Diagnosing "Asperger's Syndrome" in Children

When moms and dads seek help for their youngster, they encounter varied opinions – he'll outgrow it, leave him alone, it's no big deal, he just wants attention, and so on. Many professionals try to work with the Aspergers (high-functioning autistic) youngster as if his disorder is like other developmental disorders, but it is quite different. In most cases, there is a great misunderstanding by many people of the needs of these special individuals.

For the inexperienced, recognizing the six defining characteristics of Aspergers as outlined in the introduction can be difficult, and misdiagnoses are quite common. This is further complicated by the fact that an Aspergers youngster or teen has many of the same characteristics found in other disorders. These various characteristics are often misinterpreted, overlooked, under-emphasized, or over-emphasized. As a result, a youngster may receive many different diagnoses over time or from different professionals.

For example, if a youngster with Aspergers demonstrates a high degree of attention deficit hyperactivity disorder (ADHD) -- that might be the only diagnosis he receives. However, this is a common characteristic of Aspergers kids. The same holds true if obsessive or compulsive behaviors are displayed – the youngster gets labeled with obsessive-compulsive disorder (OCD) instead of Aspergers. The following traits are also commonly seen in those with Aspergers in varying degrees. However, just because these traits are there, it doesn't mean that the youngster should be diagnosed differently; these traits should be noted as significant features of Aspergers:

• Anxiety

• Difficulty with pragmatic language skills

• Hyperlexia (advanced word recognition skills)

• Motor deficits

• Oppositional defiant disorder (ODD)

• Sensory difficulties

• Social skills deficits

As mentioned, professionals who do not have much experience with Aspergers have a hard time identifying the defining characteristics. For example, social skill deficits may be noted by a professional, but then they are often downplayed because the youngster or adolescent appears to be having appropriate conversations with others or seems to be interested in other people. But with an Aspergers youngster, the conversations are not generally reciprocal, so the youngster must be carefully observed to see whether or not there is true back-and-forth interaction.

Also, many Aspergers kids have an interest in others, but you need to clarify if the objects of their interest are age appropriate. Do they interact with peers in an age-appropriate fashion? Can they maintain friendships over a period of time or do they end as the novelty wears off? These are the types of observations and questions that must be asked in order to ensure a proper diagnosis.

Another example of an overlooked area is the narrow routines or rituals that are supposed to be present. This does not always manifest as obsessive-compulsive behavior in the typical sense, such as repeated handwashing or neatness, but rather in the insistence on the need for rules about many issues and situations. These kids may not throw tantrums over their need for rules, but may require them just as much as the person who has a meltdown when a rule is violated. In essence, there is no single profile of the typical Aspergers individual. They are not all the same, as you will see in later chapters.

Because of these subtleties and nuances, the single most important consideration in diagnosis is that the person making the initial diagnosis be familiar with autistic spectrum disorders – in particular, Aspergers. They should have previously diagnosed numerous kids. To make a proper, initial diagnosis requires the following:

1. An evaluation by an occupational therapist familiar with sensory integration difficulties may provide additional and valuable information.

2. It is important to include a speech and language evaluation, as those with Aspergers will display impairments in the pragmatics and semantics of language, despite having adequate receptive and expressive language. This will also serve to make moms and dads aware of any unusual language patterns the youngster displays that will interfere in later social situations. Again, these oddities may not be recognized if the evaluator is not familiar with Aspergers.

3. The youngster should see a neurologist or developmental pediatrician (again, someone familiar with autistic spectrum disorders) for a thorough neurological exam to rule out other medical conditions and to assess the need for medication. The physician may suggest additional medical testing (blood, urine, fragile X, hearing).

4. You and your youngster should have sessions with a psychologist where your youngster is carefully observed to see how he responds in various situations. This is done through play or talk sessions in the psychologist's office and by discussions with both moms and dads. The psychologist may ask you to complete checklists or questionnaires to gain a better understanding of the youngster's behaviors at home and/or school. If the youngster is in school, the psychologist may call the youngster's teacher or ask her to complete additional checklists. The checklists or questionnaires used should be ones that are appropriate for individuals with Aspergers. It is important to determine the IQ level of your youngster as well. An average or above-average IQ is necessary for a diagnosis of Aspergers.

