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

Anxiety-Based Absenteeism and School-Refusal in Kids on the Autism Spectrum

Some youngsters with ASD level 1, or High-Functioning Autism (HFA), experience fear or panic when they think about going to school in the morning. These kids may tell their moms and dads that they feel nauseous or have a headache, or may exaggerate minor physical complaints as an excuse not to go to school.

When the HFA youngster exhibits a developmentally inappropriate and excessive anxiety concerning separation from their home or from those to whom they are attached, they may be experiencing a Separation Anxiety Disorder. This disorder is characterized by the youngster exhibiting three or more of the following for a period of more than four weeks: 
  1. persistent and excessive worry about losing, or about possible harm befalling, major attachment figures
  2. persistent and excessive worry that a troublesome event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped)
  3. persistent reluctance or refusal to go to school or elsewhere because of fear of separation
  4. persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
  5. persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
  6. recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
  7. repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated
  8. repeated nightmares involving the theme of separation



In addition to the symptoms described above, HFA kids with an unreasonable fear of school may also:
  • display clinging behavior
  • fear being alone in the dark
  • feel unsafe staying in a room by themselves and frequently go check to find their parent or have a need to be able to see their parent (e.g., a child in a shopping mall who feels a lot of distress if he can't always see his parent may be exhibiting a symptom of separation anxiety)
  • have difficulty going to sleep
  • have exaggerated, unrealistic fears of animals, monsters, burglars, etc.
  • have nightmares about being separated from their parent(s)
  • have severe tantrums when forced to go to school

School-Refusal versus School-Refusal Behavior—

There is a significant difference between “school-refusal” and “school-refusal behavior.” The child who ditches school to hang out with his buddies is exhibiting school refusal behavior. Often, this is nothing more than a phase brought on by a sense of rebellion. On the other hand, the youngster who clings to his mom’s leg, screaming at the thought of having to enter the school building, is showing signs of school refusal (also called "anxiety-based absenteeism"). However, the label doesn't matter nearly as much as getting your youngster back in school. Working with school officials (and in serious cases, a therapist) to create a plan is a necessary step. 
 
==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

Is your child refusing to go to school due to real separation anxiety issues, or is he or she simply being defiant? Answers to the following questions may help to determine the motivation behind school-refusal or school-refusal behavior:
  • Are symptoms of school-refusal evident on weekends and holidays?
  • Are there any non-school situations where anxiety or attention-seeking behavior occurs?
  • Have recent or traumatic home or school events influenced your youngster’s school-refusal?
  • How did your youngster’s school-refusal develop over time?
  • Is your youngster willing to attend school if incentives are provided for attendance?
  • Is your youngster willing to attend school if you accompany him or her?
  • Is your youngster’s refusal to attend school legitimate or understandable in some way (e.g., due to a school-based threat, bullying, inadequate school environment, etc.)?
  • Is your youngster’s school-refusal relatively acute or chronic in nature? 
  • What are your youngster’s specific forms of absenteeism, and how do these forms change daily?
  • What comorbid conditions (e.g., anxiety, depression, sensory sensitivities, etc.) occur with your youngster’s school-refusal?
  • What family disruption or conflict has occurred as a result of your youngster’s school-refusal?
  • What is your youngster’s academic and social status? (This would include a review of academic records, formal evaluation reports, attendance records, and IEP or 504 plans.)
  • What is your youngster’s degree of anxiety or misbehavior upon entering school?
  • What specific problematic behaviors are present in the morning before school?
  • What specific school-related stimuli are provoking your youngster’s concern about going to school?
  • What specific social situations at school are avoided?
  • What specific tangible rewards does your youngster pursue outside of school that cause him or her to miss school?

One way of conceptualizing absenteeism involves reinforcers. For example:
  1. to pursue tangible reinforcers outside of school (e.g., sleeping late, watching television, playing with peers, engaging in delinquent behavior or substance use, etc.)
  2. to pursue attention from significant others (e.g., wanting to stay home or go to work with the parent)
  3. to escape aversive social situations (e.g., conversing or interacting with classmates, performing before others in class presentations, etc.)
  4. to avoid school-based stimuli that creates anxiety, frustration, or despondency (e.g., interactions with educators and/or classmates, bus, cafeteria, classroom, transitions between classes, etc.)

Issues 1 and 2 above are maintained by positive reinforcement, or a desire to pursue rewards outside of school. Issues 3 and 4 above are maintained by negative reinforcement or a desire to leave anxiety-provoking stimuli. HFA students may also refuse school for a combination of these reasons. In the case of one young female with Asperger’s, she was initially anxious about school in general. But, after her parents allowed her to stay home for a few days, she was refusing school to enjoy playing video games.

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

School-refusal Warning Signs—

While one student may complain of headaches or stomachaches, another may refuse to get out of bed, while a third repeatedly gets "sick" and calls home during the school day. Symptoms can run the gamut and may even include combinations of behaviors. Here are some typical warning signs that an HFA youngster is suffering from Separation Anxiety Disorder:
  • Anxiety or panic attacks
  • Depression
  • Drug/alcohol use
  • Failing grades
  • Fatigue
  • Frequent physical complaints (e.g., headaches, stomachaches, etc.)
  • Physical aggression or threats
  • Risk-taking behavior
  • Social problems

Many symptoms, particularly physical complaints, can mimic other disorders. When these occur in combination with a pattern of not attending school, a complete evaluation should be made by qualified professionals to determine whether the child has Separation Anxiety Disorder or another psychological or physical disorder.

