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

ASD: Difficulty Identifying and Interpreting Emotional Signals in Others

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that affects an individual's ability to communicate, interact with others, and understand the world around them. One of the key challenges faced by individuals with autism is the inability to identify and interpret emotional signals in others.

Emotional communication is an essential aspect of human interaction, and being able to recognize and understand the emotions of others is crucial for building and maintaining relationships. However, individuals with autism often struggle in this area, which can lead to social isolation and misunderstandings.

There are several reasons why people with ASD have difficulty interpreting emotional signals in others. One of the primary factors is impaired social cognition, which refers to the ability to understand and interpret social cues, including facial expressions, body language, and tone of voice. Studies have shown that individuals on the spectrum may have difficulty recognizing these nonverbal cues, making it challenging for them to understand the emotions of others.

Moreover, individuals with autism may also have difficulty understanding the perspective of others, which can further hinder their ability to interpret emotional signals. Theory of mind, which involves understanding that other people have their own thoughts, feelings, and perspectives, is often impaired. As a result, they may struggle to empathize with others and understand the emotions they are experiencing.

The inability to identify and interpret emotional signals can have significant consequences. It can lead to social difficulties, misunderstandings, and feelings of isolation. Furthermore, it can also impact their ability to form meaningful relationships and navigate social situations effectively.

However, it's essential to recognize that individuals with ASD can learn and develop strategies to improve their ability to identify emotional signals. For instance, they can benefit from targeted social skills training, cognitive behavioral therapy, and interventions aimed at improving emotional recognition and empathy.

Social skills training plays a crucial role in enhancing their abilities to interact, communicate, and navigate social situations. There are various types of social skills training designed to address the specific needs of autistic individuals. These types include:

1. Behavioral Therapies: Behavioral therapies such as Applied Behavior Analysis (ABA) focus on breaking down social interactions into manageable components and teaching specific social skills through repetition, reinforcement, and prompting. These therapies often use structured activities and visual aids to teach social skills in a systematic way.

2. Cognitive-Behavioral Therapies: Cognitive-behavioral therapies aim to help autistic individuals understand social cues, perspectives, and emotions. These therapies emphasize teaching individuals how to identify and manage their own thoughts and emotions in social situations. Techniques such as role-playing, social stories, and video modeling are often used in cognitive-behavioral social skills training.

3. Peer-Mediated Interventions: Peer-mediated interventions involve working with peers and typically developing individuals to provide opportunities for autistic individuals to practice social skills in naturalistic settings. These interventions focus on promoting social inclusion and fostering meaningful interactions between autistic individuals and their peers.

4. Social Communication Interventions: Social communication interventions target specific communication difficulties often experienced by autistic individuals. These interventions may include strategies to improve conversation skills, nonverbal communication, and understanding social norms and expectations.

5. Group-Based Interventions: Group-based social skills training involves participating in structured groups where individuals can practice various social skills in a supportive environment. Group settings can provide opportunities for individuals to engage in social activities, develop friendships, and learn from each other's experiences.

6. Technological Interventions: With the advancement of technology, there are various technological interventions such as social skills apps and virtual reality programs designed to supplement traditional social skills training. These interventions often provide interactive and engaging ways for autistic individuals to learn and practice social skills.

In summary, the inability to identify and interpret emotional signals in others is a significant challenge faced by individuals with autism. By understanding the underlying factors contributing to this difficulty and providing appropriate support and intervention, we can help individuals with autism improve their social communication skills and lead fulfilling lives.

 

 

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Finding Which Behavior Problems to Target First: Tips for Parents of Kids on the Autism Spectrum

Your child with High-Functioning Autism (HFA) or Asperger’s (AS) seems to have a multitude of behavioral and emotional issues. Which ones should you attempt to address first? With so many problems, where do you start?

A careful analysis of the most problematic symptoms is crucial, because the choice of interventions is influenced by symptom traits. Moreover, the wide array of symptoms results in the tendency of those closest to the HFA or AS youngster to lose sight, over time, of the intervention targets.

When parents (and teachers) turn their attention to a new troubling cluster of symptoms, an intervention that has been effective may be reinterpreted as ineffective. Being attentive to symptom traits allows the parent to measure effects and introduce helpful responses. 
 
==> Parenting System that Significantly Reduces Defiant Behavior in Teens High-Functioning Autism

The most important traits to consider include the following:
  1. Distribution of the behavior problems
  2. Intensity of the behavior problems
  3. Onset: Time and Location of the behavior problems
  4. Duration of the behavior problems
  5. Ameliorating Factors for the behaviors
  6. Aggravating Factors for the behaviors
  7. Trends of the behavior problems: upward or downward

1. Distribution—

The distribution of behaviors is a term for the frequency of symptoms over time. It may be obvious, but it’s worth underscoring that for most kids on the autism spectrum, the frequency of symptoms changes within days, weeks, and months. Thus, having a good awareness of the course of a symptom is important for monitoring the behavior problem.

