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

The Use of “Structure” to Reduce Problematic Behavior in Kids with ASD [level 1]

"Any methods for preventing problem behaviors in an out of control child with an autism spectrum disorder? Please help with advice!"

For many children with Asperger’s (AS) and High-Functioning Autism (HFA), problematic behaviors are common. The term “problematic behavior” is a controversial one, but it’s intended to suggest that certain behaviors present a “problem” for parents, siblings, peers, teachers, therapists, etc. This helps to prevent internalizing the cause of the behaviors and blaming the “special needs” child.

This is a very important concept in AS and HFA, because it’s unlikely that any behavior which causes difficulties for parents and others is intended vindictively or maliciously. There is usually some other, unidentified, cause that provokes problematic behavior. Young people on the autism spectrum derive no enjoyment by being a problem to others.



Most problematic behaviors occur in the presence of parents and siblings (probably because AS and HFA children feel more comfortable simply being themselves when around familiar people). If such behavior is a problem for therapists and other professionals (which it is), then it can certainly be a challenge for moms, dads and siblings. Thus, it’s crucial that problematic behaviors are dealt with in way that (a) helps the entire family to cope more effectively, and (b) allows the “special needs” child to develop social skills and emotion management. 

Low-frustration tolerance is one of the most common problems in young people on the autism spectrum. They often appear to go into a state of anger, rage, anxiety, or fear for no reason. All children get frustrated and then act-out from time to time, but this problem is more of a challenge for moms and dads of autistic children. These children may seem inconsolable during the episode of frustration, the episode often lasts a long time, and the resolution that typically accompanies the end of feeling frustrated rarely occurs.

Low-frustration tolerance is just one example of problematic behavior. Similar episodes of panic, anxiety, anger, and aggression may be seen all through childhood, the teenage years, and even into adulthood (e.g., yelling, crying, resisting contact with others, pushing others away, refusing to respond to interaction, using others as objects, refusing to comply with daily tasks, etc.). These behaviors are “problematic” in the sense that they cause disruption (e.g., to a classroom engaged in a lesson, a family outing or event, etc.).

Children and teens with AS and HFA often rely on rituals, routines and structure, which helps define the world in terms of consistent rules and explanations. Consistency helps these young people to function more comfortably in a world that would otherwise be perceived as confusing, chaotic and hostile. Most kids on the autism spectrum find their own strategies for imposing structure and maintaining consistency. Without this structure, they would be totally overwhelmed and unable to function …they would be unable to understand the behavior of others …and the information they receive through their senses would be nearly impossible to bring together into a purposeful whole.

==> How to Prevent Meltdowns and Tantrums in Asperger's and HFA Children

When structure and consistency are disrupted in the AS or HFA child’s life, the world becomes confusing and overwhelming again – thus launching him or her into “problematic” behaviors as a response. This disruption of structure can be obvious (e.g., getting up at an unusual hour, having a collection of objects disturbed, not being able to engage in a favorite activity, being made to go a different way to school, etc.) …or it may be hidden (e.g., sensory sensitivities, subtle changes in the environment which the youngster is used to, etc.). Many of these “triggers” may be out of the control of the child. Thus, it’s important to remember that low-frustration tolerance and similar behaviors are not cases of “misbehavior” necessarily, rather they may simply be natural reactions to various unwanted stimuli.

"Structure-Dependent" Thinking in Kids with Asperger's and High-Functioning Autism 

 

How parents can begin to reduce problematic behaviors in their AS or HFA child:

1. At the time of the inappropriate behavior, be sure to limit your talking to “stating the rule and consequence.” Lengthy debates, explanations and arguments should be avoided at this time. Also, ignore complaints from your youngster. Further discussion about the rule and consequence can be done at a later time when things have calmed down.

2. Avoid anger and over-reaction to your child’s problematic behavior. Don’t let your emotions take control. Refrain from demanding or shouting. Stay calm! You’re “over-reacting” will through “gas on the fire.”

3. Establish family rules and put them in writing. Rules should be (a) specific, (b) easy to understand, (c) achievable, (d) age-appropriate, and (e) consistent. Rules should be discussed and decided upon ahead of time in mutual collaboration between the mom and dad without the youngster present. Then, after the rules have been agreed upon, they should be explained to the youngster in simple, concrete terms.

4. Help your youngster use problem-solving skills in order to make a plan for changing behavior in the future. For example, if the behavior involves difficulties getting along with peers, help your youngster learn appropriate communication and conflict resolutions skills.

5. Listen to your youngster’s point of view about a particular rule. When appropriate, consider making changes to the rule based on your youngster’s reasoning. This doesn’t mean you are “giving in” to your youngster’s demands, rather it means that (at times) you will negotiate with your youngster on a rule and reach a compromise.

==> How to Prevent Meltdowns and Tantrums in Asperger's and HFA Children

6. Make your expectations very clear. For example, let your child know that (a) she WILL be required to perform certain tasks (e.g., completing homework, cleaning her bedroom, getting ready for school on time, etc.), and (b) there WILL be consequences for not completing such tasks.

7. Set up routines for daily living that are consistent and predictable (e.g., morning, mealtime, and bedtime routines). Your youngster will learn many things from these routines (e.g., how to take care of herself, how to interact with others, discovering that life runs more smoothly if things are organized and predictable, etc.).

8. Simply ignore some behaviors (e.g., whining and complaining).

9. Structuring your youngster’s environment. Determine what activities he will engage in and how he will fill his time. Also, be available physically and mentally to provide appropriate monitoring and supervision.

10. Try to anticipate problem situations (e.g., don’t let your youngster get into a situation where he becomes overly tired, hungry, or bored).

11. Use distraction techniques. If your youngster is acting-out, distraction with something of interest can focus her on more positive behaviors.