Separation Anxiety Disorder can be exhausting and frustrating for moms and dads to deal with, but it is worse for the HFA youngster who feels such intense fear and discomfort about going to school. If parents are unable to get the youngster to school, he may develop serious educational, emotional, and social problems.

Because the anxiety is about separating from the parent (or attachment object), once the youngster gets to school, he usually calms down and can function. It's getting him there that is the real challenge.

School avoidance may serve different functions in different kids. For some, it may be the avoidance of specific fears or phobias triggered in the school setting (e.g., fear of school bathrooms due to contamination or other fears associated with Obsessive-Compulsive Disorder, fear of noisy and crowed hallways, fear of test-taking, etc.). For other kids, it may serve to help them avoid or escape negative social situations (e.g., being bullied by peers, being teased, having a critical teacher, etc.). 
 

When school-refusal is anxiety-related, allowing the HFA youngster to stay home only worsens the symptoms over time. Getting her back into school as quickly as possible is one of the factors that is associated with more positive outcomes. However, this requires a multimodal approach that involves the student's physician, a mental health professional, the mom and/or dad, the student, and school officials. The same therapeutic modalities that are effective with Panic Disorder and Obsessive-Compulsive Disorder are also effective for school-refusal, namely, “exposure-response prevention” (i.e., a form of cognitive-behavior therapy that may include relaxation training, cognitive alterations, and a graded hierarchy of steps towards the goal).

There is some research that suggests that education support therapy may be as effective as exposure therapy for treating school-refusal. Working with the school psychologist, the student talks about his fears and is educated in the differences between fear, anxiety, and phobias. He learns to recognize the physical symptoms that are associated with each of these states and is given information to help him overcome his fears about attending school. 
 
The student is usually asked to keep a daily diary where he records his fears, thoughts, strategies, and feelings about going to school. The time of day that he arrived at school is also recorded, and the record is reviewed each morning with a school psychologist. Although it may seem like a good idea to incorporate positive reinforcement for school attendance, that may backfire and simply increase the student's stress levels and anxiety.

Parent training in strategies to work with the HFA youngster in the home is also an important piece of any school-based plan to deal with the student with school-refusal.




When it comes to school-refusal and school-refusal behavior, accommodating the HFA youngster by letting her stay home is generally contraindicated (unless there are other issues). So, what can moms and dads do to address this dilemma? Here are some tips:

1. Try to find ways to empower the HFA youngster to go to school. For example, a youngster is likely to feel reassured if times are set for him or her to call the mother from school. In extreme cases, mothers may stay with the youngster in school, but for a specified length of time (which is gradually reduced).

2. Punishment does not work. Kind, consistent, rational pressure and encouragement do.

3. Investigate what's going on at school. If it's bullying, parents need to find out who the perpetrator is. Once they know whether their youngster’s complaint is a valid one, it's easier to work with him around the issue, both in and outside of school.

4. It is most important to tell the HFA youngster exactly what she is to expect. There should be no "tricks" or surprises. For example, if the youngster is told that she should try to stay in school for only one hour, but after the hour, she is asked to stay longer either by the teacher or parent, this WILL backfire! The youngster will eventually refuse future arrangements for fear that they will be modified arbitrarily. Part of being anxious is anxiety about the unknown and the “what if?”
 

5. Prevent “secondary gain.” Some parents frequently – yet unintentionally – reinforce separation anxiety symptoms in their HFA child. For instance, when parents get a divorce and the youngster expresses refusal to leave the custodial parent (who may be distraught or saddened by the divorce), the youngster may not be firmly encouraged to appropriately separate and instead is rewarded either overtly or covertly for refusal to separate (e.g., when the youngster who refuses to attend school is excused by the parent). In this case, the parent does not clearly give the youngster the task of developing strategies to adapt to the divorce.

6. Do not quiz your child about why he feels scared. The youngster often does not know why. By not being able to provide an explanation, in addition to being anxious, he may feel guilty about not making sense of what is happening. It’s better to acknowledge that the fears are inflated (e.g., a child’s fear that the parent may die while he is at school) and that the youngster has to fight them.

7. Coordinate with school officials. Parents shouldn’t try to address this situation alone. Whether it's arranging to have someone meet you on the playground to escort your youngster into school, or trying to ease the amount of makeup work due to missed school days, it's critical that the school plays a role in integrating your youngster into the classroom.

8. Do not deny or minimize your youngster's anxiety or worries. Instead, acknowledge them and reassure her (e.g., "I know you're worried that I won't be there to pick you up, but there's no reason to worry. I'll be there.").

9. Set a baseline expectation. Having your youngster in school for any amount of time is better than having her at home. Even though your youngster may only come to school for a couple hours or sit in the library all day, it is much easier to get her back into the regular classroom from that point.

10. Be open to hearing about how your youngster feels. However, lengthy discussions about his problems are not always helpful and can be experienced as a burden by the youngster. The focus must always be that you want to help him be free of worries and fears.

11. Make it less inviting to stay home. If your youngster knows she can sit at home and watch TV during the school day, the incentive to stay home is greater than the incentive to be at school. Create a contract, set some boundaries, and make it more worth her while to go to school.