The early, short-term effects of a particular behavioral intervention may not be the most reliable ones for predicting the overall effect that intervention delivers. Frequency also is related to settings and circumstances. Aggression or perseverative behaviors often increase or appear under certain circumstances (e.g., when there are many people talking, or when there are crowds). As a result, for behaviors that are periodic, it’s useful to rate the behavior at the time when it’s most frequent or likely to surface, rather than a general rating throughout the day, week, or month. 
 
==> Parenting System that Significantly Reduces Defiant Behavior in Teens High-Functioning Autism

2. Intensity—

Intensity is a measure of the energy the child uses when engaging in the behavior. It also can be helpful to base this rating on the ease with which the child may be redirected to another, different line of behavior.

3. Onset: Time and Location—

The onset of symptoms is often related to a time and a location. The parent’s ability to know when and where symptoms surface, or under what circumstances they surface, is helpful in rating progress. When symptoms are concentrated to specific times or places, parents should first consider behavioral or educational interventions carefully. It may be that greater direction for certain activities, a break from interaction, or modifying the expectations for the HFA or AS youngster in an activity, will go a long way toward reducing maladaptive behaviors.

If a symptom only occurs in one setting, then this may lead the parent to consider intensive behavioral interventions first. More generalized behaviors can lend themselves more to pharmacologic treatments, because it can be difficult to maintain uniform responses across many different settings for behavioral interventions.

4. Duration—

Duration is self-explanatory.

5. and 6. Ameliorating and aggravating and factors—

These can indicate what triggers a behavior or what sustains it.

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

7. Trends—

The reason to consider the trend of a behavior (i.e., whether it’s increasing or decreasing) is that an intervention that is introduced as a behavior is winding down may be wrongly considered as having helped. Often, parents seek treatment for their child when a behavior is peaking in severity. For periodic situations, by the time a therapist intervenes, the behavior may be cycling down by itself. Thus, it’s often helpful to wait before intervening in order to learn about the pattern of a behavior.

Obviously, this can’t be considered when the risks to safety or jeopardy to other aspects of the child’s wellbeing prevent the therapist from taking this time. If there is some doubt about whether symptoms may respond to behavioral treatment, or if one is unsure whether things have improved or remained the same, the therapist should wait.

Case in point—

A 10-year-old girl with autism (high-functioning) was brought to treatment for picking behaviors that had become a part of her bedtime routine. Each night, she would dig at her arms. After extensive efforts by the parents to learn about the pattern of her behavior, it appeared that it was influenced by the course of interactions at school during the day. 

Although the child herself didn’t make the connection between being teased or having arguments with peers and her self-picking, it was possible to use relaxation techniques to reduce the intensity and duration of this behavior. In addition, the child’s mother and father were able to talk with her in the early evening about specific events from throughout the day that created angst before she went to bed. Overtime, the behaviors were significantly reduced (although they didn’t disappear altogether).


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Aspergers and Anxiety: What Parents and Teachers Need To Know


The following is a transcript of the question-and-answer portion of Mark Hutten's seminar on "Aspergers and Anxiety: What Parents and Teachers Need To Know":


Question: Both of my boys have Aspergers, but one exhibits a lot of anxiety, whereas the other does not seem anxious at all. Is there a good explanation for that?

It’s very normal for different children to have different temperaments. Some children are more outgoing and seem to be impervious to feelings of anxiety, whereas other children may always seem to be anxious. But it’s very possible for the more anxious child to learn skills to help manage his anxiety better so he can participate in activities, do well in school, and not be held back due to anxiety-related issues, and so on.

Question: How common is anxiety in children with this syndrome?

Anxiety is extremely common. It’s estimated that up to 80% of people with Aspergers experience intense anxiety symptoms. It can take the form of obsessive-compulsive disorder, specific fears and phobias, and generalized anxieties. Also, 1 in 15 children with Aspergers meet the diagnostic criteria for depression, which can be both a cause and a result of anxiety. We don’t know exactly what causes the depression, but it’s likely a combination of the child’s realization of his difference from peers and the ostracizing that occurs from these peers. Bullying is an extremely common problem among children with Aspergers, and this often leads to an increased rate of both anxiety and depression.

Question: How should I go about choosing a child therapist for my 12-year-old Aspergers son?

In the field of child anxiety as it specifically relates to Aspergers, there are some therapists who have been specifically trained in implementing what we call ‘cognitive-behavioral therapy’ – or CBT. Cognitive-behavioral methods are essentially a set of skills that Aspergers children can learn to help them change their fearful thoughts, anxious behaviors, and to reduce their physical feelings of tension.

Cognitive-behavioral approaches to treating child anxiety have been found to have high levels of success. For example, a child who is experiencing panic attacks might learn how to identify anxious thoughts that trigger panic attacks, learn how to change his anxious feelings, and learn how to change anxiety-triggering behavior. In any event, ideally you will want to seek a Child and Adolescent Psychiatrist who specializes in CBT specific to the Aspergers condition.

Question: How long will it take before I see a change in my Aspergers son once he has started this cognitive-behavioral therapy?

