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Characteristics of Females with ASD Level 1

"We think our daughter may have a form of autism due to her severe shyness, excessive need to have things just so, certain rituals she has with food, major touch sensitivity, a lot of anxiety, just to name a few. What are some of the signs to look for to help us decide if an assessment is in order?"

Females with ASD, or High-Functioning Autism. often present with a unique set of characteristics that can make diagnosing their disorder very difficult. In addition, their strengths often mask their deficits.

There has been considerable discussion among professionals about the way girls with ASD demonstrate their major characteristics. Some girls have obvious social difficulties, whereas others appear to have excellent skills because they imitate the behaviors of others (often without understanding them).



There are many females who do not receive a diagnosis, possibly because, compared to males, (a) they have fairly good social skills (particularly when interacting with adults in a one-to-one situation), (b) their special interests are different, and (c) their clinical presentation is different.

Sometime during childhood, a female with autistic traits will begin to know she is different compared to her peers. For example:

1. Due to adopting an alternative persona, she may begin to have problems of self-identity and low self-esteem

2. Due to observing and analyzing social behavior and trying not to make a social error, she may become emotionally exhausted

3. During the stress of adolescence, she may develop routines and rituals around food and a special interest in calories and nutrition that develops into the signs of an eating disorder

4. Her interests may be different to her peers in terms of intensity and quality of play

5. She may be an avid observer of human behavior and try to decipher what she is supposed to do or say

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism
 
6. She may be extremely sensitive to the emotional atmosphere at a social gathering

7. She may be like a chameleon, changing persona according to the situation

8. She may be more likely to apologize and appease when making a social error

9. She may be overly well-behaved and compliant at school so as not to be noticed or recognized as a different.

10. She may be vulnerable to “peer predators” who take advantage of her social immaturity

11. She may become increasingly aware of her social confusion and frequent faux pas, and thus prefer to be on the periphery of social situations

12. She may enjoy living in a fantasy world and creating a new persona

13. She may escape into the world of nature, having an intuitive understanding of animals, but not people

14. She may fear that her “true self” must remain secret because she is defective, thus she is almost always acting like someone else

15. She may have a pet that she views as a loyal friend

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

16. She may have a single - but intense – friendship with another female who may provide guidance for her in social situations

17. She may have a strong desire to collect and organize her toys (e.g., dolls) rather than to share her toys with friends

18. She may have an aversion to the traditional concept of femininity

19. She may have an encyclopedic knowledge of specific topics

20. She may have an intense interest in reading and escaping into fiction

21. She may have an interest in ancient civilizations to find an old world in which she would feel at home

22. She may have an interest in other countries (e.g., France) where she would be accepted

23. She may identify with a fictional character (e.g., Harry Potter), who faces adversity but has special powers and friends

24. She may not be interested in the latest craze among her peers to be 'cool' and popular

25. She may not identify with her peers

26. She may not play with her toys in conventional ways

27. She may not want to play cooperatively with her peers

28. She may prefer non-gender specific toys (e.g., Lego)

29. She may prefer to play alone so that she can play her way

30. She may prefer to play with males, whose play is more constructive and adventurous than emotional and conversational

==> Teaching Social Skills and Emotion Management to Children and Teens with ASD

31. She may suffer social confusion in silence and isolation in the classroom or playground, but she may be a different character at home

32. She may talk to imaginary friends, or write fiction at an early age

33. She may think that the way her peers play is stupid and boring

34. She may use imaginary friends that can provide companionship, support and comfort when she feels lonely

35. She may use passive-aggressive behaviors in order to control her family and/or social experiences


  
As young girls, many (but not all) females with ASD:

1. Apologize frequently and want to please others

2. Are an expert on certain topics

3. Are determined

4. Are honest

5. Are involved in social play, but are led by their peers rather than initiating social contact

6. Are kind

7. Are misunderstood by peers

8. Are more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of autism
 
9. Are more aware of - and feel a need to - interact socially

10. Are perfectionists

11. Are so successful at "faking it" that they only come to the attention of a therapist when a secondary mood disorder emerges

12. Are specially gifted in the areas of mathematics and engineering

13. Are very good at art

14. Are visual thinkers

15. Are well-liked by adults

16. Become a target of teasing

17. Do not ‘do social chit chat’ or make ‘meaningless’ comments in order to facilitate social communication

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

18. Enjoy solitude

19. Have a faster rate of learning social skills than males

20. Have a single friend who provides guidance and security for them

21. Have a special interest that is more likely to be unusual in terms of intensity rather than focus

22. Have difficulty knowing what someone else may be thinking or feeling

23. Have difficulty making friends

24. Have difficulty managing feelings

25. Have difficulty showing as much affection as others expect

26. Have difficulty taking advice

27. Have difficulty with writing skills

28. Have extremely detailed imaginary worlds

29. Have imaginary friends

30. Have interests that are very similar to those of neurotypical girls (e.g., animals, dolls, classical literature), and therefore are not seen as unusual

31. Have what is classified as a "male brain"

32. Make reliable and trustworthy friends

33. Mimic or even try to take on all the characteristics of someone they are trying to emulate

34. Notice sounds that others do not hear

35. Read fiction to help them learn about inner thoughts, feelings and motivations

36. Show little interest in fashion

37. Speak their minds (sometimes to the point of being rude)

38. Still need to be directly taught certain social skills

39. Try to understand a situation before they make the first step

40. Use doll play to replay and understand social situations

By

Loneliness in Kids with Autism Spectrum Disorder

It is hard to know if kids with ASD (high functioning autism) are as lonely as their moms and dads believe they are. Therapists do know that playing with a friend, making a friend and being with a friend are "overwhelming skills" for ASD children. Kids without autism make no sense to "autistics," because they are totally preoccupied with their own agendas.