12. An HFA youngster's reluctance to go to school can be irritating to moms and dads. Expressing resentment and anger is counterproductive though. You won't feel the urge to do so if you adopt specific strategies to assist your youngster.

School-refusal can be viewed along a spectrum of absenteeism, and a child on the spectrum may exhibit all forms of absenteeism at one time or another (e.g., the child could be anxious during school on Monday, arrive late to school on Tuesday, skip afternoon classes on Wednesday, and fail to attend school completely on Thursday). When you have identified the issue, make a plan and stick to your guns. Once your youngster has overcome the fear of school, he or she will probably thank you.


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

Click here to read the full article…

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

Click here for the full article...

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

Click here to read the full article…

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

Click here to read the full article…

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

Click here to read the full article...

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

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

Click here for the full article...
By

Asperger’s and High-Functioning Autism: Do Symptoms Improve with Age?

Asperger’s (high functioning autism) is a lifelong developmental disorder, but ironically, most research studies on the disorder have been cross-sectional (i.e., they only provide a snapshot of what it looks like at a single point in time). Why?

Because following people with Asperger’s and HFA over long periods of time is expensive and requires a lot effort on the part of families and researchers, which is unfortunate since long-term studies are the only way to understand what early-life factors help some kids with the disorder do better than others over the long haul (something that can’t be assessed in cross-sectional studies).

Thanks to new statistical techniques, researchers can now group their study participants based on shared characteristics that unfold over time. A handful of long-term studies, each including up to several hundred participants, have now followed individuals on the autism spectrum for nearly 20 years. As the young people in these studies come of age, researchers are piecing together how the disorder progresses through the life span. Let’s look at a few of these studies (in no particular order):
  • Study #1: The researcher assessed cognitive skills in 37 kids on the autism spectrum and average IQ. She found that kids between 4 and 7 years of age who have the strongest “executive function skills” (i.e., skills required for planning and carrying out complex tasks) also have the strongest “theory of mind” (i.e., the ability to understand others’ thoughts and beliefs) 3 years later. The study suggests that improving executive function skills in kids with Asperger’s (HFA) may also yield benefits for “theory of mind.”
  • Study #2 showed that kids whose moms and dads are more engaged in their treatment early on have better verbal and daily living skills as teenagers. Unpublished data showed that the kids with the best outcomes (e.g., able to attend college with no extra support) all had moms and dads who had been involved in their treatment beginning at age 2 (this should not be interpreted as assigning blame to parents if their kids do poorly though).
  • Study #3 revealed that adolescence is a time of behavioral and symptomatic improvement for some Asperger’s and HFA teens; however, this improvement slows down around the time the teens leave high school. This may be in part because (a) the structure and routine of school is beneficial for these teenagers, and (b) these young people frequently lose access to services around the time they finish school.
  • Study #4 followed about 300 participants from age 2 to 21, and found that about 10% improved dramatically by their mid-teens. It should be noted that these young people tended to (a) start out with a high verbal intelligence quotient and (b) improve their verbal skills early on. This is supportive of other studies suggesting that language skills and IQ are the strongest predictors of a youngster’s outcome.
  • Study #5 was a longitudinal study that tracked 39 kids on the spectrum from about age 4 to age 19. Analysis of the data suggests that building “theory of mind” skills may help kids who start out with poor language skills overcome their deficits. These findings are typical of the way researchers are using longitudinal studies to analyze how changes in one area of development influence another.
  • Study #6: According to yet another study, most teenagers and grown-ups with Asperger’s have less severe symptoms and behaviors as they get older.



It has long been the hope of moms and dads with Asperger’s and HFA kids that the right care and support can reduce - or even reverse - some of the developmental problems associated with the disorder. But, while studies find that behavioral intervention programs are linked with improved social skills, the question of whether kids can technically “outgrow” the disorder remains difficult to answer. Studies to date that have hinted at this possibility are fraught with questions about whether the kids who apparently shed their autistic traits were properly diagnosed in the first place.

Who better to poll than the people who grew up on the autism spectrum? So, we asked a few young adults with Asperger’s to address the following question: “Was there a reduction in Asperger’s-related symptoms as you got older, or did things tend to get worse?” Here are their responses:

“Although the condition remains a constant certainly, the expression can change over time. At times, I might seem quite neurotypical (albeit shy) and at other times....well, the opposite. From my own personal observation, I have days when I really seem to "read" others better and other days are not. Certainly I've had really rough periods, but inside I am still the same.”
 
“Asperger's is actually supposed to get easier to manage as the person gets older. This isn't to say, however, that big set-backs can't happen. The truth is that they WILL happen. I have improved overall since my teenage years, but this 'improvement' has brought with it two suicide attempts and many really low moments too.”

“For me, when under stress I'm just not able to put in the effort to initiate my coping mechanisms. Some of them are automatic (e.g., blocking out too much sensory input) and fail when I'm under stress. The net effect is my autistic nature affects me worse - it's not that I'm any more autistic, it's that my coping strategies aren't working.”
 
“From my experience I have gotten more aspergery every year since 16 years old, however I got less every year from 11-16, which was high school. So the high school environment must have made me much more NT, almost certainly because I was in a group of NT guys the whole time. Now as I get older the differences become increasingly apparent and it's increasingly harder to relate to people and to tolerate society. A lot of things changed around, for example when I was young I used to collect rocks and I was much more verbose for my age, now I find it harder to relate to people though and I have more social anxiety. I'm sure AS traits will continue to switch around as I grow. I think a part of it is the people you have in your life and the way you see yourself.”

