Multisystemic Therapy for "At-Risk" Youth on the Autism Spectrum

"What therapy (or therapies) are recommended for struggling teenagers on the high functioning end of the autism spectrum?"

Not all teenagers enjoy the "happy-go-lucky" days of adolescence. Unfortunately, there are those who suffer from development disorders such as Asperger’s (AS) and High-Functioning Autism (HFA). When things start to go wrong (e.g., behavioral problems, meltdowns, poor academic performance, etc.), parents often despair of not being able to effectively help their child.

Arguments are waged as to the management of “special needs” teens who act-out aggressively at home or school, commit crimes, or even attempt suicide. Sadly, our society has impoverished resources to address such issues, and while some hospitals are available, all too often the answer is jail. However, research has demonstrated that “troubled” young people on the autism spectrum do not need to be hospitalized or incarcerated to get the help they need. A home-based model of therapy called Multisystemic Therapy (MST) offers treatment services to these teenagers, as well as their parents and siblings.

AS and HFA teens with serious emotional and/or behavioral problems (e.g., substance abuse, severe depression, suicidal thoughts, delinquency, severe anxiety, antisocial behaviors, etc.) have been successfully treated through Multisystemic Therapy. This therapy shows a more hopeful and positive approach and focuses on how to help moms and dads assist their “special needs” teens and how to teach these teens to cope effectively with their schools and communities. In addition, this therapy has been found to be an effective alternative to hospitalization and incarceration.

There is heated debate in our society about the proper roles of psychotherapies and medications for teens “at risk,” as well as teens already suffering. But, what we know for sure is that AS and HFA teens who go untreated: (a) often suffer in silence, (b) can’t learn, (c) tend to act-out their emotions rather than articulate them, (d) have great difficulty forming healthy relationships with friends and family, and (e) tend to isolate themselves from constructive social contacts. Some of these “special needs” teens are placed on a trajectory for jail rather than college at a very early age.

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

Multisystemic Therapy is a mental health service that focuses on changing how these young people function in their natural settings (i.e., at home, school, in the neighborhood, etc.). It is designed to promote positive social behavior while decreasing problematic behavior (e.g., substance abuse, delinquency, violence, etc.). Therapy involves the following:

• The family sets treatment goals, and the therapist suggests strategies to accomplish them. Specific treatments are used within therapy.
• The interventions are individualized to the family's strengths and weaknesses and address the needs of the AS or HFA youngster, family, peers, school, and neighborhood.
• Treatment teams usually consist of crisis caseworkers, professional counselors, and psychiatrists or psychologists who provide clinical supervision. 
• Therapists focus on strengthening the ability of moms and dads to raise “special needs” teens who have complex problems.
• Therapists working in the home have small caseloads and are available 24-hours-a-day, 7-days-a-week.
• Therapists identify strengths in the families and use these strengths to develop natural support systems and to improve parenting skills.
• Therapy is a collaboration between the family and the therapist.

Multisystemic Therapy gets its name because it involves treatment that addresses each of the “systems” that factor into an adolescent’s health and well-being (e.g., his or her social circle, school environment and interactions with teachers, neighborhood environment, family, and home environment).

During therapy, therapists typically meet with the entire family in the home where they focus on such things as assessing and improving parenting skills, as well as the quality of the relationships the adolescent has outside the home (e.g., relationships with peers and the larger community). As a rule, therapists (a) are available to their clients at all times, (b) only work with a small number of families at any given time, and (c) place special emphasis on positive critiques during the therapeutic process. A typical course of therapy lasts for about four months. During this time, therapists typically meet with their families several times a week.

In clinical trials, Multisystemic Therapy has proven effective in reducing long-term rates of criminal offending in serious juvenile offenders – and in reducing their rates of out-of-home placements. Positive long-term effects of Multisystemic Therapy – even 4 years post-treatment – were found. Also, it was found that this therapy reduced long-term rates of re-arrest by 25% to 70% compared with control groups.

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


Multisystemic Therapy:

• increases family cohesion and school attendance compared with hospitalization
• is an effective alternative to psychiatric hospitalization with “special needs” teens in a psychiatric emergency
• is successful in preventing a significant proportion of teens from being hospitalized
• reduces symptoms of internalizing distress and depression
• significantly decreases behavior problems

In addition, families who received Multisystemic Therapy were significantly more satisfied with their treatment than were families whose teenager was hospitalized.

There is an urgent need for clinically-effective, cost-effective methods to manage antisocial and criminal behavior in “special needs” teens. Oppositional Defiant Disorder, as well as Conduct Disorder, is increasingly prevalent in today’s society and is associated with a range of negative outcomes.

Quantitative reviews carried out for the National Institute for Health and Clinical Excellence have identified Multisystemic Therapy as one of the most promising interventions for (a) reducing antisocial or offending behavior and (b) improving individual and family functioning. If you have an AS or HFA teen who is acting-out in self-destructive ways, consult your family doctor for a referral to a mental health professional.

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

Obsessions in Kids on the Autism Spectrum

"Why is my 6-year-old son (high functioning autistic) so engrossed in Minecraft, and how can I tell if it is an unhealthy obsession rather than just a fun time activity for him?"