Teaching ASD children social skills is a big task for moms and dads and educators. It is not like teaching the child how to ride a bicycle or tie a shoe, but rather trying to teach something no one formally taught you. How do you teach someone how to read a room, especially someone who has no understanding of other individual's emotions and body language? 

Kids with autism have no idea about how to reason socially and come up with proper courses of action in social situations (e.g., one guy with ASD level 1 got lost in the school corridors on his way to gym. He had forgotten the route, but he did not think to simply follow his classmates to the gym).

Yet therapists emphasize the need to teach ASD children social skills because they desperately need them to get along in life. The child's lack of social understanding virtually colors every other experience in his/her life. Yet the question of whether kids on the spectrum are truly lonely and want friends is a different discussion. Like all kids, some are extroverted and others are more withdrawn. Like all kids, they probably vary in their need for social interactions.


When researchers ask kids with ASD about friendship, they are usually very negative. They think of friendship with other kids as too much work and often prefer grown-ups. For example, when a teacher was forcing a six-year-old to participate in a playgroup with other kids, he said, "I hate kids. I don't play with kids. I'm not a kid. I was born a grown-up." 

Michael, a fourteen-year-old with Aspergers advises other Aspergers children, "If you like being on your own, then be happy with your own company and don't let anyone convince you its wrong." His advice to ‘pushy moms and dads’ is "Never force your youngster to socialize. Most ASD children and autistic individuals are happy to just be by themselves."

However, these kids might be happier by themselves because social activity has caused them so much pain in the past. In one study, gifted kids with ASD could not describe friendship in positive terms such as "a friend is someone who is nice to you." They had only negative associations such as "a friend is someone who does not hit you." These kids told interviewers only about how mean other children had been to them and seemed to lack any idea of what reciprocal friendship really means.

Yet as autistic children go through the teen years, most realize that they are missing out by not fitting in. It is at this point in their lives that they crave friendships with peers, yet this unfulfilled desire on top of high school pressure to conform, constant rejection and harassment can often cause depression in ASD teenagers. They grow more isolated even as they crave more interaction with other teenagers. Young kids with ASD often believe everyone in their class is the same and everyone is a potential friend. ASD teenagers know better.

Research shows that the more time a person with ASD spends socializing, the happier she is. Autistic children can and do form friendships. When they do, research shows that even one friendship will speed up their entire social development.


People married to someone with ASD often talk about their own feelings of loneliness. They tell counselors that marriage to a person with autism feels like living alone. An ASD husband/wife often does not attend to details like anniversaries, may not connect with the couple's kids on an emotional basis, and may not benefit from marriage counseling. A parent of a youngster with ASD may feel rejection when their youngster refuses to cuddle or express affection. 

The youngster's needs are unrelenting and yet the moms and dads' rewards are sometimes rare. Brothers and sisters hide their lonely feelings about living in a family where their autistic sibling monopolizes their moms and dads' precious time and they miss the normal give and take of sibling relationships. Many siblings believe that the ASD child's “disability” is an advantage …a passport to special attention, recognition and privilege.

Helping kids with autism spectrum disorder develop social skills will no doubt become easier in the future. Every day educators are developing better techniques. Researchers are closing in on the genetic and environmental causes of autism and may someday develop a cure. There is promising new research being conducted in a study on "Friendship and Loneliness in Individuals with ASD." Perhaps someday the answers will be clearer for individuals with autism and those who love them.

ASD Teens and Social Isolation—

In the teenage world where everyone feels insecure, teens that appear different are ostracized. Autistic teens often have odd mannerisms. For example, they may talk in a loud un-modulated voice, avoid eye contact, interrupt others, violate others’ physical space, and steer the conversation to their favorite “weird” topic. These teens may appear willful, selfish and aloof, mostly because they are unable to share thoughts and feelings with others. Isolated and alone, many of these adolescents are too anxious to initiate social contact.

Many teens on the spectrum are stiff and rule-oriented and act like little grown-ups – a deadly trait in any adolescent popularity contest. Friendship and all its nuances of reciprocity can be exhausting for a person with ASD, even though he wants it more than anything else.


By

Kids with ASD [level 1]: Gifted or Hyperlexic?

Parents who have discovered that their young child is "gifted" because he/she may be able to recite the alphabet at 18 months of age - or can read words by the age of 2 - may want to reassess the situation.

Hyperlexia often coexists with ASD level 1 [high-functioning autism]. Hyperlexia is not seen as a separate diagnosis; however, with current fMRI research revealing that hyperlexia affects the brain in a way completely opposite to that of dyslexia, a separate diagnosis may be on the horizon.



Children with hyperlexia may recite the alphabet as early as 18 months, and have the ability to read words by age two and sentences by age three. Many are overly fascinated with books, letters, and numbers. However, the child’s ability is looked at in a positive light, so many moms and dads delay in getting their “precocious” youngster any help because they believe that he/she is a blooming genius.

Hyperlexia has many characteristics similar to Autism, and because of its close association with Autism, hyperlexia is often misdiagnosed. The main characteristics of hyperlexia are an above normal ability to read coupled with a below normal ability to understand spoken language. Many of the social difficulties seen in hyperlexic children and teens are similar to those found in Autism. Often, hyperlexic kids will learn to speak only by rote memory and heavy repetition. They may also have difficulty learning the rules of language from examples or from trial and error.

Hyperlexic kids are often fascinated by letters or numbers. They are extremely good at decoding language and thus often become very early readers. Some hyperlexic kids learn to spell long words (e.g., elephant) before they are two years old and learn to read whole sentences before they turn three.

Hyperlexia may be the neurological opposite of dyslexia. Whereas dyslexic kids usually have poor word decoding abilities but average or above average reading comprehension skills, hyperlexic kids excel at word decoding but often have poor reading comprehension abilities.