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

“I don't necessarily think your Aspergers gets worse as you get older, or better for that matter. The things you're doing and the skills you've learned can either help you manage your condition, or make things go out of control. Stress fluctuates, and stress/anxiety makes our coping mechanisms less effective. So, sometimes, it looks like we're getting worse as we get older because there are life changes that are very stressful... spouse, kids, home, job, etc. The longer you work, the more "upper level" you are generally expected to become, so you get promoted into a job that has more social interaction.”
 
“I don't think it is a matter of AS getting worse (at least in my case), so much as comorbidities and just plain life making it harder to compensate for. It's tough to do anything when you also have to deal with depression or anxiety. I know that during the very stressful times in my life, it was extremely hard to deal with the negative effects of AS on top of it all. Changing jobs, graduating, recuperating after a bad relationship, etc. I found that my ability to compensate and adapt could at times drastically decrease.”
 
“I think I have improved some things over the years what are related to my disability, for example I am better at handling my special interests at a ''safer'' level. By that I mean when I was aged 13-15, I got obsessed with some local people who lived next door to my cousin. I started this obsession, and got to a point where I tried getting really involved in their lives (in other words, stalking), and it got too ''freaky'' for them (plus they had a baby), so they went to the police station and reported me. The obsession got so out of hand, and I went on about this couple to people at school - who got so fed up with me that I did lose a lot of friends because of it. Now I am obsessed with some people who I didn't know before (these are bus-drivers), but they don't know it. So I have learnt to keep my obsessions under control more - which is one improvement. I'm proud of myself there.”

“I would have to say it is up to the individual. Though technically Aspie symptoms are supposed to get better with age, your will to constantly struggle with it can weaken. Some Aspies choose to give up and seclude themselves and with no social interaction to keep your symptoms in check. And some Aspies are perfectly content like this… it's all about what makes you happy.”
 
“In some ways it seems like I’m getting more autistic as I get older, and in other ways less. My autistic traits have mostly just moved around, and in some cases just show up differently. As a kid I didn't stim much, at least not noticeably. Now I stim A LOT. But I’m more tolerant of certain sensory things... My social abilities have improved a little as I’ve gotten older and learned things, and I’ve gotten more outgoing around people. So, I talk more sometimes, but that means that I'm more likely to make mistakes in socializing and that my special interests are more obvious to other people. When you're an adult there's more stuff expected of you than when you're little, so my problems with life skills are more apparent now.”

“It doesn't get worse, but it may seem like it does because there is the anxiety and the depression. Depression makes your AS symptoms worse. It's just an illusion.”
 
“I've found myself becoming more isolated as time goes on. I think in school you have friends (often with similar traits) but once you leave, your true nature slowly takes control. If you are stressed or don't like being around people much, then you will inevitably find solitude. I'm not sure if things have gotten worse regarding my aspie traits or if I'm just more aware of what they are.”
 
“I've had some 'worsening,' but it's not been like a path back to where I was when I was younger. It's just different. Even though I have cognitive losses, I still have what I learned when pushing myself hard to interact with people. As a teen, I found interacting even with store clerks to be terrifying, but I eventually learned how to deal with it, and it remains not-a-very-big-deal, today. And, I can still even manage short bursts of small talk (though it is still exhausting).”
 
“Periods of high stress definitely regress my symptoms, my obsessions become more intense and impulsive behaviour harder to control. You lose those management skills developed over many years. I would say yes, your AS can appear to deteriorate (get worst) during periods of high stress throughout life.’
 
“Stress is my culprit. All of the coping strategies I've learned over the years shut down systematically as stress increases. Verbal communication is the first to go... I do not desire it, I shy away from it to the point I finally don't bother to speak at all. Meltdowns start to increase. Auditory problems seem to get more sensitive. One by one, it seems to be getting worse. But, if I can eliminate the stress, my ability to cope increases. I don't think there is any literal change in my challenges, only my ability to deal with them.”




In working with clients on the autism spectrum over the years, it has been my experience that many of these individuals do not get worse over time. In fact, it often gets somewhat better with time as they learn some coping skills that they lacked earlier in life. Most people with Asperger’s and HFA tend to gain these skills by default as they age (the concept of “the longer you live, the more you learn”).

Having said this, there does seem to be a period of time (lasting about 5 – 10 years) post high school where there is an increase in symptoms (e.g., anxiety, depression, isolation, etc.). As suggested in the information above, this may be due to (a) the loss of structure provided by regularly attending school, and/or (b) the absence of frequent association with “typical” peers. But, by the time these young adults reach their mid-to-late 20s, many find that the accumulation of life experiences has helped lessen some their (unwanted) Asperger’s-related symptoms.

However, the exception to this (again, based on my practice) seems to be those who are unemployed, not attending college or some other form of continuing education, and still living with their parents. This suggests that being insulated from the community (i.e., isolation) exacerbates the symptoms - and possibly stunts emotional growth due to the lack of ongoing, multifaceted life experiences.