That’ll depend on his unique set of symptoms. At one of our facilities in Indianapolis, children are typically treated within 7-12 sessions for difficulties like specific fears, panic disorder, generalized anxiety disorder, and obsessive compulsive disorder. In some cases, however, additional sessions are needed to help a child make the maximum progress. But even then, 15 sessions will usually be the max.

Question: I'm an anxious person also. Is it possible that I give this anxiety to my Aspergers daughter?

Although research has shown that anxiety may be heritable, there are many other ways that fears can be acquired. Your daughter may have a more anxious, inhibited temperament, which may make her more vulnerable to feeling anxious. Fears are often acquired through the media, through modeling from others, and so on. Fears might also occur after children have experienced some form of trauma. So, although you may feel you are anxious, it is not likely that you simply are ‘giving’ an anxiety disorder to your daughter. There are ways that you can interact with her, though, that may function to increase her anxiety, and it might be important to examine such factors with a therapist.

Question: What do anxiety symptoms look like in a child with Aspergers?

Not much is known about what anxiety symptoms actually look like in a child with Aspergers, but there are symptoms that overlap with Anxiety Disorders, for example: avoidance of new situations, irritability, somatic complaints, and withdrawal from social situations. Another set of anxiety symptoms may be unique to children with Aspergers, for example: becoming ‘silly’, becoming explosive, having anger outbursts or what we call ‘meltdowns’, increased insistence on routines and sameness, preference for rules and rigidity, repetitive behavior, and special interest.

Question: What is the difference between cognitive-behavioral treatment and other kinds of treatment for anxiety?

CBT is focused on teaching children and parents specific skills for changing their fearful thoughts, anxious and tense physical feelings, and avoidant behaviors. Other types of therapy are more focused on using play therapy and/or talk therapy to produce change. There’s a lot of evidence suggesting that cognitive-behavioral techniques are quite successful in reducing anxiety in Aspergers children. Other forms of therapy have less empirical support.

Question: Will my child’s anxiety go away naturally or does he need treatment?

This is an excellent question, and one that is commonly asked by parents. Many childhood fears are part of normal developmental. Fears tend to rise and dissipate at predictable ages in a kid’s life. A child might develop a fear of the dark at age 4, which dissipates by the time he’s 6. Also, it’s normal for children to feel fearful of loud noises when they are very young. However, no matter how old your son is, if he is experiencing a fear that is beginning to interfere with aspects of his functioning, such as academic, social or family functioning …then these fears may warrant treatment.

Very often, successful short-term therapy can help to alleviate an Aspergers child’s fears and help him return to healthy functioning. If you’re unsure whether your son’s fear is normal, or whether it is interfering in his life, it may be a good idea to consult with a psychologist to determine whether he could benefit from treatment.

Question: You say that cognitive-behavioral treatment is the best treatment for anxiety symptoms in children with Aspergers. What does it consist of exactly?

CBT is a time-limited approach designed to change thoughts, emotions, and behaviors and has been shown to be successful in treating Anxiety Disorders in Aspergers children. It should consist of both a child component and a parent component. In using CBT, children should be helped to identify what their own anxiety symptoms look like.

Activities like feeling dictionaries (which is a list of different words for anxiety) and emotional charades (which is guessing people's emotions depending on faces) are helpful in developing this self-awareness. Worksheets, written schedules of activities, and drawings can be added to increase structure during therapy sessions. Games and fun physical activities are important to include in group therapy because they promote social interactions. A reward and consequence system should be used to maintain structure and prevent anger outbursts. Also, to build on the attachment between child and parent, it is important to have parents learn the techniques and coach children to use them at home.

Other useful techniques may include body brushing and massage, chewing gum or sucking on a candy cane to relieve pressure in the jaw, deep pressure activity like lying under a heavy blanket or cushions, physical energy burn like running and jumping on a trampoline, redirection and distraction, and whole-body activities like tug-of-war or rolling on the floor.

As a side note, know that kids with Aspergers tend to have perfectionist attitudes in many areas of their lives. This can be witnessed through their obsessive-compulsive behaviors, repetitive patterns of behavior, and their difficulty coping with change. Now …this self-imposed perfectionism can contribute to their anxiety and pressure to perform. So, since Aspergers kids usually place extreme and unrealistic demands on themselves, it’s important to not push the child too far in therapy. Small steps and taking it ‘one therapy session’ at a time will go a long way in effecting permanent positive change in the child. Go slow, have realistic therapeutic expectations, and monitor progress – these are the big 3 in CBT as far as I’m concerned.  

Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

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

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

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

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

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

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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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Investigating and Resolving "Problem Behavior" in Kids on the Autism Spectrum

"I need to understand my son better (ASD, age 7) so we can you come up with some consequences that are appropriate and not so punitive as to remove all possibility of improvement. Please help!"

If you have a youngster with High-Functioning Autism (HFA) who exhibits problematic behavior, you have probably felt like an investigator, searching for clues and seeking hidden motivations. 

You may have come up with some quick and easy explanations for your youngster's behavioral issues (e.g., ones offered by parents at the park, your mother-in-law, and even by behavioral experts), but your youngster often has something completely different up his sleeve. Operating according to the easiest explanation will often make matters worse.