12. Use rewards to increase appropriate behavior. When it comes to children on the autism spectrum, it’s usually better to reward desirable behaviors than to discipline undesirable ones. Also, it’s best to provide the reward immediately after the desired behavior has occurred.

AS and HFA Kids Want Structure 

 

Note: While providing structure and consistency are important skills for you to use with your AS or HFA child, it’s also important to be aware of the importance of allowing her some independence and autonomy. As often as is appropriate, allow your child to have opportunities to make her own choices and decisions, respect her choices and decisions, and allow natural “real-world” consequences to occur (when safety is not an issue, of course).

By

Help for the Vindictive, Revengeful Child on the Autism Spectrum

"I need some advice on how to help my child (autistic) deal with his revengeful attitude. He's quick to fly off the handle whenever he thinks he's been treated unfairly (quite a black-and-white thinker)."

A youngster with ASD level 1, or high functioning autism, who is vindictive is demonstrating that something is wrong. His rage and hostility are symptoms of an underlying problem.

It may be the result of (a) the expression of emotions, attitudes and behavior that have been inadvertently or purposefully conditioned; (b) an expression of emotional distress; (c) an attempt to cope with sensory sensitivities; and/or (d) a physical, developmental, neurological or mental illness.

Symptoms of a vindictive or revengeful child include the following:
  • angry and irritable mood
  • argues with parents and teachers
  • behavior causes significant problems at home and school
  • blames others for his or her misbehavior
  • deliberately annoys siblings and peers
  • is easily annoyed by others
  • is often resentful
  • often loses temper
  • refuses to comply with parents’/teachers’ requests or rules



For some kids, symptoms may first be seen only at home, but with time, these symptoms extend to other settings (e.g., with friends, at school, etc.).

No matter the cause, the behavior of a vindictive youngster is hurtful to others and ultimately self-destructive. It is to everyone’s benefit to find ways to handle the autistic youngster that will limit the aggression and amend the underlying issues that feed his or her malevolence.

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

Parents can begin chipping away at problem behaviors by utilizing these suggestions:

1. Assign a household chore that's essential and that won't get done unless your child does it. It's important to (a) set your youngster up for success with tasks that are relatively easy to achieve, and (b) gradually blend in more important and challenging expectations. Also, give clear, easy-to-follow instructions for the chore. Kids who feel competent tend to have higher self-esteem and improved behavior.

2. Show your youngster – in your own behavior – how you can use reason, talk and problem-solving to achieve goals as opposed to “acting-out.”

3. Never use insults, sarcasm or satire as a means of verbal punishment or as a strategy for enlightenment. ASD children have difficulty understanding figurative or metaphorical statements.

4. Use “labeled praise” when your child exhibits the kind of positive behavior you would like to see more of (e.g., “I saw that you were irritated, but you did a good job of being courteous and not losing your temper”).

5. At first, your youngster may not be cooperative or appreciate your changed response to his behavior. Understand that behavior may worsen temporarily in the face of new expectations (called an "extinction burst" by therapists). Remaining consistent in the face of increasingly difficult behavior is the key to success initially.




6. Build in time together by developing a regular weekly schedule that involves you and your youngster spending time doing something the two of you enjoy.

7. Cognitive problem-solving training is a type of therapy that is aimed at helping your youngster identify and change thought patterns that lead to behavior problems. Collaborative problem-solving, in which you and your youngster work together to come up with solutions that work for both of you, can help improve defiant behavior.

8. Consider “Parent Training.” A mental health provider can help you develop parenting skills that are more positive and less aggravating for you and your youngster. In some cases, your youngster may participate in this type of training with you so that everyone develops shared goals for how to handle problems.

9. Find out what your youngster’s perceptions of the situation are, and try to understand her motivation.

10. Get your child to verbalize his feelings so he can learn how to talk about anger, aggravation, and bitterness rather than “acting it out.”

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

11. If your youngster is acting unkindly toward others and not responding to limits, then monitor and limit movies, television, and video games to venues that provide only appropriate models. Do not allow exposure to aggression, violence, and disrespect of others.

12. Pick your battles carefully, and avoid power struggles. Almost any minor conflict can turn in to a “knock-down-drag-out” fight if you let it.

13. Establish a strict zero-tolerance policy for teasing, bullying, and verbal/physical aggression. Respond to every incident of these behaviors. If the behavior problem is minor, offer a verbal warning – but do not allow the behavior to continue or worsen. After warnings have been given, meet every occurrence of vindictiveness with a consequence.

14. Set up a routine by developing a consistent daily schedule for your youngster. Asking your youngster to help develop that routine will be favorable.

15. Social skills training is greatly needed for children on the autism spectrum. Their social skills are characteristically very poor. Your youngster also may benefit from therapy that will help her learn how to interact more positively with friends and classmates.

16. Try individual and family therapy. Individual counseling for your youngster may help him learn to manage anger and express feelings in a more appropriate manner. Family counseling may help improve your communication skills, and help all family members learn how to work together.

17. Work with your youngster to identify alternative behavioral options. Ask her if there are other ways she could have handled the situation, and talk about how to use those alternative responses (at a time when she is calm, of course).

18. Show consistent, unconditional love and acceptance for your youngster — even in the face of difficult and disruptive circumstances. Staying calm and rational during stressful encounters can be tough for even the most patient mom or dad.

19. Work with your spouse/ partner to ensure consistent and appropriate disciplinary methods. Also, enlist the support of teachers, coaches, and other adults who spend time with your youngster.

20. If the strategies listed above do not bring significant improvement in your child’s behavior, then consult with a physician and/or therapist. Medical issues (e.g., ADHD, allergies, diabetes, exposure to toxins, hypoglycemia, nutritional deficits, etc.) can contribute to verbal and physical aggression. Likewise, a psychological evaluation can expose issues that may contribute to persistent vindictiveness (e.g., neurological and psychiatric illnesses, emotional distress, depression, anxiety, etc.).