The intensity and duration of the child’s interest in a particular topic, object or collection is what determines whether or not it has become an “obsession.” Children with Aspergers and High-Functioning Autism (HFA) will often learn a lot about a thing they are obsessed with, be intensely interested in it for a long time, and feel strongly about it. There are several reasons why these kids may develop obsessions, including:

• they can get a lot of enjoyment from learning about a particular subject or gathering together items of interest
• those who find social interaction difficult might use their special interests as a way to start conversations and feel more self-assured in social situations
• obsessions may help children cope with the uncertainties of daily life
• obsessions may help children to relax and feel happy
• obsessions may provide order and predictability
• obsessions may provide structure

 

Many children with Aspergers and HFA have sensory sensitivity and may be over- or under-sensitive to sights, sounds, smells, taste and touch. This sensitivity can also affect children’s balance ('vestibular' system) and body awareness ('proprioception' or knowing where our bodies are and how they are moving). Obsessions and repetitive behavior can be a way to deal with sensory sensitivity.

Although repetitive behavior varies from child to child, the reasons behind it may be the same:

•  a source of enjoyment and occupation
• a way to deal with stress and anxiety and to block out uncertainty
• an attempt to gain sensory input (e.g., rocking may be a way to stimulate the balance or vestibular system; hand-flapping may provide visual stimulation)
• an attempt to reduce sensory input (e.g., focusing on one particular sound may reduce the impact of a loud, distressing environment; this may particularly be seen in social situations)
• some adolescents may revert to old repetitive behaviors (e.g., hand-flapping, rocking if anxious or stressed)

Reality to a child on the autism spectrum is a confusing, interacting mass of events, people, places, sounds and sights. Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life. Trying to keep everything the same reduces some of the terrible fear.

Many children with the disorder have a strong preference for routines and sameness. Routines often serve an important function. For example, they introduce order, structure and predictability and help to manage anxiety. Because of this, it can be very distressing if the child’s routine is disrupted.

 

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

Sometimes minor changes (e.g., moving between two activities) can be distressing. For others, big events (e.g., holidays, birthdays, Christmas, etc.), which create change and upheaval, can cause anxiety. Unexpected changes are often most difficult to deal with. 

Some children on the spectrum have daily timetables so that they know what is going to happen, when. However, the need for routine and sameness can extend beyond this. You might see:

•  a need for routine around daily activities such as meals or bedtime
• changes to the physical environment (e.g., the layout of furniture in a room), or the presence of new people or absence of familiar ones, being difficult to manage
• compulsive behavior (e.g., the child might be constantly washing his hands or checking locks)
• rigid preferences about things like food (e.g., only eating food of a certain color), clothing (e.g., only wearing clothes made from specific fabrics), or everyday objects (e.g., only using particular types of soap or brands of toilet paper)
• routines can become almost ritualistic in nature, having to be followed precisely with attention paid to the tiniest details
• verbal rituals, with a child repeatedly asking the same questions and needing a specific answer

Children's dependence on routines can increase during times of change, stress or illness and may even become more dominant or elaborate at these times. Dependence on routines may increase or re-emerge during adolescence. Routines can have a profound effect on the lives of children with Aspergers and HFA, their family and care-takers, but it is possible to make a child less reliant on them.

Obsessions versus Hobbies—

Most of us have hobbies, interests and a preference for routine. Here are five questions that can help us distinguish between hobbies/interests versus obsessive behavior:

1. Can the child stop the behavior independently?
2. Does the child appear distressed when engaging in the behavior or does the child give signs that he is trying to resist the behavior (e.g., someone who flaps their hands may try to sit on their hands to prevent the behavior)?
3. Is the behavior causing significant disruption to others (e.g., moms and dads, care-takers, peers, siblings)?
4. Is the behavior impacting on the child’s learning?
5. Is the behavior limiting the child’s social opportunities?

If your answer to any of the questions above is 'yes', it may be appropriate to look at ways of helping your youngster to reduce obsessive or repetitive behavior. Think about whether, by setting limits around a particular behavior, you are really helping your youngster. Is the behavior actually a real issue for him, for you, or for other people in his life?

Focus on developing skills that your youngster can use instead of repetitive or obsessive behavior. Try to understand the function of the behavior, then make small, gradual changes and be consistent. Here are some ideas to help you:

1.     Coping with change: If unexpected changes occur, and your youngster is finding it hard to cope, try re-directing them to a calming activity, or encourage them to use simple relaxation techniques such as breathing exercises. You could use praise or other rewards for coping with change. In the long term, this may help make your youngster more tolerant of change.

2.     Explore alternative activities: One way to interrupt repetitive behavior is for a youngster to do another enjoyable activity that has the same function (e.g., a youngster who flicks their fingers for visual stimulation could play with a kaleidoscope or a bubble gun;  a youngster who puts inedible objects in their mouth could have a bag with edible alternatives that provide similar sensory experiences such as raw pasta or spaghetti, or seeds and nuts; a youngster who rocks to get sensory input could go on a swing; a youngster who smears their poop could have a bag with play dough in it to use instead).

3.     Intervene early: Repetitive behaviors, obsessions and routines are generally harder to change the longer they continue.  A behavior that is perhaps acceptable in a young child may not be appropriate as they get older and may, by this time, be very difficult to change. For example, a youngster who is obsessed with shoes and tries to touch people's feet might not present too much of a problem, but a teenager doing the same thing - especially to strangers - will obviously be problematic. It will help if you can set limits around repetitive behaviors from an early age and look out for any new behavior that emerges as your youngster gets older. Making your youngster's environment and surroundings more structured can help them to feel more in control and may reduce anxiety. If anxiety is reduced, the need to engage in repetitive behavior and adhere strictly to routines may also, in time, be reduced.