Some experts denote three explicit types of hyperlexics, specifically:
  • Type 1: Neurotypical kids that are very early readers.
  • Type 2: Kids on the autism spectrum, which demonstrate very early reading as a splinter skill.
  • Type 3: Very early readers who are not on the autism spectrum though there are some “autistic-like” traits and behaviors which gradually fade as the youngster gets older.

The severity, frequency, and grouping of the following symptoms will determine an actual diagnosis of hyperlexia:
  • A precocious ability to read words far above what would be expected at a youngster’s age
  • Abnormal and awkward social skills
  • An intense need to keep routines, difficulty with transitions, ritualistic behavior
  • Auditory, olfactory and / or tactile sensitivity
  • Difficulty answering "Wh–" questions, such as "what," "where," "who," and "why"
  • Difficulty in socializing and interacting appropriately with people
  • Echolalia (repetition or echoing of a word or phrase just spoken by another person)
  • Fixation with letters or numbers
  • Listens selectively / appears to be deaf
  • Memorization of sentence structures without understanding the meaning
  • Normal development until 18-24 months, then regression
  • Self-stimulatory behavior (hand flapping, rocking, jumping up and down)
  • Significant difficulty in understanding verbal language
  • Specific or unusual fears
  • Strong auditory and visual memory
  • Think in concrete and literal terms, difficulty with abstract concepts
  • Youngster may appear gifted in some areas and extremely deficient in others

Hyperlexia appears to be different from what is known as hypergraphia (i.e., urge or compulsion to write), although as with many mental conditions or quirks, it is possible that this is more a matter of opinion than strict science.

Despite hyperlexic kid’s precocious reading ability, they may struggle to communicate. Their language may develop in an autistic fashion using echolalia, often repeating words and sentences. Often, the youngster has a large vocabulary and can identify many objects and pictures, but can’t put their language skills to good use. Spontaneous language is lacking and their pragmatic speech is delayed. Between the ages of 4 and 5, many kids make great strides in communicating and much previous stereotypical autistic behavior subsides.

Often, hyperlexic kids have a good sense of humor and may laugh if a portion of a word is covered to reveal a new word. Many prefer toys with letter or number buttons. They may have olfactory, tactile, and auditory sensory issues. Their diets may be picky, and often potty training can be difficult. Social skills lag tremendously. Social stories are extremely helpful in developing effective age-relative social skills, and setting a good example is crucial.

Many moms and dads have had their hyperlexic kids go through numerous evaluations, with various confusing and contradictory diagnoses applied – ranging from Autistic Disorder to ADHD, or language disorder. In other cases, there is no diagnosis applied except “precociousness” or “gifted.”

Controversy exists as to whether hyperlexia is a serious developmental disorder like autism, or whether it is in fact a speech or language disorder of a distinct and separate type, or, in some cases, it is simply advanced word recognition skills in a normal (neurotypical) youngster, especially when sometimes accompanying “autistic-like” symptoms are present.

Treatment—

The first step in treatment is to make the proper diagnosis. Then management of the condition follows. When precocious reading ability and extraordinary fascination with words presents itself in a young son or daughter – especially when accompanied by other language or social problems that might suggest an autistic spectrum disorder – a comprehensive assessment by a knowledgeable professional or team familiar with the differential diagnosis of the various forms of hyperlexia is indicated. 

By

High Pain-Tolerance in Children with Autism Spectrum Disorder

It is not uncommon for ASD youngsters to experience great pain and discomfort that goes unreported, unnoticed by others, undiagnosed, and untreated. Enduring pain and allowing it to become chronic is extremely detrimental to your youngster's ability to function, grow, and learn. Untreated pain and discomfort will also seriously affect your child's behavior and ability to communicate with others.

Of all the “meltdown triggers” that drive behaviors, experiencing pain and discomfort is extremely significant. This is because pain affects behavior. Think of the last time your youngster was sick and feeling significant pain or discomfort (e.g., flu symptoms, migraine, menstrual cramps, pulled muscle, etc.). Now, think of how being in such pain manifested in his/her behavior. Perhaps he/she:
  • Felt especially vulnerable
  • Just wanted to be left alone
  • Just wanted to crawl under the covers and stay there
  • Lashed out or snapped at family members
  • Lashed out or snapped when anyone made a demand of him/her
  • Was especially hypersensitive to light or sound

What if the pain and discomfort is not treated and is allowed to persist due to a high pain tolerance?

Revisit the list above and consider how your child’s behavior might intensify the longer he had to endure the pain. Not only would he feel lousy, he would also feel disoriented and distracted. His attention would be focused on trying his best to cope and manage the pain that threatens to overwhelm him. Slowly but surely, any – or all – of the following could occur:
  • he might stop caring about his appearance
  • his ability to function, care for yourself, or interact with others would be greatly reduced
  • his mental health would be affected, eroded, and over time, seriously impaired
  • his self-esteem would suffer
  • the culmination of feeling physical pain would converge with mental anguish, leaving him weak and vulnerable

One prevalent form of pain in kids on the autism spectrum occurs with allergies. The challenge is that many moms and dads do not recognize this and see their youngster's symptoms in isolation, if at all (e.g., the youngster may frequently experience ear blockages and ear infections, sometimes from a very young age). 


Perhaps the youngster manifested outwardly visual symptoms (e.g., red, sore, pussy ears that drained spontaneously). The youngster may have been treated with antibiotics or had tubes in her ears to relieve pressure. More often than not, the ear problems were one symptom within a cluster of other symptoms, indicative of allergies.