Even though there are explanations for your HFA youngster's “bad” behavior that take some of the fault from him, the effects of the behavior are unfortunate and must be addressed. For example, your youngster may push one of his friends or break a toy because of autism-related challenges not under his control, but he still has to face the consequences associated with this behavior. 

A full understanding of the situation can help you come up with some consequences that are effective and not so punitive "as to remove all possibility of improvement" (as you say). And the best way to come to a full understanding is through good detective work.

One way to be a good detective is to observe behavior by using a functional behavioral assessment (i.e., observing your youngster and noting everything that happens before, during, and after problem behaviors). With a few weeks of observation, you can often uncover the things that provoke your youngster (e.g., the itchy sweater he is wearing, the long wait in the gym after the bus drop-off, the breeze coming through a classroom window, etc.).

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Here’s is an example of a functional behavioral assessment:

Student’s name: Ricky

Issue: Ricky had difficulty transitioning from resource room to physical education class

Location: The resource room

People involved: Resource teacher and classmates

Antecedent (i.e., what occurred before the incident): Resource teacher states, “It’s time for everyone to put their drawing materials away and get ready to go to the gym.”

  • Behavior #1 (i.e., what occurred during the incident): Ricky continued to draw in his art notebook. He glanced at classmates who had moved to the doorway.
  • Consequence #1 (i.e., what resulted at this stage of events): Resource teacher talked with the students for about one minute. She looked at Ricky and told him to put his pencil down and to get in line.
  • Behavior #2: Ricky turned his back to the teacher and threw his pencil on the floor.
  • Consequence #2: Teacher approached Ricky and told him to pick up the pencil.
  • Behavior #3: Ricky got up and picked up the pencil and took it to the art supplies drawer. Then he ran to the front of the classroom and climbed under the teacher’s desk.
  • Consequence #3: Teacher bent down to be at eye level with Ricky under the table and told him he was wasting everyone’s gym time, and that he needed to come out from under the desk and get in line.
  • Behavior #4: Ricky reached out his hand.
  • Consequence #4: Teacher took Ricky’s hand and led him to the end of the line.
  • Behavior #5: Ricky waved goodbye and smiled to his teacher and walked with the others to the gym.
  • Consequence #5: Teacher smiled, waved back and stated, “I’ll see you again tomorrow.”

Hypothesis (i.e., best guess as to why the behavior occurs based on the assumption that other antecedents, behaviors and consequences showed a similar pattern): Ricky was seeking attention from his resource teacher

Goal (i.e., corrective action plan): Teach Ricky a more appropriate way to seek his teacher’s attention

Objectives (i.e., potential strategies used to accomplish the goal):
  • allow Ricky to ask a classmate to walk next to him on the way to gym
  • allow Ricky to be “line-leader”
  • allow Ricky to be the "timer" who pushes the two-minute warning buzzer
  • post Ricky’s name on the "hard workers of the week" bulletin board
  • praise Ricky for a specific work-related behavior or academic response just before asking students to line up for gym time

Although the example above involved problematic behavior at school, the same method can be applied by parents for behavior at home. The more you learn about your youngster’s disorder and his unique quirkiness, the better you will be able to discover the true motive behind the behavior and apply appropriate discipline (or leniency if warranted).

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

More Structure Equals Less Behavioral Problems 




Here is a personal example of applying functional behavioral analysis (see if you can identify the antecedent, behavior, and consequence):

One of my child clients with High-Functioning Autism was experiencing meltdowns pretty much daily whenever he was in special education class, which he attended for one hour each morning for writing practice since his penmanship was poor. As most people know who work with children on the autism spectrum, they tend to have poor writing abilities due to fine motor skills deficits.

I was asked by Michael's parents to go to the school and sit in the classroom to investigate.  Here is what I observed:

Michael entered the classroom and took his seat, which was in the rear of the room nearest the door that led to the hallway. As he began to practice writing, he would get frustrated and erase what he had written repeatedly to the point where he wore several holes in the paper. At that point, he picked up his paper, tore it into tiny pieces and threw it on the floor. This resulted in the teacher escorting Michael to another room where he was isolated from the other students for a period of time.

To make a long story short, on the day of my investigation, I took my seat in the very back of the classroom behind Michael. I immediately noticed that since we were sitting near the exit, most of the hallway noise was very audible. I also knew that based on personal experience, many children with High-Functioning Autism and Asperger's have hearing sensitivities. 

As I sat there, I had the thought that it would be difficult for even me to concentrate with the hustle and bustle right on the other side of the door. So purely on a hunch, we moved Michael to the front of the room furthest away from the door. We were pleasantly surprised to see that Michael was able to stay focused on his writing at that point and was not making as many mistakes, thus reducing his frustration-level.

So the hypothesis was this: Michael was unconsciously distracted by the noises in the hallway, which contributed to his frequent writing mistakes and frequent erasing. This in turn resulted in the writing paper being torn, which was the tipping-point for Michael to slip into a total state of frustration.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with High-Functioning Autism
 
Obviously, the corrective action was to move Michael to an area of the classroom that was less noisy and distracting. It also appeared to help that he was near the teacher and could receive frequent one-on-one assistance.