4.     Pre-planning: You may be able to help your youngster to cope with change, or activities and events that could be stressful, by planning for them in advance.  Change is unavoidable, but it can be really difficult for many children with the disorder. You may not always be able to prepare for change a long time in advance, but try to give your youngster as much warning as possible. Gradually introducing the idea of a new person, place, object or circumstance can help them cope with the change. Try to talk about the event or activity when everyone is fairly relaxed and happy.  Presenting information visually can be a good idea, as your youngster can refer to it as often as they need to. You could try using calendars so that your youngster knows how many days it is before an event (e.g., Christmas) happens. This can help them feel prepared. 

 

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

 

Your youngster might also like to see photos of places or objects in advance so they know what to expect (e.g., a picture of their Christmas present) or a photo of the building they are going to for an appointment. Using social stories could also be helpful. These are short stories, often with pictures, that describe different situations and activities so that children with Aspergers and HFA know what to expect.  Pre-planning can also involve structuring the environment. 

 

For example, a student with HFA might go to use a computer in the library at lunchtime if they find being in the playground too stressful – or if a youngster has sensory sensitivity, minimizing the impact of things like noises (e.g., school bells) or smells (e.g., perfumes or soaps) can help them to cope better.  It is possible that more structured environments may reduce boredom, which is sometimes a reason for repetitive behavior. You might prepare a range of enjoyable or calming activities to re-direct your youngster to if they seem bored or stressed.

5.     Self-regulation skills: Self-regulation skills are any activities that help your youngster to manage their own behavior and emotions.  If you can help your youngster to identify when they are feeling stressed or anxious and use an alternative response (e.g., relaxation techniques or asking for help), you may, in time, see less repetitive or ritualistic behavior.  Research has also shown that increasing a child’s insight into an obsession or repetitive behavior can significantly reduce it. This includes children with quite severe learning disabilities.

6.     Set limits: Setting limits around repetitive behavior, routines and obsessions is an important and often essential way to minimize their impact on your youngster's life. You could set limits in a number of ways depending which behavior concerns you. For example, you can ration objects (e.g., can only carry five pebbles in pocket), ration places (e.g., spinning only allowed at home), and ration times (e.g., can watch his favorite DVD for 20 minutes twice a day). Everyone involved with your youngster should take the same consistent approach to setting limits. Have clear rules about where, when, with whom and for how long a behavior is allowed. You could present this information visually, with a focus on when your youngster can engage in the behavior. This may help if they feel anxious about restricted access to an obsession or activity.

7.     Social skills training: Teaching social skills (e.g.,  how to start and end a conversation, appropriate things to talk about, how to read other people's 'cues') may mean someone with Aspergers or HFA feels more confident and doesn't need to rely on talking about particular subjects (e.g., a special interest). 

8.     Understand the function of the behavior: Obsessions, repetitive behavior and routines are frequently important and meaningful to children on the  spectrum, helping them to manage anxiety and have some measure of control over a confusing and chaotic world. For others, the behavior may help with sensory issues. Take a careful look at what you think might be causing the behavior and what purpose it might serve.  For example, does your youngster always seem to find a particular environment (e.g., a classroom) hard to cope with? Is it too bright? Could you turn off strip lighting and rely on natural daylight instead?

9.     Visual supports: Visual supports (e.g., photos, symbols, written lists or physical objects) can really help children with Aspergers and HFA.  A visual timetable could help your youngster to see what is going to happen next. This makes things more predictable and helps them to feel prepared. It may lessen their reliance on strict routines of their own making. 

 

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

 

Visual supports like egg timers or 'time timers' can help some children with an autism spectrum disorder to understand abstract concepts like time, plan what they need to do, when in order to complete a task, and understand the concept of waiting.  Visual supports can also be useful if your youngster asks the same question repeatedly. One parent wrote down the answer to a question, put it on the fridge and, whenever her son asked the question, told him to go to the fridge and find the answer. For kids who can't read, you could use pictures instead of words.

10.   Make use of obsessions: Obsessions can be used to increase your youngster's skills and areas of interest, promote self-esteem, and encourage socializing. You may find you can look at a particular obsession and think of ways to develop it into something more functional. Here are some examples:

• A child with a special interest in historical dates could join a history group and meet others with similar interests.
• A child with knowledge of sport or music would be a valuable member of a pub quiz team.
• A strong preference for ordering or lining up objects could be developed into housework skills.
• An interest in particular sounds could be channeled into learning a musical instrument.
• An obsession with rubbish could be used to develop an interest in recycling, and the youngster given the job of sorting items for recycling.

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

 

COMMENTS:

•    Anonymous said… Mine is 17 and still obsessed. I think we have every game, plus the cards, and watch the cartoon. HELP!
•    Anonymous said… My 14 year old- obsessed with Pokemon. Sets him noticeably apart from his peers, and is definitely an issue. frown emoticon
•    Anonymous said… my 25 year old son with ASPERGERS is obsessed with stunt riding.. he is getting good at it. came 12th in the british stunt championships last year. wink emoticon
•    Anonymous said… My Aspie son was too at that age. Rest assured, he will move on to other things but with just as much obsession! Whatever makes them happy.....
•    Anonymous said… My lad of 21 now he has aspergers.was mad on pokemon and digimon.
•    Anonymous said… My son is obsessed with this too!
•    Anonymous said… My teenager( Aspergers) at age 6 was obessed with Spongebob. We would turn the Television and he could repeat the episode without pictures or words. I think that they just love different things and have a likeable interest. My normal 6 year old is obsessed with Sonic. He is at the top of his class and this is the 2nd 9weeks weeks of report cards. He wants every character. At least it is a good thing and not something bad.
•    Anonymous said… Pokemon was created by an autistic man, so I can see why they can become an interest.
•    Anonymous said… Sounds familiar our 12 year old loves pokemon magic the gathering mine craft and Spider-Man
•    Anonymous said… This is an excellent article! Our 7-year-old grandson is obsessed with Minecraft. We have to curb his enthusiasm for discussing Minecraft every single minute of the day, or we would go completely batty! We tell him that although he loves Minecraft, not everyone shares his interest, and it's important to find out what other people's interests are, and not to monopolize conversations talking about his interests only.
•    Anonymous said… When our Aspergers son got into Pokemon it was actually a HUGE help for him socially. Since all the kids were into it, he actually had common interests and they could all talk Pokemon. We saw a lot of social growth during this phase so the obsession was actually very healthy for him.

*    Anonymous said...I have a 9 year old son. He was assessed two years ago by a Dr. at Stanford University. I went in there thinking he would come out with a diagnosis for ADHD Inattentive at the bare minimum, but instead we walked out an hour later being told he was only dyslexic. I still don’t understand how that one was the official diagnosis because I really don’t see a connection with him. He doesn’t have troubles reading, and he never complains about the letters looking different. Fast forward to today. At 9 years old his mannerisms are starting to really stick out from other kids his age. You can’t really play it off as him being a “little” boy because he is acting sort of immaturely for a 9 year old. He is also very in tune with remembering dates to when certain people were born. When certain musicians first played a rock and roll song and when movies we’re first released. He then compares that to something like when he was born. “Mom you know that movie, (movie title) came out on November five, 1987”. (He says “five” rather than saying “fifth). Then he says, “that means it came out 27 years before I was born!” Mind you, no one inquired about the song or asked him anything about it but he’s correct on the dates and feels the need to tell you about it. He’s also obsessed with space and Roblox right now and loves informing you on all things associated with them. With all his knowledge of dates and times in history, he absolutely struggles in school. He’s in speech because he has a little trouble speaking and pronouncing sounds. He’s also in “Learning Lab” getting extra one-on-one help with school work with a school resource teacher. Ask him to write an essay about a certain topic and he can’t form thoughts and write them down. The teacher wants a intro. paragraph, main body and a conclusion. He writes random sentences that are not cohesive and go way off track. Have him read a one page, age appropriate news article written for kids and he can’t answer a 5 question quiz afterwards of what they just read. It’s very interesting how he can be so correct with recalling dates off the top of his head but his short term memory is so much different. I just feel like something is going on with this wonderful child of mine. He’s so quirky and ridiculously sweet, I love him to bits but I’m concerned about him. :-/

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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).

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

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

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

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

Social Skills Training for Children with High-Functioning Autism and Asperger's

This post will provide some crucial guidelines for how parents and educators can teach social skills to children with Asperger’s (AS) and High-Functioning Autism (HFA) at home and in the classroom.

These “special needs” children often have difficulty saying what they mean, planning and controlling what they do, noticing and interpreting facial expression and body language, understanding what someone has told them, and accurately perceiving what other people do, say, or demonstrate.

Fortunately, they have a patient and supportive adult like you. The ideas presented below will show you how to support them as they struggle to show the new behavior, and how to focus on progress rather than perfection.

Social skills are those self-management, problem-solving, peer-relations, decision making, and communication abilities that allow the AS or HFA youngster to initiate and maintain positive social relationships with others. Deficits in social behavior interfere with learning, teaching, and the classroom atmosphere. Social competence is linked to peer-acceptance, teacher-acceptance, inclusion success, and post-school success.

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

Displaying poor social skills is THE #1 factor involved in the “odd” behavior that gets AS and HFA children rejected and bullied by peers. Young people on the autism spectrum often fail socially because they have difficulty monitoring and controlling their behavior when unexpected situations occur. They may misread social cues given off by others. They may view the positive social interactions of others as threatening. And they may not even notice when a peer rejects, teases, or bullies them.


Why AS and HFA Is Largely a Disorder of Social Skills

Depending on the child’s specific needs, a good “social skills training” program can include any of the following:

• ability to respond to a given environment in a manner that produces, maintains, and enhances positive interpersonal relations
• acceptable ways to resolve conflict with others 
• accepting the consequences of one's behavior
• approaching others in socially acceptable ways
• appropriate classroom behavior
• asking for permission rather than acting
• attending to task
• awareness of own and other's feelings
• being able to predict how others might feel in a situation and understanding that others might not feel as you do
• better ways to handle frustration and anger 
• coping with negative feelings
• counting to 10 before reacting
• dealing with stress
• distracting oneself to a pleasurable task
• following directions
• handling teasing and taunting
• how to make and keep friends 
• learning an internal dialog to cool oneself down and reflect upon the best course of action
• listening
• manners and positive interaction with others 
• positive, non-aggressive choices when faced with conflict
• seeking attention properly
• seeking the assistance of the teacher or conflict resolution team
• sharing toys and materials
• using words instead of physical contact
• what to do when you make mistakes
• work habits and academic survival skills

How to Teach Social Skills to AS and HFA Children—

You will do well to teach social skills just like you teach academics. Assess the level of the AS or HFA child, prepare the materials, introduce the material, model it, have him or her practice it, and provide feedback. If you purchase a social skills curriculum, simply follow the directions in the kit (it should include an assessment device, lessons, and activities). If you're developing your own curriculum and devising lessons, follow the tips below.