In addition to ear blockages and infections, the Autistic youngster may also manifest symptoms of an allergy, such as:
  • Congestion and runny nose
  • Coughing and sneezing
  • Headaches and migraines
  • Red, itchy, or runny eyes
  • Sinus pressure over or under eyes
  • Sore throat
  • Swollen glands

You might have discovered that several of these symptoms manifest together at the same times of the year. The allergens could be absolutely anything — from one indicator (e.g., seasonal pollen) to an exhaustive collection of many known indicators. While you may have been treating one or two symptoms, you may not have been addressing the bigger picture (i.e., chronic allergies).

Treatment is available to relieve many of the physical side effects of severe allergies, but testing is necessary to determine the allergen type and degree of severity. This may be problematic for many kids on the spectrum, especially if they have had unpleasant experiences with doctors who were not as patient or sensitive as they should have been.

Some of the testing and treatment may involve drawing blood or receiving steroid shots, which may be an overwhelming experience (and perhaps not worth the potential trauma). Another type of testing is non-intrusive and involves the child holding various physical examples of allergens to ascertain a reaction. It is also possible that standard, over-the-counter medications may work to contain some or all symptoms of the allergies — at least until the child or teen can determine if she wishes to pursue other forms of obtaining relief.

Another prevalent factor that drives pain and discomfort in ASD kids is the gastrointestinal issues (e.g., severe gas and cramping, bloating, constipation, impaction, diarrhea, etc.). A number of such kids have an inability to properly digest dairy and wheat-based food products (among others), such that the enzymes from these foods “leak” through the gut and into the bloodstream, potentially creating an adverse reaction described by some as an “opiate” effect. In clinical trials, the dairy products are referred to as “casein,” and the wheat-based foods are referred to as “gluten.”

Moms and dads may find themselves frustrated with a youngster who seems “inappropriately” or embarrassingly gassy or who seems to have bowel complaints. Again, the youngster is not being deliberately difficult; there is a legitimate issue that is driving pain and discomfort.

As with pursuing the treatment of allergies, there are options that range from restrictive to less intrusive forms of treatment. In some instances, bacteria of the lower gastrointestinal tract may be responsible for creating these issues. This can be an excruciatingly painful experience that may cause a youngster to double over in pain. 

If the youngster is unaware of the root of the problem or doesn't know how to describe the pain in the moment, his “behavior” may be misinterpreted instead of correctly identified as a communication. Consult with your pediatrician to determine the appropriate treatment to get rid of all traces of the bacteria.


The procedures to determine the cause of the gastrointestinal tract problems may be very physically intrusive. You may want to explore less invasive methods of intervention as an alternative if the youngster has not had a good history with medical practitioners. These may include:
  • Avoiding foods with dyes or preservatives
  • Considering soy and other substitute foods, perhaps for a select time frame, to note any cause and effect
  • Cutting back on red-meat proteins in favor of chicken, fish, or other food options
  • Increasing consumption of natural food fiber found in fruits and vegetables
  • Increasing fluid intake, especially water, which may prove helpful as well
  • Promoting massage and exercise
  • Pursuing a diet free of dairy and wheat, in partnership with the youngster and in consultation with a dietician or nutritionist
  • Using any over-the-counter products designed to aid gas relief or alleviate bowel distress, like fiber-based additives

Some gastrointestinal problems may be compounded by the youngster's fears and anxieties around toileting. Children on the spectrum tend to be careful observers. Most will attempt toileting — especially urinating — in their own way and in their own time, just at a time later than what might be considered developmentally appropriate. Still others may appear to deliberately wet or soil themselves. But understand that your youngster is not deliberately being insubordinate. He really is struggling and feeling just as frustrated as you.

Here are some tips that may help clarify your understanding of toileting issues in the youngster:
  • If the youngster is not feeling safe and comfortable and in control, withholding body waste is one way of independently attempting to gain control.
  • Your youngster may be frightened by the toilet, believing that he may fall in and get sucked down.
  • Your youngster may be in a “perfectionism” mode, unwilling to admit his need to use the toilet when asked, or embarrassed to confess the need.
  • Your youngster may be overwhelmed by the loud roar of a flushing toilet.
  • Your youngster may not be connected enough with his body to consistently receive the physical “signals” or pressure indicating the need to evacuate waste.
  • Your youngster may panic, believing that in making a bowel movement, he is shedding a vital, living piece of his body.

To counteract these and other issues, it will be important to deconstruct the whole toileting process for your youngster using very basic, visual information. Explain the process of how and why the body rids itself of waste. Use your own visuals (e.g., graphics) to explain the human digestive system and name the internal parts of the body. Reinforce with your youngster that the process of eliminating waste from the body is natural. Also reinforce that using the toilet is a private matter. It is not to be discussed freely in public. It should only be discussed with close, trusted individuals (list them in writing), usually if there is cause for concern like constipation, impaction, diarrhea, etc.

Some of these kids will want specific assurances about exactly what happens to their stool once it gets flushed away (e.g., “where does it go?” … “what becomes of it?”). You may need to research this yourself, or look it up on the Internet with your youngster. If you are uncertain if your youngster experiences the sensations indicating the need to use the bathroom, first ask him about it. Talk about the ways in which you know your body gives you the appropriate signals, and plan daily, gentle exercises designed to better connect your youngster with his body (e.g., yoga, breathing, stretching exercises, etc.).

There may be some adaptations you can make in giving your youngster control in toileting (e.g., adjusting the water pressure to avoid a rushing roar when the toilet is flushed, partnering with your youngster to select a new toilet seat that is more comfortable and makes the toilet opening less imposing).

Keeping a sticker or piece of tape handy when in public will empower your youngster's encounters with automatic flush toilets, which can create great anxiety for being so unpredictable. Simply have your youngster cover the toilet sensor with the adhesive, and remove it when ready. The toilet will be disabled until the sticker is removed.