Complications of the Aspergers Diagnosis: Help for Clinicians

When moms and dads look for assistance for their Aspergers (high functioning autistic) youngster, they encounter diverse opinions (e.g., “he'll outgrow it” … “leave him alone” … “it's no big deal” … “he just wants attention” ...and so on). Many therapists try to work with the Aspergers youngster as if his disorder is like other developmental disorders, but it's very different. Generally, there's a profound misunderstanding by many people regarding the needs of these special children.

For the unskilled, identifying the defining features of Aspergers as outlined below can be challenging, and misdiagnosis tends to occur frequently:

• A lack of emotional empathy
• Clumsy, uncoordinated movements
• Intense absorption in certain subjects
• Limited ability to establish relationships
• Naïve, inappropriate, one-sided social interactions
• Odd postures
• Pedantic, repetitive speech
• Poor non-verbal communication

Diagnosis is further complicated by the fact that an Aspergers youngster or adolescent has many of the same features present in other disorders. These numerous features are often misinterpreted, overlooked, under-emphasized, or overemphasized. Consequently, a youngster may obtain a variety of diagnoses over time or from various therapists. For instance, if the Aspergers child shows a high level of ADHD-like signs and symptoms, this may be the sole diagnosis he gets. However, many ADHD characteristics are also common in Aspergers kids. The same holds true if obsessive or compulsive behaviors are exhibited - the youngster will get tagged with OCD rather than Aspergers.

The following traits are also generally seen in Aspergers children in varying degrees. However, simply because these traits exist does not mean that the youngster ought to be diagnosed in a different way. These traits ought to be noted as significant features of Aspergers:

• Anxiety
• Difficulty with pragmatic language skills
• Hyperlexia (advanced word recognition skills)
• Motor deficits
• Oppositional defiant disorder (ODD)
• Sensory difficulties
• Social skills deficits

Therapists who do not have much knowledge about Aspergers have a problem identifying the defining characteristics. For instance, social skill deficits might be noted by a therapist, but then these deficits are often downplayed since the youngster or adolescent seems to be having appropriate conversations with other people or appears to be interested in others. But with an Aspergers youngster, the conversations aren't usually reciprocal, therefore the youngster should be carefully observed to determine if there is true back-and-forth conversation. Additionally, many Aspergers kids are interested in other people, but the diagnostician must clarify if the objects of their interest are age appropriate (e.g., Do they connect to friends in an age-appropriate manner? Can they maintain relationships over a period of time, or do they end as the novelty wears off?). These are the kinds of observations and queries that must be asked to guarantee a proper diagnosis.

Another illustration of an overlooked area may be the “narrow routines or rituals” which are supposed to be present. This doesn't always show itself as obsessive-compulsive behavior in the usual sense (e.g., repetitive hand-washing or neatness), but instead in the insistence on the need for rules about numerous problems and circumstances. These types of kids might not throw temper tantrums over their need for rules, but may require them as much as the person who has a meltdown whenever a rule is violated. Essentially, there isn't any solitary profile of the standard Aspergers child.

Due to these subtleties and technicalities, the single most significant consideration in diagnosis is that the therapist making the initial diagnosis be familiar with Autistic Spectrum Disorders - in particular, Aspergers. They should have previously diagnosed numerous kids. To make a correct, initial diagnosis demands the following:

1. An evaluation by an occupational therapist acquainted with sensory integration issues may provide additional and useful information.

2. It is essential to incorporate a speech and language assessment, as individuals with Aspergers will display impairments in the pragmatics and semantics of vocabulary, in spite of having sufficient receptive and expressive vocabulary. This can also serve to make moms and dads aware of any abnormal vocabulary patterns the youngster shows that will interfere in later social situations. Once again, these oddities might not be acknowledged if the therapist isn't acquainted with Aspergers.

3. The youngster ought to see a specialist or developmental pediatrician (again, someone familiar with Autistic Spectrum Disorders) for a comprehensive neurological examination to rule out other health conditions and to assess the need for prescription medication. The physician might recommend additional medical testing (e.g., blood, urine, fragile X, hearing).