As a mother or father, you will need to develop a trained eye for your AS or HFA child, as well as an intuitive understanding of what makes him tic. Your youngster needs you to read all the hidden cues. He also needs to follow his own instincts, which may be telling him that something's too difficult, too uncomfortable, etc. Your youngster has no choice but to follow his instincts. Knowing this can help you be more empathetic and skilled in addressing difficult behavior.

Not all hidden cues are worth following. When you're investigating your youngster's confusing behavior, red herrings may show up (e.g., his eagerness to end a stressful situation by accepting blame even when it’s not his fault, your preconceived notions of “whodunit,” another youngster's self-protecting accusations, another adult's spin on the situation, etc.). 

If it feels to you like something is awry, chances are it is. Keep an open mind even in the face of seemingly “solid evidence,” and allow for the possibility that things may not be what they seem. Your intuition is still worth following – all “evidence” to the contrary.

Of course, there will be times when you have developed a wonderful hypothesis based on a good-faith investigation, but for some reason it just doesn’t pan-out (e.g., there is a missing piece of the puzzle that would make the picture so much clearer and turn your guesswork into certainty – if you could just find it; the strategies that have always worked in the past don't get the job done this time; the explanation you've developed through your intuition is not what is really going on, etc.). 

Always keep an eye out for that “missing link,” even if you seem to have resolved the situation to an acceptable degree. That little bit of extra information can resolve things more completely, and can help you prevent a particular problem behavior from occurring again.


 
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

Click here to read the full article...

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...
 
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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
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Children on the Autism Spectrum and Social Phobia

The diagnosis of social phobia in Aspergers and high-functioning autistic (HFA) kids emphasizes the following:
  1. A youngster with social phobia must show the capacity for age-appropriate social relationships with familiar people, and his/her anxiety must occur in peer contexts, not just with grown-ups.
  2. Due to limitations of cognitive and perceptual skills, Aspergers and HFA kids with social phobia need not recognize that their fear in social situations is excessive or unreasonable.
  3. The anxiety brought on by social situations may be evidenced by crying, tantrums, meltdowns, freezing, shutdowns, or shrinking from social situations with unfamiliar people.
  4. There must be evidence of the social fears existing for a minimum of six months.

Developmental Pathways to Social Phobia—

1. Genetic factors: Taken as a whole, studies using twins to determine whether genetics play a significant part in the development of social phobia are inconclusive. Some twin studies have examined the heritability of shyness and social fears rather than the clinical disorder social phobia. Overall, these studies suggest that genetics play a modest to moderate role in the development of symptoms and temperamental traits associated with social phobia.

Studies examining the rates of social phobia in the offspring or in other first-degree relatives of socially phobic people show that social phobia rates in relatives are higher than in the relatives of people with other anxiety disorders or no disorder. Overall, these studies suggest that social phobia is at least moderately familial and possibly specific in its transmission. However, family studies cannot specifically sort-out the relative contributions of genetic influences and family environmental influences on the development of a disorder. Thus, the mechanisms behind this familial connection in social phobia still need clarification.

2. Normative developmental factors: Kids as young as 6 months through 3 years of age commonly show anxiety in the forms of stranger and separation anxiety. Some young kids, when confronted with a new social situation, throw tantrums, cling to a familiar person, avoid contact, refuse to take part in group play, and become overly vigilant. By late childhood and early adolescence, kid's fears of social evaluation of academic and social performance are forefront. Although at some point during their adolescence all youth will experience some level of anxiety about being judged in school or social situations, obviously not everyone goes on to develop pathological levels of social anxiety (i.e., social phobia).

3. Parenting/family environment factors: Research indicates that parent characteristics and family environment (through such mechanisms as modeling of avoidant responses and restricted exposure to social situations) are likely to have at least a moderate effect on the development of social phobia in kids and adolescents. It appears likely that if the parent's own anxiety is communicated to the youngster, a cycle is established in which parent and youngster reinforce each other's anxiety.


Controlling/overprotecting and less affectionate parenting styles have been found to be associated with social phobia in adult offspring, although the cause and effect relationship between these characteristics and social phobia is unclear. A major gap in this area is research that uses kids with social phobia or kids at high risk for social phobia, and this needs to be filled before the developmental impact of parental and family factors can be specified.

4. Physiological factors: Researchers have just begun to explore the physiology of social phobia, and studies have been primarily conducted with grown-ups. When facing phobic situations, socially phobic people commonly experience such symptoms as blushing, racing heart, sweating, and increased respiration, all of which are reactions associated with the autonomic nervous system (ANS). However, the few studies that have examined ANS functioning in socially phobic people have provided mixed results.

Other research has examined the function of the amygdala, a small region in the forebrain involved in the output of conditioned fear responses, e.g., freezing up behavior, blood pressure changes, stress hormone release, and the startle reflex. Hypersensitivity in the neural circuitry that centers on the amygdala may be responsible for behavioral inhibition in kids. The application of currently developing neuroimaging technologies to kids and adolescents may prove to be especially useful in elucidating the continuities and differences between social phobia in youngsters and in grown-ups.