As your youngster grows into an adult, she should be able to identify and advocate for her own relief from pain. As with toileting, it will be useful to visually explain how the brain and body usually work together to send signals indicating pain. Sometimes the signals are accompanied by visuals that help reinforce that something is wrong (e.g., bleeding, a cut or blister). Other times, the signals may be exclusively inside the body and unseen, just felt. The Internet or your local library should be a resource in accessing images, books, or videos that describe these physiological processes.

There are some kids with ASD who are inconsistent in reporting pain – if they report it at all. Here’s why:
  • As with toileting, your youngster may not have a nervous system he feels fully connected with, such that the pain is delayed or not “registering” properly.
  • Being inherently gentle and exquisitely sensitive, your youngster may have been severely traumatized by experiences with doctors and nurses so that he considers enduring the pain the better option.
  • Your youngster may not realize that what he's feeling in the moment is anything any different from what anyone else feels.
  • Your youngster may not understand that there exists an unwritten social expectation that all people report pain and discomfort in order to gain relief.

In addition to educating your youngster about how the body works when communicating pain, it will also be important to partner with your youngster in gaining self-awareness and control leading to lifelong self-advocacy. This means reinforcing that it is good and desirable to identify and report one's own pain. The message needs to be loud and clear: “It is not okay to live with chronic pain.” Also, it will help considerably in relieving your youngster’s anxiety if you endeavor to demystify the entire concept of going to the doctor in advance of an appointment. You may do this by partnering with your youngster to consider doing the following:
  1. Arrange to get as many specifics about the appointment as possible, including approximate wait time and details of any procedures, along with literature and other visuals.
  2. Assign your youngster the responsibility of reading you driving directions to and from the office location, noting street names and landmarks.
  3. Because of downtime while waiting, suggest your youngster bring something to read or work on, possibly to share with the doctor as well.
  4. Before making the trip, partner with your youngster to develop a list of questions to ask the doctor, nurse, or receptionist. If there's the opportunity to do this, allow your youngster to take the lead in gleaning the information desired.
  5. Discuss flexibility of time frames with your youngster, and empower him to keep track of the time during the actual appointment.
  6. Gain clear information about the tentative sequence of events in order to visually list these out with your youngster (he can bring this list with him on appointment day).
  7. If at all possible, arrange to meet the doctor, the nurse practitioner, and — at the least — the receptionist. Again, provide the opportunity for your youngster to take pictures.
  8. Once at the office, empower your youngster by allowing him to take photographs inside and out. Review these later at home (where your youngster feels most comfortable), eliciting details from him.
  9. Schedule a pleasurable activity for your youngster to follow the appointment. Ensure that the activity occurs regardless of how well you think your youngster does or if he “earned” it.
  10. Suggest that your youngster photograph a typical private room, being remindful that, next visit, you may not get that exact room but one very much like it.
  11. With your youngster, schedule a time to drive to the doctor's office before the appointment day.

This is a lot of prep work and a significant investment of time, but in the long run, this investment of time up front will go a long way in supporting your youngster to feel safe and comfortable and in control. Empowering her to take the lead during this process promotes her ownership and sense of self-advocacy.



==> Videos for Parents of Children and Teens with ASD
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5 Ways to Make Your Autistic Child’s Life Easier

 

Source: https://www.pexels.com/photo/a-young-girl-playing-a-board-game-7943969

Autism spectrum disorder is a neurological condition that can cause a range of social, communication, and behavioral challenges. Many autistic children struggle with anxiety, sensory processing issues, and difficulty transitioning between activities. As a result, everyday tasks can be a challenge. However, there are many things that parents can do to make their autistic child’s life happier and more fulfilling. Here are five of the most important:

Teach Them Coping Skills for Dealing With Difficult Emotions

Autistic children often have difficulty understanding and expressing their emotions. As a result, they may become overwhelmed by negative emotions like anxiety or anger. It is essential to teach your child coping skills for dealing with these emotions. This can reduce or prevent meltdown episodes and help your child lead a happier life. There are many different coping skills that you can teach your child. The most popular include deep breathing, muscle relaxation, and positive self-talk.

Establish a Daily Routine

For children with autism, having a daily routine can be invaluable. Predictability and routine can help to reduce anxiety and provide a sense of security. When establishing a daily routine, it is crucial to involve your child in the process as much as possible. This will help them to understand the expectations and feel more comfortable with the new routine. Start by brainstorming together what activities should be included in the daily routine. Then, create a visual schedule that your child can follow. Place this schedule in a prominent location, such as on the fridge, so that everyone in the family can refer to it throughout the day. It is also essential to be flexible and adjust the routine as needed.

Care for Their Health Needs

Most autistic children have sensory processing disorder, which means that they are overloaded by certain stimuli and under-sensitive to others.  This can make everyday activities challenging, like going to the grocery store or getting a haircut. One way to ease your child’s anxiety is to equip them with earplugs or noise-canceling headphones. This will help reduce the amount of sensory information they are taking in and make it easier for them to concentrate on the task. Visit HearCanada to find the best earplugs that will work for your child’s individual needs.

Enroll Your Child in Auditory Integration Training

Auditory Integration Training (AIT) is a therapy that can help autistic children with sound sensitivity. The therapy involves listening to music through headphones for a set amount of time each day. AIT is effective in reducing sensitivity to sound, as well as improving communication and social skills. Talk to your doctor or a local therapist if you think your child would benefit from AIT.

Use Visual Supports

Many autistic children have difficulty understanding spoken language. As a result, they may benefit from the use of visual support. This can help with communication, behavior, and daily routines. For example, you could use a picture schedule to help your child understand the sequence of activities for the day. You could also use visual cues to help your child stay on task during an activity. There are many different types of visual supports that you can use. Talk to your child’s therapist to find out which ones would be most helpful for your family.

Implementing these five strategies will help to make your autistic child’s life easier. However, it is essential to remember that every child is different. What works for one child may not work for another. Talk to your child’s therapist to find out what strategies would be most helpful for your family. Patience, love, and understanding are crucial to raising a happy and healthy autistic child.