Although many parenting strategies may seem like common sense, learning to use them in the face of opposition is tough – especially if there are other anxiety-producing factors in the home. Learning the skills listed above will require consistent practice and patience.


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

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

Behavior Problems in Teens with Aspergers and High-Functioning Autism

Parents often have difficulty recognizing the difference between variations in “normal behavior” versus “Aspergers-related behavior.” In reality, the line between ‘normal’ and ‘Aspergers behavior’ is not always clear – usually it is a matter of expectation.

A fine line can often divide normal from Aspergers teen behavior, in part because what is normal depends upon the teen's level of development, which can vary among teens of the same age. Development can be uneven, too, with a teen's social development lagging behind his intellectual growth, or vice versa. In addition, normal teen behavior is in part determined by the particular situation and time, as well as by the teen's own particular family values, expectations, and cultural or social background.

Understanding your Aspergers (high-functioning autistic) teen's developmental progress is necessary in order to interpret, accept or adapt his behavior (as well as your own). Remember, teens have great individual variations of temperament, development and behavior – especially when they have to deal with the Aspergers condition.

Your responses, as a parent, are guided by whether you see the adolescent's behavior as a problem. Frequently, parents over-interpret or over-react to a minor, normal short-term change in the teen’s behavior. At the other extreme, moms and dads may ignore or downplay a serious problem. Also, they may seek quick, simple answers to what are, in fact, complex Aspergers teen problems. All of these responses to teen behavior may create more difficulty or prolong a resolution.

Adolescent behavior that moms and dads tolerate, disregard or consider acceptable differs from one family to another. Some of the differences come from the parent’s unique upbringing. They may have had very strict parents themselves, and the expectations of their kids follow accordingly. Some behavior is considered a problem when parents feel that others are judging them for their teen's behavior. This leads to inconsistent responses from the parent, who may tolerate behavior at home that he/she would not tolerate in public.

Sometimes moms and dads feel so hurt by their Aspergers teen’s behavior that they respond by returning the “disrespect” – which is a mistake. Teens know that they still need their parents even if they can't admit it. The rollercoaster they put the parent on is also the one they're feeling internally. As the parent, you need to stay calm and try to weather this teenage rebellion phase, which usually passes by the time a child is 16 or 17.

But no one's saying your Aspergers teenager should be allowed to be truly nasty or to curse at you, for example. When this happens, you have to enforce basic behavior standards. By letting your teenager know that you're here for him no matter what, you make it more likely that he'll let down his guard and confide in you once in a while.

My Aspergers Teen: Discipline for Defiant Aspergers Teens
By

Finding Hidden Meaning Behind Problematic Behaviors in Kids with ASD

"Question: How to know what triggers my son's (high functioning autistic) difficult behavior? Thanks in advance!"

Many parents of children with ASD - Level 1 [High-Functioning Autism] have discovered that some of their youngster’s behaviors make no obvious sense and do not serve any clear purpose. But when these children engage in “odd” or confusing behavior, they are also sending the parent hidden clues about things that are important to them. Thus, it’s the parent’s job is to break the code so she can interpret the clues.

By becoming more like a “detective,” parents can begin to notice coded messages they didn’t see before, and as a result, find more effective ways to help their “special needs” youngster. Becoming a good detective also helps parents respond more carefully to peculiar behaviors so they don’t unintentionally reinforce or reward them.

Parents of autistic children can begin to develop “investigator skills” by recording problematic behaviors, similar to how Jane Goodall studied chimpanzees. For example: 
  • Is the child attempting to avoid a demanding task?
  • What activities or interactions take place just prior to the problematic behavior? 
  • Does the same thing often happen first?
  • What time do these events most often happen?
  • Are there any settings where the behavior does not occur?
  • In what settings is the behavior observed? 
  • Is the behavior problem associated with certain social or environmental conditions? 
  • What usually happens immediately after the behavior? 
  • Who is present when the behavior occurs?

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

Most difficult behaviors are triggered by an event. Just as you might suddenly feel thirsty as you walk past a lemonade stand, there are “triggers” in your youngster’s life that elicit certain behaviors. Use a diary to try to identify these triggers for your youngster’s most challenging behaviors. Instead of getting upset with your child when he or she acts-out, look for how the context is out of synch with him or her. View the incident as an opportunity to learn more about your child.



Here is a good example of items to list in your diary:

Behavioral Investigation—

Date: ______
  1. Describe the behavior of concern: _______________
  2. How can I tell the behavior is about to start? _______________
  3. How intense is the behavior? _______________
  4. How long does it last? _______________
  5. How often does the behavior occur? _______________
  6. What behavior(s) might serve the same function for my child that is appropriate within the social/environmental context? _______________
  7. What conditions are most likely to precipitate (“set-off”) the behavior? _______________
  8. What does my child get or avoid? _______________
  9. What is happening when the behavior occurs? _______________
  10. What is the likely function (intent) of the behavior (i.e., why do I think my child behaves this way)? _______________
  11. What usually happens after the behavior? _______________
  12. When/where is the behavior most/least likely to occur? _______________
  13. With whom is the behavior most/least likely to occur? _______________
  14. What other information might contribute to creating an effective behavioral intervention plan (e.g., under what conditions does the behavior not occur)? _______________

Cognitive, Behavioral, and Moral Inflexibility in Kids on the Autism Spectrum 



Here are some crucial things to consider when doing your investigation:

1. As with any child, being hungry, thirsty, or tired can make your youngster grouchy. A chronic illness or low-grade infection can cause behavioral issues as well. Try to discover any – and all – possible sources of pain (e.g., abscesses, broken bones, bruises, cuts and splinters, gut, infections, acid reflux, sprains, teeth, etc.).

