a sleep expert.
 
More resources for parents of children and teens on the autism spectrum:
 
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COMMENTS:
•    Anonymous said…  She said she was a single mom I assume she has to work to provide... so she may not be able to adjust her schedule... I am single mom of HFA 11yr old with simular issues... and I am debating homeschooling but I am only one person !!!!
 •    Anonymous said… Exactly my thought. We have a 6pm rule. No electronics after that time. Increased his exercise, and it works for us. No drugs needed. X
 •    Anonymous said… Exercise, no electronics on in the house after 6 (a bored brain is a tired one), wake up same time every time with daylight, and same basic diet. We do a fruit/veg/chia smoothie to start the day. My son loves to seek electronics at night (all electronics blocked during certain hrs and collect xbox and remotes every night)
 •    Anonymous said… Go to your GP and try him on Melatonin, a natural hormone that helps us to sleep. We produce it in our bodies but some have less than others hence the difficulty sleeping. It may take a little while to find the right dosage that is agreeable to his body. My son is 13 and is on it. He was like a new born with sleep patterns until he was 6 yrs old. By 11 I was going nuts. He is much better now thank goodness and gets the rest that his body and mind needs to grow and function properly. You may have to restrict the internet/pc use at night and reward him with it during the day only so as to encourage him to sleep at night. The 'blue light' projected from the pc/laptop suppresses the normal secretion of melatonin and doesn't really help ones circadian rhythms. Getting off any electronic devices atleast an hour or two before regular bedtime allows the brain to begin the whole process of slowing down and releasing that melatonin. Look, I for one know that all of this information works but unless we as the parents/carers put it into practise, our kids will never do it. I'm not perfect, some days I forget to give my son his dose at the right time and then he's struggling to wake up at the right time the next morning and so I pay the price with his bad mood and getting to school on time etc. But we all have to start somewhere right? He was doing the school refusal thing last year and not wanting to leave the house or socialise at all. We enlisted the help of a psychologist who specialised in ASD and the school and recommitted to being the driving force behind implementing new routines. Baby steps was and is what it takes at the moment for my son and I. Its so tough for him especially I know, as I'm sure it is for your son but we have to push them out of their comfort zones for them to face challenges and grow from them. How else will they grow and learn? They wont! Plain and simple. Unfortunately its up to us. We become their "Executive Secretaries" as stated in the book "The Complete Guide to Aspergers Syndrome" by Tony Attwood.
 I think I have gone on too much already but I hope you will find what your son needs to help him sleep and learn and grow. Wishing nothing but joy and success for our special Aspies!!!
 •    Anonymous said… i also have a 12 yrs old with similar tendancies. Our Pead told us to avoid any Blue lights (whether that be in ceiling light or of electronics) after 4pm as it over stimulates their brain. I am now also trying reading before bed. I feel your pain
 •    Anonymous said… I could have written this about my (undiagnosed) 11 year old. She also is now totally not Going to school (it's always been an issue but is much worse lately), she doesn't sleep and basically stays up all night every night (sometimes until 5-6am). She gets into bed ok at around11-12 but won't/can't sleep. She is very aggressive verbally and physically towards me almost all of the time and is very anxious. She doesn't go out with her friends or actually talk to them at all anymore. (She's never had tons of friends but now doesn't talk to the ones she did have) I'm also a single mum and have w younger daughter who is really effected by all this. It's so hard! I can't really offer any advice I'm waiting on things happening from the countless referrals that have gone in to community peads, cahms, child psychologist, education physcholigist etc xx
 •    Anonymous said… I guess it doesnt work for everyone. If there is a physical activity or sport that he likes to do then try to do it everyday as it will help use up that 'boy' energy during the day. A bath or warm shower at night, a warm drink, reading some stories, di...See More
 •    Anonymous said… If you're homeschooling anyway flip your schedule to match his. Do schoolin the afternoon. Theres a whole raft of studies about teen boys needing to sleep later. Make wake up time 10am and shift things. If the way everyone else does things isnt working for you and him create your own path.
 •    Anonymous said… I'm not a Dr but have Aspergers girls and their consultants prescribed "Melatonin" it worked a treat to get their bodies back in a sleep routine and we only use it now if required. Hope this helps xx
 •    Anonymous said… I've had similar issues, and since I've started to listen to his feelings, I work around him more now allowing him to sleep in as many days as possible, he is amuck happier boy all round for it 🏻
 •    Anonymous said… Melatonin did nothing for our grand son any thing else