4. Both parents and the Aspergers child should have sessions with a therapist in which the youngster is very carefully observed to see exactly how he responds in various situations. This is accomplished through play or talk sessions in the therapist's office and by discussions with the parents. The therapist may ask the parents to complete checklists or questionnaires to gain a better understanding of the youngster's behaviors at home and school. If the youngster is in school, the therapist may call the youngster's teacher or ask him to complete additional checklists. The checklists or questionnaires used should be ones that are appropriate for children with Aspergers.

5. Another important factor is to determine the IQ level of the Aspergers youngster. An average or above-average IQ is necessary for a diagnosis of Aspergers.

Help for Clinicians—

Kids can begin to show signs of Aspergers by the age of 3. However, because most kids with Aspergers are of average or above average intelligence, the condition may not be noticed until later. When a youngster begins to develop socially and is placed in a school or playgroup setting, symptoms of Aspergers may become more apparent. In some cases, Aspergers is not diagnosed until adolescence (especially in girls).

Most experts agree that Aspergers symptoms can vary greatly. In general, each youngster who has the disorder has his or her own unique set of symptoms. Kids with Aspergers usually have a combination of the following symptoms:

• Unusual speech patterns with regard to tone, pitch, or accents
• Unusual sensitivity to sound, light, or touch
• Strong aversion to change or spontaneity
• Strong attachment to routine
• Obsessive interest in one topic which they may talk about excessively
• Late development of motor skills or a lack of physical coordination
• Inability to sense other people's needs for personal space
• Inability to read non-verbal social cues and other people's feelings
• Inability to be empathetic
• Extreme difficulty with peer relationships and social situations
• Difficulty understanding their feelings
• Below average handwriting
• Awkward, repetitive gestures, body postures or facial expressions
• Average or above average vocabulary skills
• Above average memory skills

Kids who have Aspergers may show any or all of these symptoms to various degrees. However, all kids with the disorder generally have particular difficulty with social relationships.

Kids who have mild symptoms of Aspergers may simply be labeled as eccentric and not receive appropriate care and attention. It is also common for kids with the disorder to become targets of teasing, ridicule, harassment, or bullying. As a result, kids with Aspergers are at increased risk for developing depression and other mental illnesses.

Moms and dads who suspect their youngster may have Aspergers should talk with his or her pediatrician about their observations and concerns. To rule out other conditions that may be causing the youngster's symptoms, the health care provider will perform a complete physical examination and may perform x-rays and blood tests. If no physical cause for the youngster's symptoms is found, he or she may be referred to a health professional that specializes in developmental disorders in kids.

A thorough diagnosis and evaluation are important for determining the most effective treatments for the youngster. Diagnosis of Aspergers can be performed by one or more of the following health care professionals:

• Pediatric neurologist
• Developmental pediatrician
• Child/adolescent psychologist
• Child/adolescent psychiatrist

Diagnosis of the conditions involves taking a complete medical history of the youngster, usually based on the observations and recollections of the parents and other family members. Input from other caregivers or teachers who have had contact with the youngster are also helpful.

The medical history includes information about:

• how the youngster expresses his or her feelings
• the family's medical history
• the infancy period of the youngster
• the pregnancy
• the youngster’s social interactions with peers, siblings, and other family members
• the youngster's development of motor skills, language development, and interests
• the youngster's early (preschool) development

In addition to a medical history, a communication assessment may be performed. This test is used to gather information about the youngster's communication skills, including the following:

• Speech (e.g., clarity, volume, pitch)
• Non-verbal communication (e.g., gestures, glances)
• Non-literal language (e.g., humor, irony)
• Formal language (e.g., vocabulary, sentence structure, comprehension)
• Conversation skills (e.g., turn-taking, sensitivity to cues, ability to follow typical rules of conversation)

In kids who have Aspergers, formal language often is an area of strength, and other forms of communication are usually areas of difficulty.

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

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

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

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

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

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

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

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

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

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

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

When parents (and teachers) turn their attention to a new troubling cluster of symptoms, an intervention that has been effective may be reinterpreted as ineffective. Being attentive to symptom traits allows the parent to measure effects and introduce helpful responses. 