2. Consider sensory and emotional regulation. Your youngster’s sensory experiences are very different from the “typical” child. He is likely easily overwhelmed by information coming in through the senses (e.g., loud noises) and isn’t getting enough input from the senses responsible for self-awareness and regulation. We all know about the five senses: taste, touch, smell, sound, and sight. But there are two additional senses that are important to understand: the vestibular sense (controls balance) and proprioception (the sense of one’s body in space). In many autistic children, some of the information from these senses is too little, too much, or distorted –  leading to feelings of anxiety, physical pain, or disengagement. As a result, the child may “act-out” behaviorally as a way to cope.

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

3. Coordination problems can contribute to stress and behavior issues. For example, as anyone who has ever been picked last for a team knows, gym class can be nerve-wracking. If your youngster has trouble undoing zippers or buttons, the short time allotted for bathroom breaks or locker room changes can add tremendous pressure. Also, if the child walks awkwardly, negotiating a crowded hallway between classes is anxiety-producing. These issues often influence “acting-out” behaviors that, unfortunately, may result in the child receiving some form of punishment.

4. Peer-rejection is a big contributor to difficult behaviors. For example, maybe your son realizes he has no friends, so recess time is particularly tough for him. Also, do some investigation to see if bullying or teasing is an issue.

5. Attention-span difficulties can influence behavior, resulting in unwarranted punishment from teachers. For example, your youngster may “tune-out” during class because the teacher or the subject matter isn’t engaging enough. Talk with your child’s teacher if this appears to be an issue.

6. Some problematic behaviors, especially those that seem abrupt or particularly odd, may be due to seizures. If you think this could be an issue, keep a very careful record of what you observe. Also, see if your youngster’s teacher has similar observations.

7. Changes in home-life can contribute to behavior problems (e.g., health crisis, job change, move, new sibling, mom and dad going through a divorce, etc.). Often times, well-meaning parents think their “special needs” child is handling everything fine, so there is no reason to be concerned. But if parents are stressed about something, chances are their youngster will be, too – especially if she is powerless to do anything about it.

8. Try to identify any food sensitivities or allergies that could be troubling your youngster. Look for the signs of a problem in this area (e.g., red/flushed cheeks or ears, diarrhea within a few hours of eating a particular food, etc.). Food sensitivity is often one of the biggest contributors to “mysterious” and sudden changes in behavior.

In summary, rather than viewing your child’s behavior as “misbehavior,” look attentively for the clues that he or she is sending by conducting your own investigation. With a little good detective work, parents can narrow down exactly what initiates certain unwanted behaviors. Then, once the problem has been identified, parents are in a much better position to employ effective prevention and intervention strategies.
By

Aspergers and HFA Temper Tantrums: 15 Tips for Parents

Does your child have periodic tantrums. Here are some tips to tame tempers:

1. A tantrum can be a request for attention. Moms and dads have a natural tendency to run to their Aspergers (AS) or High-Functioning Autistic (HFA) kids when they are in distress. Unfortunately, these kids can learn to get attention just by screaming. It is important that you stop reinforcing the behavior by giving attention to your child. Instead, give lots of positive attention during appropriate behaviors. For example, approach him when he is playing quietly and offer lots of hugs and kind words (or whatever works as positive reinforcement for the youngster).

2. As long as the child is not tantrumming, give praise when the youngster uses his words. Also, make sure you listen, don't ignore good communication (get up and meet the need or request if it is appropriate - or explain why it is not appropriate). Often we moms and dads get busy and put the youngster off for too long once he has asked appropriately for something. Show your child that appropriate communication is rewarded and honored.

3. Kids on the autism spectrum often communicate through their behavior. That may well be what is going on in a tantrum. You may acknowledge that you understand that the child is trying to tell you something but "you must use your words" or communicate in some other way.

4. Do not talk to others in the room about the child's tantrum. Talk to other adults about the news, sports, or weather. Focus on the other kids or people in the room and what they are doing right. Also, do not ignore good behavior when it occurs at other times. When you see your youngster behaving well, sitting quietly, tell him so: "I like how you are sitting so quietly!" This will let the child know that you pay attention to good behavior, not bad.

5. Have someone else observe your ignoring to make sure you are not providing any inadvertent attention to your child when he is having a tantrum. Stick to the planned ignoring for at least one month before thinking about changing tactics. Behaviors that have been around for a long time will take longer to extinguish. If the tantrum behavior occurs again after it has stopped, apply the planned ignoring all over again. Your child must get the idea that tantrums do not help them or hurt them, they just get ignored!

6. If your child begins to hurt himself, others, or property during a tantrum, you must intervene. If your youngster is trying to hurt others, remove the others from his reach and give the others your full attention. Do not talk to your child while intervening. Continue to ignore the tantrum. If your youngster is hurting himself, remove any items that may harm your youngster or move your youngster to a safer place. Do not talk to your youngster and use only the amount of physical contact necessary to assure your youngster's safety. Make all your actions appear to be matter-of-fact. Treat the tantrum with as little attention as possible. Not unlike the way you deal with an unpleasant noise from outside over which you have no control.


7. If your child was in the middle of completing a task for you when the tantrum began, ignore the tantrum but make sure the youngster completes the task, even if it means hand-over-hand help. For example, if you asked your youngster to pick up the toys and then the tantrum began, do not allow the tantrum to get the youngster out of the chore. Without talking to the youngster, help him pick up the toys and put them away. When the task is finished, walk away without praising your youngster, unless the tantrum stopped. You may also wait for the tantrum to stop and then have your youngster complete the task.

8. Never give attention to the problem behavior again. Time out or ignoring will work if the problem behavior is an attempt to gain attention. If the child is using self-injurious or destructive behavior to gain attention, don't leave the youngster alone. Block the behavior and protect the youngster but do not say anything and do not provide any “soothing” touches.

9. Read a book, call a friend (this may be a good idea as long as the friend will support you in your new, tough-love stance with your child - but do not call anyone who will convince you to give in), listen to music, watch television, sweep the floor, anything to distract you from paying attention to your youngster's tantrum.