How to teach social skills to one specific child:

1. By way of an assessment, select the AS or HFA child who needs training in certain skills.

2. Task analyze the target behavior(s). Task analysis will help to teach complex behaviors by breaking down a task into smaller objectives. Applicable replacement behaviors are usually taught when the student displays inappropriate behavior in specific environments. AS and HFA students respond well in learning new goal behaviors when they're broken down into individual steps.

3. Determine what behavior to modify or replace by observing the AS or HFA student in a variety of situations. Expose the child to a variety of environments to reveal where the behavior occurs most frequently and why he or she feels the need to engage in negative behaviors in that situation. Examples of target behaviors may include:

• accepting "no" for an answer
• accepting praise from others
• accepting responsibility for one's own behavior
• accepting the consequences administered by the teacher
• apologizing for wrong doing
• asking permission
• asking questions appropriately
• avoiding fighting with others
• complimenting others
• compromising on issues
• cooperating with peers
• coping with aggression from other
• coping with taunts
• coping with verbal or physical threats
• dealing better with anger
• dealing with frustration
• dealing with losing
• following directions
• greeting others 
• initiating a conversation with others
• interrupting others appropriately
• joining a group activity already in progress
• listening
• making a mistake in an appropriate manner without yelling or physical aggression
• making friends
• respecting the opinions of others
• saying please and thank you
• seeking attention in an appropriate manner
• showing sportsmanship
• understanding the feelings of others and accepting them as valid
• waiting one's turn

==> Teaching Social Skills and Emotion Management

4. Speak directly with the child to get a better idea of what is important in his or her life and why the behavior is occurring. This can give a lot of insight as to what the child is trying to communicate by using negative behaviors.

5. Determine an appropriate replacement behavior and decide when it should apply. Make clear the focus and purpose of the positive behavior. The behavior should promote acceptable choices in the classroom.

6. Break the appropriate behavior or task down into small and clear objectives. This encourages quicker success instead of teaching the entire task at once. Move on to the next task as the child masters each one.

7. Determine where, and under what conditions, the child should practice the behavior. Specify the expected amount of change before moving on to the next objective. Make sure each objective is measurable.

8. Discuss and model the replacement behavior with the child. Practice the appropriate behavior or smaller objectives of the behavior in the appropriate environment.

9. Use positive reinforcements. AS and HFA students who are learning to apply appropriate behaviors may display the action more frequently if they receive a tangible reward each time they behave appropriately.

Teaching social skills to a group of students:

1. Create groups of 3-5 youngsters with similar skill deficits (smaller groups give the participants a chance to observe others, practice with peers, and receive feedback).

2. Try to meet early in the day so that the participants are attentive and have the whole day to practice what they learn in the lesson.

3. Introduce the program to the participants, and describe why and how it will benefit them.

4. Identify the behaviors that you will reward during lessons (e.g., raising hands when wanting to ask a question, one child speaks at a time, paying attention, etc.). These selected behaviors will need to be taught in the initial lesson.

5. Teach the easy-to-learn skills first to ensure success and reinforcement.

6. Teach to the higher-functioning children in the group first. Have them demonstrate the new behaviors, and then reward them. Have the lower-functioning children demonstrate the behaviors after the leaders do so.

7. Have the child self-monitor and self-assess in order to build internal motivation and control.

8. Have the participants practice through homework assignments, review sessions, and assignments to real life settings.

9. Make sure your lessons are interesting and fun so that the participants look forward to the lessons.

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

10. Monitor the child’s behavior outside of the lessons. Keep track of the behavior for IEP documentation.

11. Promote generalization to different settings and circumstances by (a) having the child submit self-report forms for each class period, (b) meeting with the child to discuss performance throughout school or home life, (c) practicing in different settings and under various conditions, and (d) prompting and coaching the child in naturally occurring situations.

12. Recognize and reward proper behavior in everyday school situations.

13. When you see a good situation for a child to display a "new" behavior, prompt its use with cues or hints.

As a side note, remember that AS and HFA children generally display negative behaviors to communicate thoughts or feelings – not because they are purposely trying to be defiant. Also, as with the teaching of academics, begin with the prerequisite skills and then move on to the more advanced ones. Your social skills training program should be comprised of the skills that are most important to classroom etiquette and the AS or HFA child’s social needs.

Lastly, understand that while the teaching of social skills may consume a lot of time during the school day, over the weeks and months ahead, you will likely gain back lost time as the “special needs” child displays more acceptable behavior.

==> More crucial parenting techniques to teach social skills to kids on the spectrum can be found here...

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

Behavior-Management Techniques for Children with High-Functioning Autism

"How can parents tell the difference between deliberate, defiant and manipulative behaviors - as opposed to symptoms of autism (high functioning in this case)."

Children with Asperger’s and High Functioning Autism (HFA) often exhibit different forms of challenging behavior. It is imperative that these behaviors are not seen as willful or malicious; more accurately, they should be viewed as connected to the child’s disorder and treated as such by means of insightful, therapeutic and educational strategies, rather than by inconsistent punishment or other disciplinary measures that imply the assumption of deliberate misbehavior.