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



References:

•    Anderson D.K. et al. Am. J. Intellect. Dev. Disabil. 116, 381-397 (2011) 
•    Bennett T.A. et al. J. Can. Acad. Child Adolesc. Psychiatry 22, 13-19 (2013) 
•    Georgiades S. et al. J. Child Psychol. Psychiatry 54, 206-215 (2013) 
•    Gotham K. et al. Pediatrics 130, e1278-e1284 (2012) 
•    Green S.A. et al. J. Autism Dev. Disord. 42, 1112-1119 (2012) 
•    Pellicano E. Autism Res. Epub ahead of print (2013) 
•    Smith L.E. et al. J. Amer. Acad. Child Adolesc. Psychiatry 51, 622-631 (2012) 
By

Helping Children On The Autism Spectrum To Deal With Stress

"Is it common for a child with autism (high functioning) to quickly and easily get upset about little things throughout the day? The least little thing will set my son off."

Children with High-Functioning Autism (HFA) often suffer from different types of stress compared to other kids. Stressors can be as diverse as school issues to the texture of their clothing!

These young people often suffer from so many obsessive thoughts that they are stressed out by things such as noise, smell, certain textures, things out of place, and disorder in general.

These "special needs" kids are perceived to be quite intolerant of others as well as the environment. They often become very anxious in unstructured settings and in situations where people are moving at random.

They may not be able to tolerate people standing close to them. Whether it is sudden or it comes from general background activity, noise can cause acute stress, fear and even panic and, at the very least, the youngster may be distracted and unable to concentrate.

Each child on the autism spectrum will have his issues that stress him out. When they are younger, this kind of stress can lead to tantrums. Older kids can have anger outbursts or other evidence of distress when things aren’t going their way. They may swear or act-out in inappropriate ways to cope with their environment.





Sometimes a parent or sibling just needs to give in to the idiosyncrasies of the HFA child. They may need to keep the noise down or keep things in a specific order. Moms and dads may have to respect their youngster’s need for certain clothing textures or food preferences.

Lack of sleep can lead to stress in a child on the spectrum. Sleep disorders are very common. Medication or taking naps during the day may help ease the stress of sleep deprivation.

Some stress reduction techniques can be taught and are somewhat different from other stress reducing techniques. Your son may need to remove himself physically from the situation causing the anxiety. A quiet environment, free from distractions and where rules are followed rigidly can do much to help him concentrate.

Carrying a favored object can also give your son a sense of security. The nature of this object can seem quite bizarre to others (e.g., a "cat's eye" marble from the road), but without it, your son may be unable to settle or concentrate.

Some HFA kids derive comfort from repeating a set ritual of some kind that can be long and complex. It goes without saying that the ritual, however time-consuming, may have to be carried out in classroom situations, and the comfort object must be allowed to be present if the youngster is to be able to cope with the stressors.

When your son is upset, he is either wanting (a) immediate pleasure or (b) to avoid emotional pain. Upset feelings occur when the HFA youngster gets frustrated and has an unwillingness - or inability - to tolerate the necessary short-term discomfort that is sometimes required for long-term gain.

The opposite of this would be self-control, which is simply the ability to tolerate or cope with discomfort and hard work in the short-term in order to achieve one's long-term goals.  Thus, teaching self-control methods to your son would be the ideal "fix" for his chronically feeling upset.

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

How to Reduce School-Related Anxiety in Students on the Autism Spectrum

“My daughter with high functioning autism is always anxious in the mornings before school to the point where it has become quite a chore to get her out the door and on the bus (lots of weeping, complaining about her stomach hurting, talking about wanting to just stay home…). Would you have some ideas on how I can help her not be so stressed about going to school?”

Here are a few important tips that can help children with High-Functioning Autism (HFA) and Asperger’s (AS) to reduce their anxiety as it relates to school:

1.  Acknowledge your daughter’s fear. Hearing "it’ll be O.K." when you're anxious about something doesn’t usually help. It probably won’t comfort your daughter much, either. The most crucial thing you can do for a youngster dealing with school-related anxiety is to accept that her fears are real to her. If nothing else, you'll guarantee that she won't be scared to talk to you about them.

2.  Ask, "What three things are you most happy about?" Most kids can think of something positive, even if it's lunch or just going home after school. Chances are your daughter has things she enjoys about school that just get drowned out by all the spooky stuff. Bring those positive things out into the light.

3.  Also ask, "What three things are you most afraid of?" Making your request specific can help your daughter sort through a confusing array of emotions. If she can’t name the things that are most troublesome, have her tell you any three things (or the most recent three things).

4.  Remember that all kids feel some stress about school, even the ones who seem popular and happy-go-lucky. Knowing this won't alleviate your daughter's stress, but it may alleviate yours.

5.  Role-play. Once you have some specific examples of stress-provoking events, help your daughter discover an alternate way to cope with them. Discuss possible scenarios and play the part of your daughter in some role-playing exercises, letting her play the part of the difficult teacher or bullying peer. Model appropriate and realistic responses and coping strategies for her.

6.  Let your HFA child know that she can always talk to you, no matter what. It's not always required even to have solutions to her difficulties. Sometimes just talking about things out loud with a loving parent makes them seem less intimidating. If the situation does become too much for your daughter to handle, you want to be the first to know about it.

7.  Know when to get step in and assist. Most kids experience school-related stress to some degree, and some feel it more intensely. When does it become a big enough issue to require professional help? Some signs to look for are major changes in friends, sleeping and eating habits, and attitude and behavior. If you've developed a good rapport with your daughter and she suddenly doesn't want to talk about what’s going on at school, that's a red flag too.