10. Some kids do things in a tantrum that cause them self-harm (e.g., banging head, hitting self, etc.) and can lead to self-injurious behavior - sometimes this is a sensory issue also. Researchers believe some kids hurt themselves to release endorphins in the body that then provides them with a sensation they enjoy. If your child is hurting himself, please contact a psychologist or psychiatrist or other medical professional for evaluation.

11. Some tantrums are related to sensory issues. A tantrum may occur due to your child 's hearing a noise, seeing something that they dislike or are afraid of, smelling something, etc. If you suspect this, look into the sensory issues and consult your youngster's occupational therapist for sensory integration ideas. Some kids enjoy tantrums because they lead to the parent holding the youngster. I know some therapists recommend holding a youngster to relieve the tantrum. Just my opinion: I think this gives too much attention and may actually reinforce the tantrum.

12. Talk with supportive people who understand what you are doing with your child . Hopefully, you have a spouse, minister, friend, family member, and/or professional to share your progress with. This will help keep you on track and will help you deal with the strange looks you will get from people in the community who do not understand what you are doing to your child .

13. When the tantrum stops (in the beginning, this may take a long time), wait a few moments, and then praise your child for the next appropriate behavior. Do not discuss the tantrum and do not give your youngster the item or privilege he was tantrumming for until 30 minutes have passed. At that time it is appropriate to say: "Now ask me again for a cookie (or the item that set the tantrum off - if it is appropriate to have at that time)." Praise the youngster for appropriate asking and give the item, if appropriate. This positive reinforcement will encourage appropriate behavior.

14. Whenever and wherever a tantrum occurs, it must be completely ignored. This means no positive or negative attention. The tantrum should be treated as if it did not exist and that it will change nothing for the good or bad in your child 's life. Do not look at your youngster (except out of the corner of your eye to assure your youngster's safety). Do not talk to your youngster, correct your youngster, yell at your youngster, reason with your youngster, comment on the tantrum, or explain your actions to your youngster. Do not touch your youngster (except to protect him from harming himself, others, or property). Step over your youngster if you have to. No hugs, spankings, pats, squeezes, etc. Do not give your child anything to distract him, especially the item he is tantrumming for.

15. Another strategy is to let the child know that reinforcement is currently not available. It can be used when a child wants something that he can have, but not by throwing a tantrum:
  • Parent: “No crying.” (Start counting as soon as the child takes a breath, but stop counting as soon as the crying begins again.)
  • Parent: Repeat “No crying” (Resume counting each time the child stops crying.)
  • (Child eventually stops crying for a full count of 10.) Parent: "What do you want?"

NOTE: The post above addresses temper tantrums - not meltdowns!  A meltdown is a completely separate issue and will need to be handled differently. In a nutshell, tantrums are behavioral, whereas meltdowns are related to how the child 's brain is wired. For information regarding meltdowns, view the video below:





==> My Aspergers Child: Preventing Tantrums and Meltdowns
By

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."

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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.

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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.

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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.

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By

Managing Disruptive Behavior in Children with High-Functioning Autism and Asperger's

“We've been going in circles with our high functioning (autistic) 8 y.o. and his disruptive behavior – hitting, kicking, throwing things, just to name a few. We have tried all that we know to try. It's been difficult when he acts out, not respecting us or his siblings. It impacts the entire family! Do you have any ideas of how to handle disruptive behavior of this kind?”

One of the biggest obstacles a parent faces is managing disruptive behavior in the child with Asperger’s (AS) or High-Functioning Autism (HFA). Whether the child is refusing to eat what was prepared, or throwing tantrum on the way to school, the parent can find herself at a loss for an effective way to respond.

If you are at your wits end, the ABC method can provide a roadmap to a calmer, more reliable way to manage problematic behaviors. This method also offers a chance to help the AS or HFA child to gain the developmental skills he needs to regulate his own behavior.



The ABC Method of Behavior Management

To understand and respond successfully to misbehavior, parents have to think about what came before it – and what comes after it. Here are the 3 crucial features to any given behavior:
  • Antecedent: This is the preceding factor (or trigger) that makes a behavior more or less likely to occur. Learning and anticipating the antecedent is a very helpful tool in preventing problematic behavior.
  • Behavior: This, of course, is the specific action the parent is trying to discourage - or encourage - as the case may be.
  • Consequence: This refers to the result that logically and naturally follows a behavior. The consequence affects the likelihood of a behavior recurring, whether it’s positive or negative. Also, the more immediate the consequence, the more influential it is.

Identifying “target behaviors” is the first step in a good behavior-management plan. These behaviors need to be (a) specific (so both parent and child are clear on what is expected), (b) observable, and (c) measurable (so parent and child can agree whether or not the behavior happened). An example of poorly defined behavior is “acting-out,” or “being mean.” An example of well-defined behavior is “completing homework” (good) “pushing your sister” (bad).


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

Antecedents—

Antecedents come in many forms. Some are wonderful tools that assist the parent in managing misbehavior before it begins as well as bolstering appropriate behavior, while others facilitate misbehavior. Let’s look at each of these in turn…

Antecedents that bolster appropriate behavior:

1. Providing countdowns for transitions: As often as possible, the parent should prepare her AS or HFA child for an upcoming transition. For example, let the child know when there are 15 minutes remaining …then 10 minutes …then 5 before he must come to dinner or start his homework. Note: Making the transition at the stated time is just as important as issuing the countdown.

2. Making expectations clear: Parents will get better cooperation if they and their youngster are clear on what is expected. Its best to sit down with the child and present the information verbally – and then put it in writing and post it in a prominent location. Even the child “should know” what is expected, explaining expectations at the outset of a task will help avoid misunderstandings down the line.