Parents and teachers need to recognize the difficulties that the youngster with HFA brings to each situation as a result of his or her neurologically-based disorder. Among the common traits of this “special needs” child include the following:

• A need for predictability and routine
• A tendency to respond based on association and memory, which leads the youngster to repeat familiar behaviors even when they produce consistently negative results
• An overly reactive sensory system that makes ordinary noise, smell or touch irritating or intolerable
• Considerable difficulty organizing himself to do something productive in undirected play activities, in stimulating public situations, or when waiting
• Emotional responses that are apt to be extreme and are often based on immediate events, leading to rapid changes (e.g., from laughing to screaming)
• Lack of embarrassment or concern about other people's impressions of them
• Limited ability to recognize another person's perspective or opinion or to empathize with others
• Poor recognition of public versus private behavior
• Problems shifting attention
• Problems transitioning from one activity to another
• Recovery from emotional upset is often immediate once the problem is removed, but for some kids on the spectrum, irritability and secondary upsets can continue for hours
• Significant difficulties with understanding language, especially in group situations

     

Note: These traits are not the result of poor parenting or teaching. Also, they are not deliberate, willful or manipulative behaviors. They are simply common traits of kids with HFA.

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

Symptoms of Asperger's and High-Functioning Autism that Cause Behavioral Problems



Specific problem-solving strategies can be taught for handling the requirements of frequently occurring, problematic situations (e.g., involving novelty, intense social demands, frustration, etc.). Training is usually necessary for recognizing situations as problematic and for selecting the best available learned strategy to use in such situations.

The following steps will help parents and teachers implement behavioral management techniques for children and teens on the higher end of the autism spectrum:

Step #1: Prepare a list of frequent and challenging behaviors (e.g., perseverations, obsessions, interrupting, or any other disruptive behaviors). When listing these behaviors, it is important that they are specified in a hierarchy of priorities so that both parent and child can concentrate on a small number of truly troublesome behaviors.

Step #2: Create some specific interventions that help with the challenging behaviors whenever the behaviors arise. Here are just a few examples of appropriate interventions:

• Instructional intervention is used with a child who already wants to change his behavior, but simply doesn't know how. This is one of the easier behavior intervention strategies, because you simply need to tell the child what to do and how to do it. Once he has this information, he can change his behavior on his own.

• Positive reinforcement is a good behavior intervention technique, because it doesn't even recognize the negative behavior. To positively reinforce a child, you just tell her that she is doing a great job or otherwise reward her whenever she does the right thing. This creates a situation where she associates the right thing with a good outcome and has no such association with the wrong thing. This helps to positively change behavior without having to punish, yell or otherwise negatively reinforce behaviors.

• Negative reinforcement is the opposite of positive reinforcement. Rather than positively reinforce the correct behaviors, negative reinforcement reinforces the incorrect behaviors. This is good for more serious issues (e.g., if the youngster consistently climbs on the counter next to a pot of boiling water, you need to negatively reinforce that behavior immediately, because the consequences of knocking over the pot are so dire). Examples of negative reinforcement include stern words, loss of privileges and other forms of discipline.

• Supportive intervention is when the child needs help reinforcing a behavior. She may know it theoretically, but she may not always apply it as it is not yet internalized. So, supportive intervention is when the child is gently guided through positive and negative feedback. It is different from other forms of behavior intervention, because it has a specific spot in the behavior management cycle – specifically, after the behavior has been learned, but before it is consistently applied.

Step #3: Make sure that the interventions listed above are discussed with the HFA child in an explicit, rule-governed fashion so that clear expectations are set and consistency across adults, settings and situations is maintained.

Step #4: Help the child to make choices. Do not assume that he makes informed decisions based on his own set of elaborate likes and dislikes. Rather he should be helped to consider alternatives of action or choices, as well as their consequences (e.g., rewards and unhappiness) and associated emotions. The need for such an artificial set of guidelines is a result of the HFA child’s typical poor intuition and knowledge of self.
 
==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

Additional behavior management strategies that are critical to the success of the HFA child include the following:

• Stick to a routine: This is necessary for both the youngster and the parent. A youngster with HFA thrives on routine. Being able to anticipate what comes next is soothing and satisfying. Routine lessens anxiety, and a less anxious youngster has fewer outbursts. Adhering to a schedule is a necessary behavior management tool. If the youngster is complacent with her schedule, it eliminates some behavior issues. Behavior management for kids on the autism spectrum is about anticipating what will cause unwanted behavior and eradicating those situations. Because of insufficient social skills, the youngster often has to memorize the rules of situational norms (e.g., eating in a restaurant, waiting in line, sharing with friends, etc.). Routine-based behavioral management techniques focus on the prevention of the negative behaviors that accompany an unstructured or weak routine.

• Encourage the child’s special interest: The HFA youngster will often have a very specific interest and obsess about it. Some moms and dads are apprehensive about encouraging this peculiar behavior, but it is actually a helpful coping technique. The youngster’s special interest can be used to encourage positive behavior (e.g., “If you share with your friend, we will go to the library and check out another book about dinosaurs”). However, don’t use the special interest as a disciplinary tool. Taking away the youngster’s “go-to coping skill” is denying him a form of self-imposed therapy.

• Issue rewards for positive behavior immediately: Kids on the autism spectrum are often unable to relate cause and effect, especially if a lot of time exists between the two. Thus, reinforcements should be given immediately. The youngster can’t relate a reward received at the end of the day to a behavior exhibited earlier in the afternoon. Also, rewards should be chosen carefully, and moms and dads need to follow through with the incentive (e.g., if stickers or other tokens are being used to encourage successful behavior, be sure that these rewards are readily available at all times – and in all settings).