5. Temperamental factors: A predisposition to timidity and nervousness has been believed to be a matter of inborn temperament. The majority of recent research in the role of temperamental factors in the development of social phobia focuses upon behavioral inhibition (BI). BI refers to a temperamental style that is characterized by reluctance to interact with and withdrawal from unfamiliar settings, people or objects. In infants, BI is typically manifest as irritability, in toddlers as shyness and fearfulness, and in school age kids as cautiousness, reticence and introversion. BI includes reactions that can be seen in behavior, such as interrupting of ongoing behavior, ceasing vocalization, comfort seeking from familiar persons, and retreat from and avoidance of unfamiliarity.

BI also includes reactions that are physiological, such as stable high heart rate, acceleration of heart rate to mild stress, pupillary dilation, and increased salivary cortisol. Overall, evidence to date suggests that a behaviorally inhibited temperament may predispose a youngster to the development of high social anxiety, although BI has yet to be definitively identified as a necessary precursor to the development of the clinical syndrome social phobia.

Treatment of Social Phobia—

1. Cognitive Behavioral Treatment (CBT): Treatment from the cognitive-behavioral perspective assumes that social anxiety is a normal and expected emotion. Social anxiety becomes problematic when it exceeds expected developmental levels and results in significant distress and impairment at home, school, and in social contexts. Anxiety is assumed to be comprised of physiological, cognitive, and behavioral components.

Cognitive behavioral treatment involves specific psycho-education, skills training, exposure methods, and relapse prevention plans for addressing the nature of anxiety and its components. Psycho-education provides corrective information about anxiety and feared stimuli; somatic management techniques target autonomic arousal and related physiological responses; developmentally appropriate cognitive restructuring skills are focused on identifying maladaptive thoughts and teaching realistic, coping-focused thinking; exposure techniques involve graduated, systematic, and controlled exposure to feared situations and stimuli; and, relapse prevention methods focus on consolidating and generalizing treatment gains over the long term.

2. Social Effectiveness Therapy for Children (SET-C): This treatment is appropriate for youth ages 8 through 12 and involves 24 treatment sessions held over a 12-week period. Each youngster participates in one group social skills training session and one individual exposure session each week, with structured homework assignments serving to promote generalization of the within session experience to the youngster's real life.


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

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

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

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

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

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

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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.

____________________
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Help for Bullied Asperger’s and HFA Children Who Become Bullies Themselves

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:

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

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

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

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

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

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism
By

Aspergers Syndrome and Oppositional Defiant Disorder [ODD] Combination

Even the best-behaved Aspergers children can be difficult and challenging at times. Aspergers adolescents are often moody and argumentative. But if your Aspergers child or adolescent has a persistent pattern of tantrums, arguing, and angry or disruptive behaviors toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). As many as one in 10 Aspergers children may have ODD in a lifetime.

Treatment of ODD involves therapy and possibly medications to treat related mental health conditions. As a parent, you don't have to go it alone in trying to manage an Aspergers child with ODD. Doctors, counselors and child development experts can help you learn specific strategies to address ODD.

Symptoms—

It may be tough at times to recognize the difference between a strong-willed or emotional child and one with ODD. Certainly there's a range between the normal independence-seeking behavior of Aspergers kids and ODD. It's normal to exhibit oppositional behaviors at certain stages of a youngster's development.

However, your Aspergers child's issue may be ODD if your youngster's oppositional behaviors:
  • Are clearly disruptive to the family and home or school environment
  • Are persistent
  • Have lasted at least six months


The following are behaviors associated with ODD:
  • Defiance
  • Disobedience
  • Hostility directed toward authority figures
  • Negativity


These behaviors might cause your Aspergers child to regularly and consistently show these symptoms:
  • Academic problems
  • Acting touchy and easily annoyed
  • Aggressiveness toward peers
  • Anger and resentment
  • Argumentativeness with adults
  • Blaming others for mistakes or misbehavior
  • Deliberate annoyance of other people
  • Difficulty maintaining friendships
  • Frequent temper tantrums
  • Refusal to comply with adult requests or rules
  • Spiteful or vindictive behavior


Related mental health issues—

ODD often occurs along with other behavioral or mental health problems such as attention-deficit/hyperactivity disorder (ADHD), anxiety or depression. The symptoms of ODD may be difficult to distinguish from those of other behavioral or mental health problems.

It's important to diagnose and treat any co-occurring illnesses because they can create or worsen irritability and defiance if left untreated. Additionally, it's important to identify and treat any related substance abuse and dependence. Substance abuse and dependence in Aspergers kids or adolescents is often associated with irritability and changes in the Aspergers child or adolescent's usual personality.