8.  Don’t try to fix everything. There are some cases in which moms and dads do have to take action. For example, if your daughter is being bullied or is having trouble because an IEP isn't being followed, there are steps you should take. But you'll also want to teach your daughter that some things in life just have to be dealt with, even though they suck. Correct only what's really badly broken.

9.  Routines help alleviate stress. Creating a regular bedtime, wake-up time, and bath time is important at all ages. It’s also important that “special needs” kids learn to develop routines for themselves.

10.  Set a regular time and place for talking with your youngster (e.g., in the car, on a walk, during mealtimes, just before bed, etc.). Some kids on the autism spectrum will feel most comfortable in a comfy private space with the parent’s undivided attention, but others may welcome some sort of distraction to reduce the intensity of sharing their emotions.

11.  Understand the value of crying. It’s a great anxiety reliever and flushes out negative feelings. It's hard to see a child crying, and the parent’s first instinct may be to help her stop as soon as possible. But after the tears have all come out, your daughter may be in a particularly receptive mood for sharing what’s going on inside her. Offer a comforting and supportive presence, but let the tearfulness run its course.

12.    Family meetings are very important. Set a weekly time to regroup and to talk about what's going on and how it will work (e.g., who gets the shower first, what time to set the alarm clocks for, etc.). Also, give everyone a chance to have their input.  

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

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

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By

Coping with the Holidays: Help for Aspergers Children

With Thanksgiving and Christmas coming up, I thought we should have a conversation about coping with the holidays – an especially important topic for parents with Aspergers (high functioning autistic) children.

Aspergers kids and teens are easily over-stimulated. Their emotions overwhelm them, and it is up to the people around them to make life easier for them. The holidays are especially difficult for kids who have Aspergers. Remember, they are not social people. Crowds and noise overwhelm them. They do not cope well with the hustle and bustle of holidays, especially Christmas.

Anticipation for a youngster with Aspergers leads to increased levels of anxiety, which he cannot control. He becomes overloaded, and then you have a potential meltdown at the time when you are all supposed to be enjoying the holiday. The celebration can be ruined and everyone may get upset, especially your youngster who is trying so hard to fit-in.

Some Aspergers kids may not want to join in when the family opens presents. He may be checking out the lights on the Christmas tree, trying to figure out how they work, or he may sit in a corner participating in one of his obsessive hobbies. Let him be. If you pressure him to join in, he may become overwhelmed and go into a meltdown. This will only result in upheaval and chaos for the entire family. Allow the Aspergers youngster to check out the lights and open his presents in his own time. The holiday will be much more pleasant for everyone involved.

Aspergers Stressors—
  • Being pressured in anyway, such as to be on his best behavior, or to join in the festivities can cause overwhelming emotions in the Aspergers youngster.
  • Having too many people around. Crowds and the buzz of conversation can overwhelm the Aspergers youngster.
  • Noise. This includes the crinkle of wrapping paper, Christmas carols, singing and dancing Christmas decorations, or anything that causes sound on an ongoing basis.
  • Too many visitors at the same time. Remember, the Aspergers youngster does not like to be surrounded by people and noise.

Managing Stress—

Parenting is probably the hardest any of us have ever worked for free – or even for pay. Some days work in the office seems easier. There is more predictability, a distinct focus and a formula for doing things. Plus there is collegiality. Parenting a youngster with Aspergers is often completely the opposite: unpredictable, unfocused, and uncertain. This is especially true during the holiday season.

Here are some suggestions on how both you and your Aspergers child can manage stress:
  • Create a sanctuary in one room or part of a room, a place where you put things that make you happy, that comfort you.
  • Establish a hobby.
  • Even if there is only one activity you can do comfortably with your child, do it when you feel you can and savor whatever moments of connection you experience.
  • Exercise. It is no secret that vigorous and REGULAR exercise will alleviate depression and stress and anxiety.
  • Find a good therapist.
  • Find your little pockets of happiness every day.
  • Have a good cry.
  • Keep a journal. Writing is very therapeutic. Find one with an attractive cover and write in as often as suits you.
  • Make a “date” for coffee and talk therapy with a close friend on a regular basis or as needed.
  • Take a bath with lots of bubbles, light scented candles around the tub, and sink in (with a favorite CD playing in the background). If the door has a lock, use it!
  • Try something new like yoga or pottery or take up an instrument. Something just for you.
  • WALK. This is the easiest, cheapest and most accessible form of stress reduction.

Just as we need to be on the alert for signs of stress in our Aspergers children, we need to stay tuned in to our own feelings as parents. If you find yourself crying, sleeping more or less than usual, having a change in appetite or loss of interest in things that usually bring pleasure, you may be suffering from too much stress. Don’t be hesitant to seek help. A good therapist can be an excellent ally.

How Parents Can Help—

How can you enjoy the season while at the same time keeping your Aspergers youngster calm and behaving appropriately? Here are some tips:

• Allow only one person to open presents at a time. This will alleviate the crinkle of wrapping paper and nose from the excited voices of siblings.

• Ask the youngster to look directly into your eyes when you talk to him. Praise him when he is successful.

• Aspergers kids are often immature. Never tell them to act their age. They have no concept of age-related behavior.

• Be sure the youngster knows what is expected of him. Use simple language that he can understand.

• Encourage the Aspergers youngster to enjoy himself and have fun. If this means he retreat to a quiet area where he can be alone, let him be. This is his way of coping and of enjoying the holiday. Never pressure an Aspergers youngster to play with other kids.