• Use visual schedules: Kids on the autism spectrum crave structure, and visual schedules are helpful in creating order, clear choices and expectations. A visual schedule is a series of pictures that lists the day’s activities and choices (e.g., a morning schedule posted on the bathroom mirror can have pictures depicting the youngster brushing her teeth, washing her face, and getting dressed …or at breakfast, there may be a visual schedule showing meal options). Depending on the needs of the youngster, the schedule can illustrate more detail.

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

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

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

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

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

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

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

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

 

Addressing Self-Harm Behaviors in Children on the Autism Spectrum

"When my daughter (high functioning autistic) gets really upset, she pulls her hair (YANKS IT BY THE HANDFULL!). How can we stop this? Why does she do this? Is this something other parents deal with who have a child on the spectrum?"

Many children on the autism spectrum don’t know how to adequately verbalize their emotions. As a result, they may “act-out” their uncomfortable feelings by self-injuring. To make matters worse, research has found that self-injury is an addictive behavior. When a youngster self-injures, “feel-good” endorphins flood his bloodstream. In many cases, the rush is so pleasing that he learns to view self-injury as soothing instead of destructive.

Self-harm is one of the most devastating behaviors exhibited by children on the autism spectrum. The most common forms of these behaviors include: hand-biting, head-banging, and excessive self-rubbing and scratching. 

There are many possible reasons why a child may engage in self-harm, including the following:

1. Communication problems in children on the autism spectrum have often been associated with self-harm. If the child has poor receptive and/or expressive language skills, this can lead to frustration and escalate to self-harm.

2. Low levels of calcium have been associated with eye-poking behavior. When these “special needs” children are given calcium supplements, eye-poking decreases substantially, and language functioning improves.

3. Moms and dads often report that their youngster's self-harm is a result of frustration (e.g., a child with poor social skills becomes frustrated because of his lack of understanding of group play).



4. Positive attention can increase the frequency of self-harm (i.e., positive reinforcement), whereas ignoring the behavior can decrease the frequency (i.e., extinction).

5. Research on administering drugs to human subjects have indicated that low levels of serotonin or high levels of dopamine are associated with self-harm.

6. Researchers have suggested that the levels of certain neurotransmitters are associated with self-harm. Beta-endorphins are opiate-like substances in the brain, and self-harm may increase the production or the release of endorphins. Thus, the child experiences an anesthesia-like effect and, apparently, he doesn’t feel any pain while engaging in the behavior. In addition, the release of endorphins may provide the child with a euphoric-like feeling.

7. Self-harm has also been associated with seizure activity in the frontal and temporal lobes. Behaviors often associated with seizure activity include: slapping ears or head, scratching face or arms, knee-to-face contact, head-banging, hand-biting, and chin-hitting.

8. Self-harm is also common among several genetic disorders (e.g., Lesch-Nyhan Syndrome, Fragile X Syndrome, Cornelia de Lange Syndrome). Since these disorders are associated with some form of structural damage or biochemical dysfunction, these defects may cause the child to self-injure.

9. Some children engage in head-banging to reduce pain (e.g., middle ear infection, migraine headache, acid reflux and gas, etc.). Also, some children on the spectrum report that certain sounds (e.g., baby crying, vacuum cleaner, etc.) cause pain. In these cases, self-harm releases beta-endorphins that dampen the pain. On the other hand, these children may be “gating” the pain (i.e., stimulating one area of the body via self-injury to reduce the pain located in another area of the body).

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

10. Some children on the autism spectrum engage in self-harm to obtain privileges (e.g., the child may request something, not receive it, and then engage in self-harm). In addition, the behavior may be reinforced if the child should, on occasion, receive the desired privilege.

11. Some children on the spectrum function at a low level of arousal and engage in self-harm to increase their arousal level. In this case, self-harm is an extreme form of self-stimulation. On the other hand, some children on the spectrum function at a very high level of arousal (e.g., anxiety, tension, etc.) and engage in self-harm to reduce their arousal level (i.e., the behavior acts as a release of anxiety).

12. Some children on the spectrum engage in self-harm to avoid an undesirable social encounter (i.e., they engage in self-harm just prior to the social interaction, and as a result, may avoid the social interaction before it begins). Conversely, the child may engage in self-harm to escape a social encounter that has already begun (e.g., the parent may ask her child to leave the play area, but if the child doesn’t want to comply, he may then engage in self-harm, and as a result the parent’s initial request is dropped and attention is then directed at stopping the self-injurious behavior).



So, what can parents and teachers do to address the issue of self-harm in children on the autism spectrum? 

Below are some important considerations and strategies that may mitigate or eliminate these behaviors:

1. Biochemical interventions (e.g., nutritional supplements and drugs) appear to be the treatment of choice for these “special needs” children.

2. Following an episode of self-harm, make note how you attend to your child. Your attention may be positive (e.g., “How can I help you?"), or negative ("Stop that!"). Understand that your child may interpret a negative comment in a positive manner; thus, the behavior will be positively reinforced. In other words, he may continue the unwanted behavior.

3. If the child engages in self-harm because he doesn’t want to meet a parental request or demand, it’s important that parents “follow-through” with their request or demand anyway. If the child should engage in self-harm, parents can continue to make the request during the behavior, or they may direct the child’s attention to stop the behavior – but then present the request again until he complies.