 •    Anonymous said… My 8yr old grandson exactly the same.Wont go to school awake all night and his mum and dad cant get help for him in newzealand its shocking I feel sad for you.
 •    Anonymous said… My Aspie son has just turned 17 and his sleeping patterns starting changing at about 13yrs old. I know how you feel and it's really hard. I'm now told by UK Social that my son is neglected and we can't parent him because we don't enforce his sleeping pattern and he lives for the Internet (it's the only form of Social life the poor boy has!). Can you flipping believe it! I don't know what to suggest tbh, because as you know it's not like parenting our sons when they were little boys where they knew bed time was bed time. It gets so much more challenging.
Maybe go onto "The National Autistic Society" website and go onto the Members Forum (you can browse as a "Guest"). There are so many parents in the same boat trying to manage their Teens through to Adulthood.
 •    Anonymous said… my daughter doesnt go to bed till 1 or 2 am every day.....Melatonin diesnt wirk for her she needed stronger stuff but ended up ODing on perscription stuff....now we just let her stay up and I wake her at 7:45 for school every day
 •    Anonymous said… My daughter had similar sleep pattern issues thru the early teens (although she did lots of drama classes in the evenings so socializing wasn't an issue). All teenagers naturally will stay awake later and sleep in. The beauty of home ed is we can accomodate their changed natural bio rhythms. I treasured my mornings to myself and we did educational stuff in the afternoons/evenings. Is there anything he would like enough to entice him out of the house? Other than saying don't worry, it will pass (it did with my daughter and I miss those precious me time mornings!) I don't know what to advise. But try not to worry too much about the sleep, it is normal and entirely natural during puberty, as is needing more sleep, instead explore ways to get him outside.
 •    Anonymous said… My daughter takes melatonin a half hour before bedtime I give her 4mg in apple juice and she takes it other wise she would be up all night long. She's 12 and has been taking it since she was 2. No more sleep issues ever
•    Anonymous said… My Dr put my son on Clonidine 0.1mg to help him sleep at night otherwise he would be up all night
 •    Anonymous said… My son is 11 and has a similar pattern. He has been on increasing doses of melatonin for 3 yrs. The problem is it us meant to only be given for a month then nothing then for another month, in an attempt to train the body. The breaks just send my son back into vampire mode within days. He was quite sick for a few day so Dr prescribed phenegan for anti nausea. This knocked him out.... you can buy over the counter from Boots, alot if chemists won't sell it to you though. But I found that boots did when I explained my son was aspie and it calmed him down. Understand this is only used when the melatonin is wearing off and body is used to it. I use it maybe once a month just so he gets a decent nights sleep @weekend.
Maybe worth a try as I know many Dr's don't like to prescribe melatonin unless forced. We get all his meds through Camhs xx
 •    Anonymous said… Should talk to you'r doctor about what you can give him to help him sleep.May be you should look into a therapist to go to for help with your son. Has help with me.
 •    Anonymous said… Society imposes routines that aren't fit for all, if he's feeling ok and is willing to take responsibility for himself and things that need to be done then maybe you could be more flexible. I say this because my 13yo son is in a similar position, I worry that he doesn't have a social life but he's much calmer out of school and no longer being bullied. I'm a single parent too and have to leave him home alone while I go to work, but he's safer there than he ever was in school.
 •    Anonymous said… This sounds similar to what we experienced through the middle school years. Puberty is challenging for anyone, seems even more so for young people on the spectrum for some reason. Maybe because there was no go to rule book to reference since most info out there refers to neurotypical teens. It could be depression as well. Hang in there.
 •    Anonymous said… Turn electronics OFF
 •    Anonymous said… Unless you were/are an Aspie teenage with sleep problems, you dont have a clue what its like, it is not their fault REMEBER that! you can feed them all the tablets and chemicals you want but at the end of the day it only masks one of the many issue that we have to deal with, they are not the instigator they are the victim of their own biology.
 •    Anonymous said… we do 3 mgs of Melatonin at night. I was amazed at how much it helped my 7 year old. You can take breaks on weekends and holidays if you want but during the week we use it each night. He even said, "mom! I actually slept last night!!!"
 •    Anonymous said… We use 2 mg Clonidine and 3mg Melatonin for years. It was a life saver!
 •    Anonymous said… We use melatonin 20 minutes before bed with a warning that the tv,electrinics/internet,will be off soon. After 20 minutes we remove tv remotes,game paddles,etc and turn off the lights. Works for us.
 •    Anonymous said… Yes!! This can be a problem. Our teenager must have a sleep aid.
 •    Anonymous said… Yes, melatonin does nothing for my sleepless son also 🙁
Post your comment below…
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10 Healthy Supplements to Consider for Autism