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Kids with ASD Who Worry Excessively: Crucial Tips for Parents

"I need some advice on how to help a very anxious son (with ASD) to deal with his strong emotions. He is very unsure of himself, needing constant reassurance and last minute accommodations."
 
Some kids with ASD [High-Functioning Autism] worry excessively and are often overly tense and uptight.  Some may seek a lot of reassurance, and their fears may interfere with activities. Moms and dads should not discount their youngster’s concerns – even when they seem unrealistic. 

Because fretful kids on the autism spectrum may also be quiet, compliant and eager to please, their difficulties may be missed.  The parent should be alert to the signs of excessive worrying so he/she can intervene early to prevent complications.

There are 3 different types of worries in these young people:
  1. fretting about being separated from the parent (e.g., being overly clingy, constant thoughts about the safety of parents, extreme worries about sleeping away from home, frequent stomachaches and other physical complaints, panic or tantrums at times of separation from the mother or father, refusing to go to school, trouble sleeping or nightmares, etc.)
  2. fretting about getting physically hurt (e.g., extreme apprehension about a specific thing or situation like getting bit by a dog, stung by a bee, stuck with a needle, etc.)
  3. fretting about being around people who are not familiar (e.g., avoidance of social situations, worries of meeting or talking to new people, few friends outside the family, etc.)
 
Other symptoms of excessive worrying in kids on the spectrum may include:
  • constant concerns about family, school, friends, or activities
  • fear of making mistakes
  • low self-esteem
  • lack of self-confidence
  • fears about things before they happen
  • repetitive, unwanted thoughts (obsessions) or actions (compulsions)

Moms and dads can help their child develop the skills and confidence to overcome excessive worrying so that he/she doesn't develop phobic reactions to certain stimuli.





To help your youngster deal with worries and anxieties, consider the follow tips:

1. Don't cater to your child’s fears. If your youngster doesn't like dogs, don't cross the street deliberately to avoid one. This will just reinforce that dogs should be feared and avoided. Provide support and gentle care as you approach the feared object or situation with your youngster.

2. Never belittle your child’s concerns as a way of forcing him to overcome them. Saying, "Don't be ridiculous! There are no monsters in your closet!" may get your youngster to go to bed, but it won't make the related anxiety go away.

3. Recognize that your child’s worries are real. As trivial as it may seem to you, it feels real to her – and it's causing her to feel nervous and afraid. Being able to talk about these feelings helps. Words often take some of the power out of the negative feeling. If you talk about it, it can become less powerful.

4. Teach coping strategies. Using you as "home base," your youngster can venture out toward the feared object, and then return to you for safety before venturing out again.

5. The youngster can learn some positive self-statements, such as, "I can do this" and "I will be OK" …to say to herself when feeling out of sorts.


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


6. Relaxation techniques are helpful, including visualization (e.g., floating on a cloud, lying on a beach, etc.) and deep breathing (e.g., imagining that the lungs are balloons and letting them slowly deflate).

7. Teach your child to rate his level of worry. A youngster who can visualize the intensity of his fears on a scale of 1 to 10, with 10 being the strongest, may be able to "see" the anxiety as less intense than first imagined. The child can think about how "full of fear" I am, with being full "up to my knees" as not so afraid, "up to my stomach" as more frightened, and "up to my head" as truly petrified.

8. If your youngster's apprehension consistently seems out of proportion to the cause of the stress, this may signal the need to seek outside help (e.g., counselor, psychiatrist, psychologist). Moms and dads should look for patterns. If an isolated incident is resolved, don't make it more significant than it is. But if a pattern emerges that's persistent or pervasive, you should take action. Contact your doctor and/or a mental health professional that has expertise in working with children and teens on the autism spectrum.

The key to resolving excessive worries and anxieties is to overcome them. Using the suggestions above, you can help your youngster better cope with life's situations.


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Preparing Your ASD Child for Transition to Middle-School

Parents who have children that will attend middle-school for the first time later this year need to initiate preparations pronto!

Another school year has ended, summer is here, and for some students, this was their last year of elementary school. This is not necessarily good news for children with ASD [High-Functioning Autism]. Why?



First, THE most difficult transition for most students (ASD or not) is that of going on to middle-school. This is largely due to the fact that, for the first time in the student’s life, he/she will have several teachers AND a much larger school population to contend with. Gone are the days where the child enjoyed having only one familiar teacher and only one relatively small classroom.

Second, children with ASD have difficulty with transitions in general – especially one this dramatic.

In general, a child’s intrinsic motivation toward school (i.e., the desire to do schoolwork for its own sake rather than for an external reward) has been found to decrease with age. Intrinsic motivation especially drops during transitions between schools (e.g., from elementary school to middle-school). In other words, children may get a great deal of pleasure from doing science projects in the 5th grade but feel like they are doing a project "just to do it" in the 7th or 8th grade.
 

After entering middle-school, children tend to get lower grades than they did in elementary school. This drop does not seem to occur because of any cognitive or intellectual changes. In fact, children perform just as well on standardized tests after entering middle-school as they did before. It also does not seem that grading becomes more difficult after the transition to middle-school. Therefore, a child’s lower grades seem to reflect an actual change in how he is performing during middle-school as compared to elementary school; he appears to place academics at a lower importance than he did earlier in his life.

Also, children perceive themselves to be less academically competent in middle-school than they did in elementary school. Over the course of just one year, many kids on the spectrum begin to lose belief in their own academic abilities, and a sense of low self-esteem kicks-in. This finding is important because children who think that they can do well in school are more likely to actually perform well. Oddly enough, the strongest children seem to experience the biggest drop in belief about their abilities over the middle-school transition.