• Explain to your youngster what will be expected of him (e.g., to say ‘hello how are you’ to guests and sit at the table to share the meal). Your youngster will also need to be given permission to leave the festivities, and you can rehearse this together with some simple role play. This is really important as it gives your youngster an exit strategy and allows him to get through the celebrations without going into meltdown.

• Give the Aspergers youngster lots of support, praise and TLC. Let them know that you love them and are there for them, always.

• Have a quiet breakfast on Christmas morning.

• Identify ways to cope with behavior problems. Hugging will help some Aspergers kids, while others don’t like to be touched. Get to know your youngster.

• If you see that your Aspergers child is becoming stressed, you can activate an “exit cue” so he gets out before the situation deteriorates.

• Keep any physical changes to your home to the minimum, so by all means decorate, put up cards and a tree, but just don't make a really big change to the environment. Don’t put out any presents until the day they are to be opened, because your Aspergers youngster will have a hard time keeping his hands off and will became anxious and potentially defiant.

• Keep instructions simple and on a level that the youngster can understand.

• Keep meals quiet. Do not allow toys at the table. Ask each youngster to talk about their favorite toy, including the Aspergers youngster.

• Keep noise minimal. Do not play music for extended periods of time or it will become nothing but noise to the Aspergers youngster.

• Keep visitors minimal. Family members and friends should keep visits short and they should visit at separate times. Be sure everyone knows when they are expected and how long they are expected to stay.

• Learn to identify stress triggers and avoid them when possible.

• Limit choices to keep the youngster from being overwhelmed.

• Prepare your youngster for any changes by calmly telling him the day before what will be happening. Visual supports always work well, so use photos or simple pictures to explain what will be happening.

• Reduce the time talking about the festive occasion. Remember your Aspergers child cannot easily control his emotions and to talk constantly about the event will simply lead to stress and anxiety. It is useful to enlist the help of others in your home and keep any conversations to a minimum when your Aspergers youngster is within ear-shot.

• Sing or whisper words to young kids in order to get their attention and to help them keep focused.

• Teach the youngster stress busting techniques such as deep breathing or counting to ten. Many Aspergers kids find a stress ball beneficial.

• Try to incorporate flexibility into the youngster’s routine at an early age. This allows him to realize and accept that things do change.

• Use social stories to prepare Aspergers kids for new social experiences, the new school year, a move, and any other changes that will take place in their life.

• Warn the youngster well in advance of any changes to be made in his environment, such as moving the furniture or rearranging his room. The youngster’s school must be made aware that moving his desk can cause behavioral problems.

Remember, Aspergers kids are unique. They have their own quirks, distinct personalities, abilities, likes and dislikes. The only difference between them and any other youngster is that they look at the world in a different way. They just need a little extra love, support, understanding and patience from those who love them.

Following these simple steps should lead to a much more positive experience for everyone and will provide your Aspergers youngster with the love, support, and confidence to participate fully in the holidays.

My Aspergers Child: Preventing Meltdowns in Aspergers Children and Teens
By

Helping Your Child on the Autism Spectrum to Deal with Stress

"How can I help my little man (high functioning autistic) reduce his stress. He's usually excessively concerned about many things. Currently his main stressor is worrying about a week long summer camp coming up soon (but after that, it will be something else)."

Kids and teens with ASD Level 1, or High-Functioning Autism, tend to experience more anxiety and stress relative to neurotypical children. Issues like school and social life can sometimes create pressures that can feel overwhelming for these children.

As a mother or father, you can't protect your child from all stress, but you can help him develop healthy ways to cope with stress and solve everyday problems.

Here are some important parenting techniques to help your autistic child deal with stress:

1. Be patient. As a mother or father, it hurts to see your child unhappy or stressed. But try to resist the urge to fix every problem. Instead, focus on helping him grow into a good problem-solver. A kid who knows how to roll with life's ups and downs, put feelings into words, calm down when needed, and bounce back to try again, is a child who will be happy and healthy through the adolescent years and on into adulthood.

2. Comment briefly on the feelings you think your child was experiencing. For example, you might say "That must have been upsetting," "No wonder you felt mad when they wouldn't let you in the game," or "That must have seemed unfair to you." Doing this shows that you understand what he felt, why, and that you care. Feeling understood and listened to will help your son or daughter feel supported by you, and that is especially important in times of stress.
 

3. Having “pizza night” (or your child’s favorite food) to discuss the week’s trials and tribulations can be therapeutic for some stressed-out kids.

4. Help your child think of things to do. If there's a specific problem that's causing stress, talk together about what to do. Encourage your youngster to think of a couple of ideas. You can get the brainstorm started if necessary, but don't do all the work. Your youngster's active participation will build confidence. Support the good ideas and add to them as needed. Ask, "How do you think this will work?"

5. Just be there. Children on the autism spectrum don't always feel like talking about what's bothering them. Sometimes that's OK. Let your child know you'll be there when he does feel like talking. Even when children don't want to talk, they usually don't want moms and dads to leave them alone. You can help your youngster feel better just by being there — keeping him company, spending time together. So if you notice that your youngster seems to be down in the dumps, stressed, or having a bad day — but doesn't feel like talking — initiate something you can do together (e.g., take a walk, watch a movie, shoot some hoops, bake some cookies, etc.). Your presence really counts!

6. Limit stress where possible. If certain situations are causing stress, see if there are ways to change things. For instance, if too many after-school activities consistently cause homework stress, it might be necessary to limit activities to leave time and energy for homework.