3. Letting children have a choice: As the child grows up, it’s crucial she has a say in her own scheduling. Giving a structured choice can help her feel empowered and encourage her to become more self-regulating (e.g., “Do you want to pick up your dirty clothes before or after dinner?”).

4. Being aware of the situation: Parents need to consider and manage both emotional and environmental factors. For example, anxiety, hunger, fatigue, or distractions can all make it much more difficult for the youngster to effectively manage his behavior.

5. Adjusting the environment: Examples of adjusting the environment are (a) removing distractions such as video screens and toys when it’s time to do homework, (b) providing a snack, (c) establishing an organized space for the child to work, and (d) making sure to schedule some breaks.

Antecedents that facilitate misbehavior:

1. Initiating transitions without warnings: A transition is hard for a child with AS or HFA – especially in the middle of something he is enjoying. Providing a warning gives the youngster the opportunity to find a good stopping place for an activity and makes the transition less stressful.

2. Shouting instructions out from a distance: It’s helpful to give the child important instructions face-to-face. A parent’s request that is yelled from a distance is less likely to be understood and remembered.

3. Assuming expectations are comprehended: Parents should not assume that their child automatically knows what is expected of him. The expectation needs to be spelled out! Demands change from circumstance to circumstance, and when the youngster is unsure of what he is supposed to be doing, he’s more likely to engage in problematic behavior.

4. Giving too many instructions at once: If parents deliver a series of instructions or ask a lot of questions, it limits the likelihood that the child will hear, answer questions, remember the tasks, and do what she has been instructed to do.

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

Consequences—

Not all consequences are created equal. Some have the potential to do more harm than good, while others are an exceptional way to create structure and help AS and HFA children understand the difference between unacceptable and acceptable behaviors. As a mother or father, having a good understanding of how to consistently and intelligently employ consequences can make a huge difference in outcomes.

Consequences that bolster appropriate behavior:

1. Being clear and concrete when using time-outs: Parents should establish which behaviors will result in a time-out. When the AS or HFA youngster exhibits that behavior, the corresponding time-out needs to be relatively brief and immediately follow the misbehavior. If a time-out was delivered for not complying with a task, once it ends, the youngster needs to be instructed to complete the original task. In this way, he or she won’t begin to see time-outs as an escape method. During the time-out, parents should not talk to their youngster until he or she is ending the time-out. It should end once the youngster has been calm and quiet for a brief amount of time so that he or she learns to associate the end of time-out with this desired behavior.

2. Staying consistent: If parents arbitrarily issue time-outs when they are feeling aggravated, it will undermine the behavior-management system and make it harder for the youngster to connect behaviors to consequences.

3. Using active ignoring: Ignoring is used for minor misbehaviors and involves the deliberate withdrawal of attention when the youngster starts to misbehave. With this method, parents pick their battles carefully and save their energy for the larger issues that need to be addressed (e.g., verbal or physical aggression). As parents ignore, they wait for appropriate behavior to resume. Then they should give positive attention as soon as the desired behavior starts. By withholding attention until positive behavior is exhibited, parents are teaching their youngster what behavior gets acknowledged and praised.

4. Using positive attention for positive behaviors: When parents give their youngster positive reinforcement for behaving appropriately, it helps maintain that ongoing good behavior. Positive attention improves self-esteem and enhances the quality of the parent-child relationship. Positive attention to “brave behavior” can also help alleviate anxiety, as well as help the child become more receptive to instructions and limit-setting.

5. Using reward menus: A reward is a tangible way to give your youngster positive feedback for desired behaviors. It’s something that is earned, an acknowledgement that the child is doing something that’s difficult for him. A reward is most effective as a motivator when the youngster can choose from a variety of things (e.g., a special treat, extra time on the computer, etc.). This reduces the possibility of a reward losing its allure over time. Also, the reward needs to be linked to specific behaviors – and always delivered consistently.

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

Consequences that facilitate misbehavior:

1. Using positive consequences for negative behaviors: This reinforces the behavior you are trying to eliminate. For example, if your youngster procrastinates instead of putting on her shoes or pouring milk for her cereal, in frustration, you do it for her, you have just increased the likelihood that she will procrastinate again in the future.

2. Giving negative attention: Negative attention actually increases bad behavior over time (e.g., raising your voice, threatening to issue a consequence, etc.). Also, reacting to misbehavior with criticism or yelling negatively affects your youngster’s self-esteem. Kids value attention from their parents so much that any attention — negative or positive — is better than none.

3. Using disproportionate consequences: As a parent of a child on the autism spectrum, you understandably get perturbed from time to time. You may even have become so frustrated at a particular behavior that you said or did something that you felt guilty about later. This is normal and to be expected.  But, keep in mind that issuing a massive consequence – especially out of anger – that is not in proportion to the misbehavior is demoralizing for kids, and they may even give up trying to behave well.

4. Delaying consequences: Effective consequences are immediate. Every minute that passes after a behavior, your youngster is less likely to link his misbehavior to the consequence. As a result, you end up punishing for the sake of punishing, which makes it much less likely that the misbehavior will change.

Though kids with AS and HFA are found to have neurologically and developmental related symptoms over time, the primary problem is behavior. Moms and dads need an arsenal of coping methods to reduce the behavioral problems at home. By utilizing the suggestions listed above, such problems can be reduced to a more manageable - and livable - level.




==> More parenting strategies for dealing with behavioral problems in children and teens on the autism spectrum...
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

Oppositional Defiant Behavior in Children and Teens with Aspergers Syndrome

The American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM IV), defines oppositional defiant disorder (ODD) as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months. Behaviors included in the definition include the following:

• actively defying requests
• arguing with adults
• being touchy, easily annoyed or angered, resentful, spiteful, or vindictive.
• blaming others for one's own mistakes or misbehavior
• deliberately annoying other people
• losing one's temper
• refusing to follow rules

OPPOSITIONAL DEFIANT DISORDER is usually diagnosed when an Aspergers youngster has a persistent or consistent pattern of disobedience and hostility toward parents, teachers, or other adults. The primary behavioral difficulty is the consistent pattern of refusing to follow commands or requests by adults. Aspergers kids with OPPOSITIONAL DEFIANT DISORDER are often easily annoyed; they repeatedly lose their temper, argue with adults, refuse to comply with rules and directions, and blame others for their mistakes. Stubbornness and testing limits are common, even in early childhood.