Autism Spectrum Disorder (ASD) or simply autism is a condition that affects the way a person’s brain functions. It also impacts the social interaction, language, and basic communication of the affected person. Children with autism may involve repetitive behaviors. 


Although there is no curable remedy for autism, the treatment is based on the individual that may involve helping the patient through their symptoms with education, self-help, skill development and socialization. Children and adults who are affected with autism may develop limited food intake or choices. Since their bodies may break down fat differently it is possible that their bodies may lack certain nutrients. This is related to selective eating, decreased gut absorption, or depletion of nutrients from chronic stress. Hence, diet changes and supplementation have proved to be very helpful methods of aiding children with autism. With enhanced food choices, you can help your autistic child better manage the daily struggles.

Following are the ten broad dietary supplements that you can consider for helping autistic people:

Omega 3 Fatty Acids

Omega 3 fatty acids are essential nutrients for the development of the brain and eyes in the body. Many children with autism also suffer from Sensory Processing Disorder (SPD) where the brain has trouble receiving and responding to the signals that are sent by the senses. Omega 3s have been found to be in lower levels among people with autism and therefore it becomes an important supplement to include in your child’s diet. Foods that are rich in Omega 3 fatty acids are fish oil, plant oil and nuts and seeds. Omega 3s also help fight joint pain and inflammation. Here’s an honest review on Omega XL which is a dietary supplement containing benefits of 30 different fatty acids. However, more research is needed into how Omega 3s can really help autistic individuals therefore its best to take your doctor’s advice on it.

Vitamin D

Vitamin D helps assist the brain in creating new connections and bettering already prevailing connections. It is said to affect the neurotransmitters in the brain. Studies have shown that children with autism develop vitamin D deficiency. A daily dose of its supplement can help reduce the ASD symptoms affecting the child’s social interaction, communication and engaging in repetitive behaviors. Salmon, mackerel, tuna, fortified foods, egg yolks, milk and mushrooms are a good source of vitamin D.

Oxytocin

The chemical oxytocin is created naturally in the brain and has an effect in forming social interaction and bonding in an individual. When it comes to ASD symptoms, some children are found to have reduced oxytocin levels in their bodies and some do not. Hence, more clinical research is needed on how oxytocin can benefit kids with autism.

Melatonin

Melatonin helps regulate the sleep cycle in the body. This hormone helps in treating insomnia and those who are affected with sleeping disorders. It has been found that reduced levels of melatonin is correlated to severe ASD symptoms among kids. Effective melatonin supplementation has positive impact on autistic individuals with better sleep cycles and daytime behavior. Ask your doctor for the right dosage before starting its medicinal course. Nuts, seeds, grains like rice and barley, asparagus, tomato, olive, pomegranate, grapes and broccoli are foods that help increase levels of melatonin in the system.

Sulforaphane

Clinical trials have shown that supplements having sulforaphane (SF) have helped reduce the behavioral symptoms of people with ASD. Sulforaphane is found in broccoli sprouts, cabbage, cauliflower, and kale and mustard greens. Taking sulforaphane as a supplement can have an improved effect on social interaction, communication, and a reduction in aggressive behavior.

Methyl B 12

Methyl B12 comes from the vitamin family that plays an important role in the functioning of the body’s nervous system and it intermingles with folic acid to produce cells in the body. Children with reduced developmental capacity have an impairment in processing the body’s methyl B 12. Early lab research suggests that kids with autism showed improvement in few metabolic and cellular processes when given methyl B 12 supplements.


Vitamin C

Children with autism can find it hard to fight free radicals in the body, which can cause an imbalance in their system. Vitamin C is an essential nutrient that helps protect the body from free radicals. A study with a small group showed that children with ASD symptoms showed reduction in typical autistic activities like flapping hands, pacing and rocking. However, more research is needed in this domain to find clinical evidence of benefits of vitamin C supplementation for autism. Red and green peppers, spinach, cabbage, turnip, leafy greens, winter squash, citrus fruits and tomatoes are rich sources of vitamin C.

Vitamin B-6 and Magnesium

Another great multivitamin is B-6 that has loads of health benefits. Magnesium ensures proper functioning of the brain and muscle cells and is found in many foods like whole grains, nuts and seeds and leafy greens. Vitamin B6 and magnesium are typically used together as supplements, as B6 can sometimes cause an upset stomach, and magnesium appears to counter that. Some studies have shown that children with autism may have a magnesium deficiency. Research on supplementing B-6 and magnesium is still in an early stage when it comes to ASD.

Calcium

Calcium helps you develop strong teeth and bones. Low calcium intake may lead to a high rate of bone fractures seen in children with autism. Rickets and eye-poking is often associated with calcium deficiency. Not only is calcium found in dairy products but in green leafy vegetables as well. Many calcium supplements come in the form of chewable pills, liquid and powders. It is advisable to take your doctor’s opinion for catering to autistic patients.

Zinc

Zinc plays a vital role in enzyme function, nucleic acid metabolism, growth, and cellular repair. It is a major factor in the etiology of behavioral and mood disturbances in humans and its deficiency is high in children diagnosed with ASD. Meat foods, nuts and seeds, seafood and legumes are rich in zinc.

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Understanding the Role of Risperidone and Aripiprazole in Treating Symptoms of ASD

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by social communication challenges and restricted, re...