Causes—

There's no clear cause underpinning ODD. Contributing causes may include:
  • A biochemical or neurological factor
  • A genetic component that when coupled with certain environmental conditions — such as lack of supervision, poor quality child care or family instability — increases the risk of ODD
  • The Aspergers child's inherent temperament
  • The Aspergers child's perception that he or she isn't getting enough of the parent's time and attention
  • The family's response to the youngster's style


Risk factors—

A number of factors play a role in the development of ODD. ODD is a complex problem involving a variety of influences, circumstances and genetic components. No single factor causes ODD. Possible risk factors include:
  • Being abused or neglected
  • Exposure to violence
  • Family instability such as occurs with divorce, multiple moves, or changing schools or child care providers frequently
  • Financial problems in the family
  • Harsh or inconsistent discipline
  • Having a parent with a mood or substance abuse disorder
  • Lack of supervision
  • Moms and dads with a history of ADHD, ODD or conduct problems
  • Poor relationship with one or both moms and dads
  • Substance abuse in the Aspergers child or adolescent


When to seek medical advice—

If you're concerned about your Aspergers child's behavior or your own ability to parent a challenging youngster, seek help from your doctor, a child psychologist or child behavioral expert. Your primary care doctor or your youngster's pediatrician can refer you to someone.

The earlier this disorder can be managed, the better the chances of reversing its effects on your Aspergers child and your family. Treatment can help restore your youngster's self-esteem and rebuild a positive relationship between you and your Aspergers child.

Tests and diagnosis—

Behavioral and mental health conditions are difficult to diagnose definitively. There's no blood test or imaging technique that can pinpoint an exact cause of behavioral symptoms, though these tests are sometimes used to rule out certain conditions. Physicians and other health professionals rely on:
  • Information gained from interviewing the Aspergers child
  • Information gathered from moms and dads and teachers, who may fill out questionnaires
  • Their clinical judgment and experience


Normal child and adolescent behavior and development can be challenging in their own right, but ODD is distinct due to the frequent and significant disruptions that are caused in the youngster's life at home, school, or in a job where authority figures have clear limits and expectations for behavior.

It can be difficult for doctors to sort and exclude other associated disorders — for example, attention-deficit/hyperactivity disorder versus ODD. These two disorders are commonly diagnosed together.

Complications—

Many Aspergers kids with ODD have other treatable conditions, such as:
  • Anxiety
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Depression


If these conditions are left untreated, managing ODD can be very difficult for the moms and dads, and frustrating for the affected Aspergers child. Kids with ODD may have trouble in school with teachers and other authority figures and may struggle to make and keep friends.

ODD may be a precursor to other, more severe behavioral disorders such as conduct disorder, but this is controversial.

Treatments and drugs—

Ideally, treatment for ODD involves your primary care doctor and a qualified mental health professional or child development professional. It may also help to seek the services of a psychologist specializing in family therapy.

These health professionals can screen for and treat other mental health problems that may be interfering with ODD, such as ADHD, anxiety or depression. Successful treatment of the often-coexisting conditions will improve the effectiveness of treatment for ODD. In some cases, the symptoms of ODD disappear entirely.

Successful treatment of ODD requires commitment and follow-through by you as a parent and by others involved in your youngster's care. Most important in treatment is for you to show consistent, unconditional love and acceptance of your Aspergers child — even during difficult and disruptive situations. Doing so can be tough for even the most patient moms and dads.

Learning or improving parental skills—

A mental health professional can help you learn or strengthen specific skills and parenting techniques to help improve your Aspergers child's behavior and strengthen your relationship with him or her. For example, you can learn how to:
  • Avoid power struggles
  • Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both moms and dads will do with the Aspergers child
  • Give effective timeouts
  • Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount of time
  • Offer acceptable choices to your Aspergers child, giving him or her a certain amount of control
  • Recognize and praise your Aspergers child's good behaviors and positive characteristics
  • Remain calm and unemotional in the face of opposition


Success requires perseverance, hard work—

Although some parent management techniques may seem like common sense, learning to use them in the face of opposition isn't easy, especially if there are other stressors at home. Learning these skills may require counseling, parenting classes or other forms of education, and consistent practice and patience.

At first, your Aspergers child is not likely to be cooperative or to appreciate your changed response to his or her behavior. Expect that you'll have setbacks and relapses, and be prepared with a plan to manage those times. In fact, behavior often temporarily worsens when new limits and expectations are set. However, with perseverance and consistency, the initial hard work often pays off with improved behavior and relationships.

Individual and family counseling—

Individual counseling for your Aspergers child may help him or her learn to manage anger. Family counseling may help improve communication and relationships and help family members learn how to work together.

Lifestyle and home remedies—

At home, you can begin chipping away at problem behaviors by practicing the following:
  • Assign your Aspergers child a household chore that's essential and that won't get done unless the youngster does it. Initially, it's important to set your youngster up for success with tasks that are relatively easy to achieve and gradually blend in more important and challenging expectations.
  • Build in time together. Develop a consistent weekly schedule that involves moms and dads and youngster being together.
  • Model the behavior you want your Aspergers child to have.
  • Pick your battles. Avoid power struggles.
  • Recognize and praise your Aspergers child's positive behaviors.
  • Set limits and enforce consistent reasonable consequences.
  • Set up a routine. Develop a consistent daily schedule for your Aspergers child.
  • Work with your spouse or others in your household to assure consistent and appropriate discipline procedures.