The criteria for OPPOSITIONAL DEFIANT DISORDER are met only when the problem behaviors occur more frequently in the Aspergers youngster than in other Aspergers kids of the same age and developmental level. These behaviors cause significant difficulties with family and friends, and the oppositional behaviors are the same both at home and in school. Sometimes, OPPOSITIONAL DEFIANT DISORDER may be a precursor of a conduct disorder. OPPOSITIONAL DEFIANT DISORDER is not diagnosed if the problematic behaviors occur exclusively with a mood or psychotic disorder.

Prevalence and Comorbidity—

The base prevalence rates for oppositional defiant disorder (ODD) range from 1-16%, but most surveys estimate it to be 6-10% in surveys of nonclinical, non-referred samples of parents' reports. In more stringent population samples, rates are lower when impairment criteria are stricter and when the information is obtained from both parents and teachers, rather than from moms and dads only. Before puberty, the condition is more common in boys; after puberty, it is almost exclusively identified in boys, and whether the criteria are applicable to girls has been discussed. The disorder usually manifests by age 8 years. OPPOSITIONAL DEFIANT DISORDER and other conduct problems are the single greatest reasons for referrals to outpatient and inpatient mental health settings for kids, accounting for at least half of all referrals.

Diagnosis is complicated by relatively high rates of comorbid, disruptive, behavior disorders. Some symptoms of attention deficit hyperactivity disorder (ADHD) and conduct disorder overlap. Researchers have postulated that, in some kids, OPPOSITIONAL DEFIANT DISORDER may be the developmental precursor of conduct disorder. Comorbidity of OPPOSITIONAL DEFIANT DISORDER with ADHD has been reported to occur in 50-65% of affected kids.

In some Aspergers kids, OPPOSITIONAL DEFIANT DISORDER commonly occurs in conjunction with anxiety disorders and depressive disorders. Cross-sectional surveys have revealed the comorbidity of OPPOSITIONAL DEFIANT DISORDER with an affective disorder in about 35% of cases, with rates of comorbidity increasing with patient age. High rates of comorbidity are also found among ODDs, learning disorders, and academic difficulties. Given these findings, kids with significant oppositional and defiant behaviors often require multidisciplinary assessment and may need components of mental health care, case management, and educational intervention to improve.

Risk Factors and Etiology—

The best available data indicate that no single cause or main effect results in oppositional defiant disorder (ODD). Most experts believe that biological factors are important in OPPOSITIONAL DEFIANT DISORDER and that familial clustering of certain disruptive disorders, including OPPOSITIONAL DEFIANT DISORDER and ADHD, substance abuse, and mood disorders, occurs.

Studies of the genetics of OPPOSITIONAL DEFIANT DISORDER have produced mixed results. Under-arousal to stimulation has been consistently found in persistently aggressive and delinquent youth and in those with OPPOSITIONAL DEFIANT DISORDER. Exogenous factors such as prenatal exposure to toxins, alcohol, and poor nutrition all seem to have effects, but findings are inconsistent. Studies have implicated abnormalities in the prefrontal cortex; altered neurotransmitter function in the serotonergic, noradrenergic, and dopaminergic systems; and low cortisol and elevated testosterone levels.

Clinical Course—

In Aspergers toddlers, temperamental factors, such as irritability, impulsivity, and intensity of reactions to negative stimuli, may contribute to the development of a pattern of oppositional and defiant behaviors in later childhood. Family instability, including economic stress, parental mental illness, harshly punitive behaviors, inconsistent parenting practices, multiple moves, and divorce, may also contribute to the development of oppositional and defiant behaviors.

The interactions of an Aspergers youngster who has a difficult temperament and irritable behavior with moms and dads who are harsh, punitive, and inconsistent usually lead to a coercive, negative cycle of behavior in the family. In this pattern, the youngster's defiant behavior tends to intensify the parents' harsh reactions. The moms and dads respond to misbehavior with threats of punishment that are inconsistently applied. When the parent punishes the youngster, the youngster learns to respond to threats. When the parent fails to punish the youngster, the youngster learns that he or she does not have to comply. Research indicates that these patterns are established early, in the youngster's preschool years; left untreated, pattern development accelerates, and patterns worsen.

Developmentally, the presenting problems change with the Aspergers youngster's age. For example, younger kids are more likely to engage in oppositional and defiant behavior, whereas older kids are more likely to engage in more covert behavior such as stealing.

By the time they are school aged, Aspergers kids with patterns of oppositional behavior tend to express their defiance with teachers and other adults and exhibit aggression toward their peers. As kids with oppositional defiant disorder (ODD) progress in school, they experience increasing peer rejection due to their poor social skills and aggression. These kids may be more likely to misinterpret their peers' behavior as hostile, and they lack the skills to solve social conflicts. In problem situations, kids with OPPOSITIONAL DEFIANT DISORDER are more likely to resort to aggressive physical actions rather than verbal responses. Kids with OPPOSITIONAL DEFIANT DISORDER and poor social skills often do not recognize their role in peer conflicts; they blame their peers (e.g., "He made me hit him.") and usually fail to take responsibility for their own actions.