7. Listen and move on. Sometimes talking and listening and feeling understood is all that's needed to help an autistic youngster's frustrations begin to melt away. Afterwards, try changing the subject and moving on to something more positive and relaxing. Help your youngster think of something to do to feel better. Don't give the problem more attention than it deserves.

8. Listen to your youngster. Ask him to tell you what's wrong. Listen attentively and calmly — with interest, patience, openness, and caring. Avoid any urge to judge, blame, lecture, or say what you think he should have done instead. The idea is to let your youngster's concerns (and feelings) be heard. Try to get the whole story by asking questions like "And then what happened?" Take your time. And let your son or daughter take his or her time, too.
 

9. Notice out loud. Tell your child when you notice that something's bothering her. If you can, name the feeling you think she is experiencing (e.g., "It seems like you're still mad about what happened at the playground."). This shouldn't sound like an accusation (e.g., "OK, what happened now? Are you still mad about that?"), or put the youngster on the spot. It's just a casual observation that you're interested in hearing more about her concern. Be sympathetic and show you care and want to understand.

10. Put a label on it. Most children on the spectrum do not have words for their feelings. If your youngster seems angry or frustrated, use those words to help him learn to identify the emotions by name. Putting feelings into words helps these children communicate and develop emotional awareness - the ability to recognize their own emotional states. Kids who can do so are less likely to reach the behavioral boiling point where strong emotions get demonstrated through behaviors rather than communicated with words.

Moms and dads can't solve every problem as their child goes through life. But by teaching healthy coping strategies, you'll prepare him or her to manage the stresses that come in the future.

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

==> Videos for Parents of Children and Teens with ASD
 
----------
 
 
 
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…

---------------------------------------------------------------

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...

--------------------------------------------------------------

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…

------------------------------------------------------------

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

Click here to read the full article…

------------------------------------------------------------

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

Click here to read the full article...

------------------------------------------------------------

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

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

Click here for the full article...


 COMMENTS:
  • Anonymous said... I don't know if this helps but I am looking into yoga, mindfullnees to help me and my toddler and a professional just mentioned fun village which is activities designed to help children I am hoping use it to destress us both as his stress and aggressive behaviours stress me and then it just escalates, I know it may be different situation but heard yoga really helpful.
  • Anonymous said... my son's teacher definitely could benefit from reading this. 
  • Anonymous said... Reading this has opened my eyes a little,.. maybe the teacher needs to read this?? 
  • Anonymous said... This has been a big issue with my daughter lately. Usually about once a month she will have a meltdown and refuse to go to school. Because of the excessive number of snow days in our area and a change in my husband's work schedule, there have been a huge number of these meltdowns in the last couple of months. 
  • Anonymous said... Working on sensory strategies for heightened sound/ sensory defensiveness with an OT. This should help.

 Post your comment below...
By

Anxiety: An Intrinsic Feature of High-Functioning Autism

“Why do children on the high functioning side of autism seem to experience more than their fair share of anxiety? And, are there any drugs that can be used to help with this problem?”

Young people with High Functioning Autism (HFA) are particularly vulnerable to anxiety. This vulnerability may be an intrinsic feature of HFA due to a breakdown in circuitry related to extinguishing fear responses, specific neurotransmitter system defects, and/or their inability to make social judgments throughout development.

Other reasons for anxiety in HFA children/teens include the following:

  • Limitations in generalizing from one situation to another often contributes to repeating the same social gaffes.
  • Limitations in their ability to grasp social cues - and their highly rigid style - act in concert to create repeated social errors. 
  • Many experience the discomfort that comes from somatic responses that are disconnected from events and experience.
  • The lack of empathy severely limits skills for autonomous social problem-solving. 
  • The social challenges of AS and HFA make it difficult for kids with the disorder to develop coping strategies for soothing themselves and containing difficult emotions. 
  • There is sufficient grasp of situations to recognize that others “get it” when they do not. 
  • They are frequently victimized and teased by their peers and can’t mount effective socially adaptive responses.



Several medications have been tried for treatment of anxiety in this population. There is no reason to suspect that kids with HFA are less likely to respond to the medications used for anxiety in “typical” kids. Thus, SSRIs, buspirone, and alpha-adrenergic agonist medications (e.g., clonidine or guanfacine) have been tried. 
 
The best evidence to date supports use of SSRIs. However, it is also true that young people on the autism spectrum may be more vulnerable to the associated side-effects. Disinhibition is particularly prominent, and can be seen with any of the SSRIs.
 
As one mother states: "Working with a psychiatrist, one trained especially with children, is vital in helping our Aspergers/HFA kids with their anxiety, to managed use of medications. Fine tuning is critical to the process. We also had enroll our child into a day program as weekly counseling wasn't keeping up with his anxiety and depression. Daily and intensive individual and group therapy are the focus of this program. 5 months in and we've seen dramatic improvement. We're about to start the transition back to his normal school (they tutor at the day program). Most important is to pay attention to the child's anxiety levels. We almost waited too long to take a big step toward doing something different." 
 
 
 
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…

---------------------------------------------------------------

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...

--------------------------------------------------------------

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…

------------------------------------------------------------

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

Click here to read the full article…

------------------------------------------------------------

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

Click here to read the full article...

------------------------------------------------------------

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

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

Click here for the full article...
 
 
By
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