Research has shown that students with ASD are less interested in school, perform more poorly in their classes, and see themselves as less academically capable during middle-school than during elementary school. Figuring out why these negative changes occur is not easy and is the subject of ongoing research. 
 
There are probably many developmental reasons for the changes (e.g., shifting interests, the beginning of distracting bodily changes, bullying, sensory sensitivities, a larger building to navigate, more peers to try to relate to, being ostracized from "the peer-group" if you can't "fit-in" or be "cool," etc.). In addition, there seem to be increasing demands from educators and parents for kids to get good grades rather than to simply enjoy the learning process. But exactly how much each factor affects children remains unclear.

Many of the factors that affect ASD children during the middle-school transition are beyond the parent’s control. Still, the parent can play a role in keeping the child engaged in school. For one, parents can continue to emphasize the importance of "love of learning" during the middle-school years. Parents do this naturally during elementary school when grades are less prominent and important, thus they should keep up a similar attitude after the transition. 
 

Second, parents can encourage their youngster to realistically assess her academic abilities. As mentioned earlier, strong children tend to stop believing in themselves most of all after the transition. Parents’ supportive words can help children remember that they are competent.

Lastly, simply keep these findings in mind. Recognize that the middle-school transition is difficult and that your child may show signs of less school engagement after the transition. Try to be understanding of the challenging changes he/she is facing, and know that with some time and support, his/her passion for learning will hopefully reignite.

To help your youngster adjust, begin discussing the types of changes he can expect long before that first day of class. Take your time and be there to answer any questions your youngster might have. 

Here are a few tips parents can take to prepare their youngster for the challenges and benefits of middle-school:

1. Many kids with ASD may worry about finding their classes, opening their lockers, or dressing for gym class. Address the youngster's fears one by one, and point out that everyone in her class is new to the school and the school rules. Also, point out that many of her fears will be addressed at an open house or school orientation. In the meantime, spend a little time showing your child how to use a locker combination and offer tips on getting to her classes on time.

2. There are a number of books on the market that can prepare your youngster for the adjustments of middle-school. Some are very specific, written exclusively for ASD boys and girls. It's not a bad idea to make an investment in one of these resources. They may even help you better understand some of the challenges your youngster will face, and that can help you help your child. A good eBook on the market is Teaching Social Skills and Emotion Management.

3. You may want to begin giving your child a little independence once she starts middle-school. For many families, it's during the middle-school years when kids may be left home alone for the first time. This milestone should be approached carefully and with much consideration and preparation. Take time to transition your child from constant supervision - to home alone, and check-up on her periodically to make sure she's using her time alone wisely.

4. Homework during the middle-school years tends to increase, and moms and dads can often find themselves unable to help with specific subjects. But they can still do quite a lot to help their kids tackle homework assignments and complete class projects (e.g., setting up an environment that helps your middle-schooler concentrate on homework in order to complete it quickly; keeping a family calendar in order to track special assignments and projects and keep your middle-schooler organized, etc.).

5. Many changes take place during the pre-teen years, and your youngster probably has questions or concerns about all of them. Discuss some of the changes your child will likely encounter, and role-play how to deal with some of the more difficult challenges. For example, your child will likely encounter new school-rules when she begins middle-school. What should she do if she breaks one of them accidentally? How should she respond?

6. Touring your youngster's new school is a wonderful way to answer any questions your child might have about middle-school and ease any anxieties. A tour will show her where she can find all the places she'll have to go in the course of the day (e.g., gym, cafeteria, locker, etc.), and that will give her a sense of confidence on her first day.

7. Bullying tends to peak in the 7th and 8th grade and diminish slightly every year after. Unfortunately, most kids on the spectrum will encounter bullying at some point during middle-school. The best way to protect your youngster is to sit down and discuss behaviors common in middle-school (e.g., bullying, experimenting with tobacco, etc.). These young people who are being bullied may try to hide the fact from family members or educators, so be sure you know the signs of bullying in order to take quick action.

8. The idea of moving up to middle-school can be scary for some kids. But it's important that children understand that middle-school offers many benefits and opportunities. Talk to your child about all the organizations and clubs she'll be able to join, as well as the independence that comes with being older and more mature. Point out all the opportunities your youngster's school offers, and encourage her to become involved right away, when everyone in her class is just as new to the school as she is.

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Behavior Modification Plan for Your Child with Autism Spectrum Disorder [level 1]

"What types of behavior change methods -if any- can parents use at home instead of putting their child in a formal treatment program?"
 
Let's look at a few ideas...
 
A short-term behavior modification plan can break through a cycle of bad behavior in your child with ASD level 1 [Aspergers or High-Functioning Autism]. Think of it as a learning tool to help him or her move forward to a new level of social development. 
 
Four to six weeks on the plan is usually enough to change one or two specific behavior problems. At the very least, your youngster will have a clear understanding of your expectations for his behavior, even if he is not yet able to consistently maintain the desirable behavior.

Chips or Charts?

A chart system is useful when chores or homework are the issues. Use daily stars or stickers for completed tasks with weekly rewards for good performance. Weekend privileges or rewards are clearly dependent on consistently responsible behavior through the week. Charts make sense to ASD children since they are so visually-oriented, and they take pride in a full page of stickers showing their good behavior. Use your word processing software to make a chart, or find some on the Internet (just do a Google search for “behavior charts”).
 

A poker chip system is easy and inexpensive. All you need is a box of poker chips and a package of the new disposable food containers. Introduce the plan in a positive way when you show your youngster the chips and let him personalize his box with markers and stickers. The poker chip system is effective because it encourages immediate rewards for positive behavior.

Implementing the Behavior Modification Plan—

Talk with your child to see what system (chips or charts) would have the most meaning to him and have him help you come up with a list of meaningful rewards to choose from when he meets one of his behavioral-goals.