The following 3 classes of behavior are hallmarks of both oppositional and conduct problems:

1. emotional overreaction to life events, no matter how small
2. failure to take responsibility for one's own actions
3. noncompliance with commands

When behavioral difficulties are present beginning in the preschool period, teachers and families may overlook significant deficiencies in the youngster's learning and academic performance. When many Aspergers kids with behavioral problems and academic problems are placed in the same classroom, the risk for continued behavioral and academic problems increases. OPPOSITIONAL DEFIANT DISORDER behavior may escalate and result in serious antisocial actions that, when sufficiently frequent and severe, become criteria to change the diagnosis to conduct disorder. Milder forms of OPPOSITIONAL DEFIANT DISORDER in some kids spontaneously remit over time. More severe forms of OPPOSITIONAL DEFIANT DISORDER, in which many symptoms are present in the toddler years and continually worsen after the youngster is aged 5 years, may evolve into conduct disorder in older kids and adolescents.

Treatment—

Given the high probability that oppositional defiant disorder (ODD) occurs alongside attention disorders, learning disorders, and conduct disturbances, an evaluation for these disorders is indicated for comprehensive treatment. Pharmacologic treatment (e.g., stimulant medication) for ADHD may be beneficial once this is diagnosed. Aspergers kids with oppositional behavior in the school setting should undergo necessary screening testing in school to evaluate for possible learning disabilities. With the multifaceted nature of associated problems in OPPOSITIONAL DEFIANT DISORDER, comprehensive treatment may include medication, parenting and family therapy, and consultation with the school staff. If kids with OPPOSITIONAL DEFIANT DISORDER are found to have ADHD as well, appropriate treatment of ADHD may help them to restore their focus and attention and decrease their impulsivity; such treatment may enable their social and behavioral interventions to be more effective.

Parent management training (PMT) is recommended for families of Aspergers kids with OPPOSITIONAL DEFIANT DISORDER because it has been demonstrated to affect negative interactions that repeatedly occur between the kids and their moms and dads. PMT consists of procedures in which parents are trained to change their own behaviors and thereby alter their youngster's problem behavior in the home. PMT is based on 35 years of well-developed research showing that oppositional and defiant patterns arise from maladaptive parent-child interactions that start in early childhood.

These patterns develop when moms and dads inadvertently reinforce disruptive and deviant behaviors in a youngster by giving those behaviors a significant amount of negative attention. At the same time, the parents, who are often exhausted by the struggle to obtain compliance with simple requests, usually fail to provide positive attention; often, the moms and dads have infrequent positive interactions with their kids. The pattern of negative interactions evolves quickly as the result of repeated, ineffective, emotionally expressed commands and comments; ineffective harsh punishments; and insufficient attention and modeling of appropriate behaviors.

PMT alters the pattern by encouraging the parent to pay attention to prosocial behavior and to use effective, brief, non-aversive punishments. Treatment is conducted primarily with the moms and dads; the therapist demonstrates specific procedures to modify parental interactions with their youngster. Moms and dads are first trained to simply have periods of positive play interaction with their youngster. They then receive further training to identify the youngster's positive behaviors and to reinforce these behaviors. At that point, parents are trained in the use of brief negative consequences for misbehavior. Treatment sessions provide the moms and dads with opportunities to practice and refine the techniques.

Follow-up studies of operational PMT techniques in which moms and dads successfully modified their behavior showed continued improvements for years after the treatment was finished. Treatment effects have been stronger with younger kids, especially in those with less severe problems. Recent research suggests that less severe problems, rather than a younger patient age, is predictive of treatment success. Approximately 65% of families show significant clinical benefit from well-designed parent management programs.

Regardless of the Aspergers youngster's age, intervention early in the developing pattern of oppositional behavior is likely to be more effective than waiting for the youngster to grow out of it. These kids can benefit from group treatment. The process of modeling behaviors and reactions within group settings creates a real-life adaptation process. In younger kids, combined treatment in which moms and dads attend a PMT group while the kids go to a social skills group has consistently resulted in the best outcome. The efficacy of group treatment of adolescents with oppositional behaviors has been debated. Group therapy for adolescents with OPPOSITIONAL DEFIANT DISORDER is most beneficial when it is structured and focused on developing the skills of listening, empathy, and effective problem solving.

Obstacles to Treatment—

Oppositional defiant disorder (ODD), and other conduct problems, can be intractable. Despite advances in treatment, many Aspergers kids continue to have long-term negative sequelae. PMT requires parental cooperation and effort for success. Existing psychiatric conditions in the moms and dads can be a major obstacle to effective treatment. Depression in a parent, particularly the mother, can prevent successful intervention with the youngster and become worse if the youngster's behavior is out of control. Substance abuse and other more severe psychiatric conditions can adversely affect parenting skills, and these conditions are particularly problematic for the moms and dads of a youngster with OPPOSITIONAL DEFIANT DISORDER.

In situations in which the moms and dads lack the resources to effectively manage their Aspergers youngster, services can be obtained through schools or county mental health agencies. Many states have effective "wrap around" services, which include a full-day school program and home-based therapy services to maintain progress in the home setting. Thus, effective treatment can include resources from several agencies, and coordination is critical. If county mental health or school special education services are involved, one person is usually designated to coordinate services in those systems.


My Aspergers Child: Parent Management Training (PMT) for Parents with Defiant Aspergers Children


Keywords—
• Aspergers and ADHD
• Aspergers and antisocial actions
• Aspergers and attention-deficit/hyperactivity disorder
• Aspergers and conduct disorder
• Aspergers and defiant behavior
• Aspergers and defiant disorder
• Aspergers and disruptive behavior
• Aspergers and harshly punitive behaviors
• Aspergers and hostile behavior
• Aspergers and impulsivity
• Aspergers and irritability
• Aspergers and learning disorders
• Aspergers and maladaptive parent-child interactions
• Aspergers and noncompliance with commands
• Aspergers and ODD
• Aspergers and oppositional defiant disorder
• Aspergers and overreaction to life events
• Aspergers and parent management training
• Aspergers and peer rejection
• Aspergers and stubbornness
• Aspergers defiant disorder
• Aspergers negativistic behavior
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