Coping and support—

For yourself, counseling can provide an outlet for your own mental health concerns that could interfere with the successful treatment of your Aspergers child's symptoms. If you're depressed or anxious, that could lead to disengagement from your Aspergers child — and that can trigger or worsen oppositional behaviors. Here are some tips:
  • Be forgiving. Let go of things that you or your Aspergers child did in the past. Start each day with a fresh outlook and a clean slate.
  • Learn ways to calm yourself. Keeping your own cool models the behavior you want from your Aspergers child.
  • Take time for yourself. Develop outside interests, get some exercise and spend some time away from your Aspergers child to restore your energy.


By

Behavioral Support for Students with Autism Spectrum Disorder

Effective behavioral support for a student with special needs requires highly individualized strategies that address the primary areas of difficulty in managing anxiety, communication, preferences for sameness and rules, ritualistic behaviors, social understanding and interactions, and sensory sensitivities.

While the specific components of a positive behavioral support plan will vary from child to child, the following tips will assist teachers as they work towards achieving the best outcomes on behalf of their special needs student:

1. Students with special needs experience communication difficulties. While they are able to use language quite effectively to discuss topics of interest, they may have great difficulty expressing sadness, anger, frustration and other important messages. As a result, behavior may be the most effective means to communicate when words fail.

2. Since behaviors are influenced by the quality of relationships with teachers, teachers should monitor their own behavior when working with special needs kids. Each time a teacher reprimands a child for misbehavior, an opportunity may be lost to "reframe" the moment in terms of the child’s need to develop alternative skills.



3. Schools that focus on suspension and expulsion as their primary disciplinary approach (rather than on teaching social skills and conflict resolution) are typically less effective.

4. Parents, teachers, and other school staff should collaborate on a behavior support plan that is clear and easily implemented. Once developed, the plan should be monitored across settings and regularly reviewed for its strengths and weaknesses. Inconsistencies in expectations and behaviors will only heighten the challenges demonstrated by a child with special needs.

5. Never assume that special needs students know appropriate social behaviors. While these kids are quite gifted in many ways, they will need to be taught social and communication skills as carefully as academic skills.

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


6. “Antecedents” are events that happen immediately before the student’s difficult behavior. “Setting events” are conditions that can enhance the possibility that a child may engage in difficult behavior (e.g., if a child is sick, hungry or tired, she may be less tolerant of schedule changes). By understanding settings events that can set the stage for difficult behaviors, changes can be made on those days when a child may not be performing at her best to (a) reduce the likelihood of difficult situations and (b) set the stage for learning more adaptive skills. In the classroom, many antecedents may spark behavioral incidents (e.g., many children with special needs have difficulty with noisy, crowded environments).

Therefore, the special needs student who becomes physically aggressive in the hallway during passing periods may need to leave class a minute or two early to avoid the congestion which provokes this behavior. Over time, the child may learn to negotiate the hallways simply by being more accustomed to the situation, or by being given specific instruction or support.

7. A major issue is fitting special needs children into typical disciplinary practices. Many of these kids become highly anxious by loss of privileges, time outs or reprimands, and often can’t regroup following their application.

8. Behavior serves a purpose. The purpose or function of the behavior may be highly idiosyncratic and understood only from the perspective of the child. Students with special needs generally do not have a behavioral intent to disrupt the classroom, but instead difficult behaviors may arise from other needs (e.g., self-protection in stressful situations).

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

9. Children with special needs need to be taught acceptable behaviors that replace difficult behaviors, but that serve the same purpose as the difficult behaviors. For instance, the child may have trouble entering into a basketball game and instead inserts himself into the game, thus offending the other players and risking exclusion. Instead, the child can be coached on how and when to enter into a game.

10. Lastly, it is important to understand the idiosyncratic nature of special needs students and to consider difficult behaviors in light of characteristics associated with their disorder. Here are some general traits of the special needs student:
  • Academic difficulties: restricted problem solving skills, literal thinking, deficiencies with abstract reasoning.
  • Behavior serves a function, is related to context, and is a form of communication.
  • Emotional vulnerability: low self-esteem, easily overwhelmed, poor coping with stressors, self-critical.
  • Impairment in social interactions: difficulty understanding the “rules” of interaction, poor comprehension of jokes and metaphor, pedantic speaking style.
  • Inattention: poor organizational skills, easily distracted, focused on irrelevant stimuli, difficulty learning in group contexts.
  • Insistence on sameness: easily overwhelmed by minimal changes in routines, sensitive to environmental stressors, preference for rituals.
  • Poor motor coordination: slow clerical speed, clumsy gait, unsuccessful in games involving motor skills.
  • Restricted range of social competence: preoccupation with singular topics, asking repetitive questions, obsessively collecting items.



Too often, the focus of a behavior management plan is on discipline (i.e., strategies that focus exclusively on eliminating problematic behavior). Plans like this don’t focus on long-term behavioral change. An effective plan should expand beyond issuing consequences (e.g., time outs, loss of privileges, suspensions, etc.) and focus on preventing the problem behavior by teaching socially acceptable alternatives and creating a positive learning environment.

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

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

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

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

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

 ==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

==> Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.


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