4. If the child engages in self-harm due to “not getting his way,” parents should not give anything to the child during - or following - an episode of self-harm. Consistency is crucial here, because the self-harm behavior will continue even if the child gets what he wants on only some occasions.

5. Put positive and uplifting items in a box that your youngster can use when he gets the urge to self-injure (e.g., a journal, art supplies, upbeat music, photos of friends or his heroes –  anything your youngster finds calming).

6. With respect to over-arousal, self-harm may be observed in arousal-inducing situations (e.g., noisy or brightly lighted rooms).  Also, social interaction may be perceived by the child as very stimulating. If the child is over-aroused, steps should be taken before the self-harm behavior begins to reduce arousal level (e.g., relaxation techniques, deep pressure, vestibular stimulation, removing the child from the stimulating situation, etc.). 

7. With respect to under-arousal, self-harm may be observed when the child is bored or isn’t involved in stimulating tasks. If the child is under-aroused, an increase in activity level can be helpful. In this case, an exercise program can be implemented.





8. Visualizing a serene place is a great way to reduce painful emotions. When you practice positive imagery in front of your youngster, you help him strengthen these skills. For example, talk aloud as you describe a soothing landscape or reflect on positive memories of a place you’ve been to. Use graphic details in your descriptions. 

9. If your child has poor expressive skills, self-harm may occur after he tries to communicate with another person (e.g., by gesture) and the person doesn’t understand or doesn’t respond appropriately. With respect to expressive language, these children should be taught functional communication skills.

10. If your child has poor receptive skills, communication may be the problem if self-harm occurs after someone says something to him. With respect to receptive communication skills, the child may be chronically ill (e.g., headache, nausea, etc.) and may not be able to focus his attention to what was said.  This may be due to food sensitivities. Also, there is evidence that auditory integration training may improve receptive language skills due to better retrieval of information from long-term memory.

11. Help your youngster better understand the types of situations that trigger his negative feelings. For example, if it’s a test coming up at school, a social event, or a doctor’s appointment, talk about how the days leading up to it can feel stressful. This helps your youngster be prepared and have the necessary skills at his disposal. Also, talk about your personal triggers and the healthy strategies YOU use to cope.

12. If your child tends to receive a lot of attention following self-harm behavior, then you should do your best to ignore the behavior. If this isn’t possible because he may seriously injure himself, then minimize contact with him while displaying little facial expression – and don’t approve or disapprove of the behavior. Consistency is crucial here, because self-harm will continue if your child receives intermittent reinforcement (i.e., attention) for the behavior. Having said this, your child should receive attention – but it should not be contingent on self-harm. Instead, give him attention when he doesn’t engage in self-harm.

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

13. Many moms and dads of children on the autism spectrum have reported that vitamin B6, calcium, and/or DMG have resulted in dramatic reductions in self-harm behavior. Many parents have also reported reductions in self-harm soon after placing their youngster on a restricted diet (e.g., gluten/casein-free).

14. Nutritional and medical interventions can be implemented to regulate the child’s biochemistry, which in turn may reduce the self-harm behavior.

15. Self-harm behavior may occur sporadically. The child may show signs of illness or appear to be in pain (e.g., from a migraine or middle ear infection) on those days he exhibits self-harm. In this case, check your family history to see if migraines run in the family. Also, your child should have his ears examined and body temperature measured to check for a middle ear infection.

16. Since seizure-induced self-harm is involuntary, parents and teachers may not observe a relationship between the child’s behavior and his environment. But, since stress can trigger a seizure, there may be a relationship between self-harm and stressors in the environment (e.g., too much physical stimulation such as lighting and noise, too much social stimulation such as reprimands and demands).

17. The child can be encouraged to apply safe forms of physical stimulation to those parts of the body he rubs or scratches excessively (e.g., applying a massaging vibrator, rubbing textured objects against the skin, etc.). There is also evidence that placing a topical anesthetic on the injured area reduces self-harm behavior.

18. When self-harm is associated with a biochemical abnormality, there may be little or no relationship between the child’s environment and self-harm. Therefore, the behavior may occur in various settings and around different people. But, self-harm may occur less frequently in situations in which the child’s behavior is incompatible with self-harm (e.g., playing, eating, working on a task, etc.).

19. As you work with your child to address self-harm, know that setbacks are “normal.” Stopping self-harming behavior isn’t easy, and it’ll take time. Your youngster will experience some obstacles along the way that will slow the process down. The best approach if a setback does occur is to offer nonjudgmental support. Shame, criticism, or over-reaction when moms and dads see a wound usually causes children to withdraw back into self-harming behaviors.

20. If after working with your child, you still notice signs of self-harm, take him to a professional for an assessment. The professional will determine whether self-harm is suicidal or non-suicidal by administering a suicide assessment. He or she will also ascertain if other concerns are present.

Self-harm can usually be controlled in most situations. But, it’s important to understand that there are many different reasons why children on the autism spectrum engage in this behavior. It’s also possible that one form of self-harm may serve more than one function (e.g., the child may engage in head-banging when he is unable to communicate his needs – AND when he doesn’t get what he wants).

Based on observational data collected by the parent or teacher, the possible reasons for the behavior should be ranked-ordered, from most likely to least likely. This rank-ordering can then determine the order in which different interventions are implemented. By carefully examining the child’s behavior, parents and teachers can make a reasonable deduction regarding the appropriate intervention.

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

Parenting Difficult Teenagers on the Autism Spectrum

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

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

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

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

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

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

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

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

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

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

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

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

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

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

----------

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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