Chart System:

1. Be sure to recognize if the chosen reinforcement isn’t motivating enough and modify it. Children will lose interest if they don’t see or feel the rewards of their good behavior. Be flexible with the rewards.

2. Break the day into manageable increments of time. For some kids, it may reasonable to expect them to avoid the target behavior for an entire morning, but for others you may need to start with blocks of time as small as 15 minutes long. Remember, you are trying to help your youngster be successful in his efforts.

3. Identify both the behavior you are trying to modify and the behavior with which your youngster needs to replace it. List these behaviors in simple-to-understand, plain language either on the bottom of the chart or on a piece of paper nearby. Try color-coding the undesirable and desirable behaviors and placing them directly across from each other so your youngster can easily see which behavior is inappropriate and what the alternatives are.

4. Identify the areas where the child has strengths. For example, your child may have no problem going to bed on time. Praise the child for this behavior and encourage her/him to keep it up.

5. If focusing on a long term goal is unmanageable, a more immediate reinforcement is needed. You can work for a simpler reward, like a preferred activity such as an extra story at bedtime, a favorite bath toy or a special game.

6. It may be that your youngster has several behaviors that you would like to extinguish or many chores he doesn't complete to your satisfaction, but in order to be successful, you need to choose one or two major issues to tackle first. Behavior charts are only successful if a youngster is given the opportunity to succeed. Choosing too many target behaviors can set him up to fail.

 
7. Promote success at the beginning and work your way up to higher compliance requirements. In order to get your youngster on board and feeling good about using behavior charts at home, you'll need to set your success goals low (perhaps at 30 to 40 % compliance rate). As he shows some consistent success in meeting his goals, you can slowly increase the expectation of what constitutes success.

8. Set up a chart large enough so that your child can see the clear picture of how he is progressing. Let your child help with the designing of the chart; make him feel excited about the program. This lets him understand he is in charge of the results of the program. This is the how your child will start understanding and learning consequences.

9. Update the chart immediately after the desired behavior for a younger child. Update the chart daily for your older child. Do so in the presence of your child reiterating the goals of the program.

10. You can assign levels for different privileges. Earning all stickers every day for a week deserves a big reward. You keep the chart system motivating when you reward smaller privileges based on the number of stickers earned.

Chip System:

1. Be sure to recognize if the chosen reinforcement isn’t motivating enough and modify it. Children will lose interest if they don’t see or feel the rewards of their good behavior. Be flexible with the rewards – and on the first day, give chips out like crazy just so he gets the idea of how to earn them.

2. Break the day into manageable increments of time. For some kids, it may reasonable to expect them to avoid the target behavior for an entire morning, but for others you may need to start with blocks of time as small as 15 minutes long. Remember, you are trying to help your youngster be successful in his efforts.

3. Carry the chips with you in your pocket, and when you catch your youngster doing the right thing, hand him a chip or coin and have him put it in his box. Make a big deal every time you give him a chip, so he fees proud. Remember never to take chips away – this is a reward system – not a punishment system.

4. Chips can be used to do special activities. You can set up an activities chart with your youngster of different preferred activities (e.g., computer time, watching a movie, jumping on the trampoline, a bike ride with dad, a walk with mom, etc.). Have your youngster help you decide how many chips he needs to earn to pay for that special activity. Throughout the day, give your youngster chips when you catch him doing the right thing.

5. Chips work visually and tactilely as a delayed or immediate reward system. You can purchase poker chips or even use coins. Have your youngster decorate a box or a jar that he can place in an easy to access area, to collect chips throughout the day for good behavior. Tell him he will be earning chips for good behaviors and list those good behaviors with him (e.g., cleaning up toys, eating healthy meals, good sharing, good talking, listening when parents are talking, nice touching, etc.).
 

6. Focus on one or two specific goals for intensive behavior change. Or, make a list of generally desirable behaviors, such as cooperation, honesty, kindness, and responsibility. Then, you decide when to reward the youngster with a chip when he exhibits these qualities.

7. For the system to work effectively, the rules for behavior and rewards should be presented so that everyone clearly understands the plan. Small rewards, such as an hour of choosing his favorite TV programs, will usually cost one or two chips. The price is higher for larger rewards, such as dinner out with the family at the youngster's favorite restaurant.

8. Identify the areas where the child has strengths. For example, your child may have no problem going to bed on time. Praise the child for this behavior and encourage her/him to keep it up.

9. If focusing on a long term goal is unmanageable, a more immediate reinforcement is needed. You can work for a simpler reward, like a preferred activity such as an extra story at bedtime, a favorite bath toy or a special game.

10. If your youngster changes some behaviors immediately, continue to positively reinforce him for those behaviors, while adding one or two more challenges to his list of rewarded behaviors. After a few weeks on the chip system, take a break and observe your youngster's progress. You can start back when you recognize a problem.

Most children on the autism spectrum enjoy a behavioral system because it helps them know what is expected of them in a structured, but fun way. Explain that you want them to learn good behavior and habits, and this is a way to do it. Begin immediately, and reward chips and stickers generously. If your behaviors and privileges are not lining up fairly, or your youngster begins to manipulate the system, change it at the end of the week.

Reward systems are to be used in any situation you may need (e.g., getting dressed, keeping your hands to yourself, not making noises, good sharing, not yelling, etc.). If you find that these systems are a positive influence on your child, share the information with his teachers or anyone else that will be interacting with him. Positive reinforcement will be so much easier than any form of punishment. Reward systems are a great way to stay proactive.

A behavior modification program not only offers negative reinforcement to undesirable behaviors, but also rewards positive behavior. Have fun with the program. Negative behavior that isn’t a part of the behavior modification program still needs to be addressed. Use more conventional deterrents like time-outs and groundings. Remember to be consistent and follow through with the program.

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