 

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

The most important traits to consider include the following:

1. Distribution of the behavior problems
2. Intensity of the behavior problems
3. Onset: Time and Location of the behavior problems
4. Duration of the behavior problems
5. Ameliorating Factors for the behaviors
6. Aggravating Factors for the behaviors
7. Trends of the behavior problems: upward or downward

1. Distribution—

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

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

 

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

2. Intensity—

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

3. Onset: Time and Location—

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

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

4. Duration—

Duration is self-explanatory.

5. and 6. Ameliorating and aggravating and factors—

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

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

7. Trends—

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

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

Case in point—

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

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

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

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

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

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

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

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

Raising Children on the Autism Spectrum: The “Best-of” Techniques

"Our son was recently diagnosed with autism (high functioning). What would be the best course of action/parenting changes we need to consider/focus on at this point?"

You may have just discovered that your youngster has a diagnosis of Asperger’s (AS) or High-Functioning Autism (HFA), and you are thinking “What now?” …or you may have a youngster who you know is different …or a health professional has said that he or she has some traits of autism, but is still considered in the normal range. You may be feeling overwhelmed, and it may seem like you are the only person or family going through these issues.

Is your child intolerant to certain types of food? Have you noticed that she doesn’t like loud noises, bright lights, tight or loose fitting clothes – and reacts inappropriately to any of these particular things? Does your youngster crave fast movement, or is he almost impossible to get moving in the morning? Does your youngster’s specific behavioral problems seem worse after lunch or a party? Do you find routines hard to establish and maintain?

All these issues may seem very daunting at the moment. However, with experience and help, you can teach your youngster to rule his AS or HFA traits rather than have his traits rule him. There are many things you can do to help your youngster better understand the world – and function successfully in it. Below are some crucial ideas that you may find helpful.

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

Raising Children on the Autism Spectrum: The “Best-of” Techniques—

1. A common complaint of moms and dads with AS and HFA kids is the obsessive nature that they can have with a certain object or action. Repeated words, a fixation on a collection, or the obsession with a character or television show is an indicator of AS or HFA. As a parent, you have the power to limit the interest so that your youngster can experience other things. Make time each day for your youngster to indulge in his interest, but introduce other things to him as well.

2. As a mother or father, you may find yourself constantly explaining the condition to other parents, teachers and friends. It is your duty to clear the path for your youngster's interactions by letting others know about the disorder and explaining how it might affect their relationship with your youngster. Creating awareness makes it easier for your youngster to interact with others who understand why she is different. Awareness also helps others to not take offense to the things she says and does.

3. Children with AS and HFA tend to enjoy being isolated, because it is less stressful for them – and they do not have to socialize with others. So, when parents use a “time-out” as a form of punishment for misbehavior, it can actually be a positive experience for these “special needs” kids, which makes the consequence ineffective. Removing them from something fun is a better alternative. For example, if your youngster loves to play with blocks, perhaps the blocks should go in the time-out area. A timer can be used, which will help parents be more consistent when applying time-outs. Kids prone to destructive tantrums may be placed in a room that contains no breakable items, or one that has pillows they can use to get out their frustrations.

4. Choose your battles carefully. Teach your AS or HFA youngster how to make a request without a meltdown, and then honor the request. For example, say, “Try asking for that toy nicely, and I’ll get it for you.”

5. Cognitive-behavioral therapies are often used to help a child with AS or HFA unlearn his undesirable behaviors and replace them with more positive behaviors. Through this therapeutic technique, the child will learn to recognize the behaviors that need to be discontinued and come up with strategies to change his behaviors in the moment, until the change becomes permanent.

6. Create a list of behaviors and actions your youngster can’t control due to her diagnosis. These may include repetitive behaviors, along with poor peer relations and easy distractibility. Your youngster may require help and guidance to overcome these issues. However, she should not be punished for behaviors related directly to the disorder.

7. Determine preventative instructions to help your youngster learn the appropriate way to handle difficult situations. Through role play, discussion and stories, you can provide your youngster with alternatives to hitting, yelling and throwing. Social stories (developed to help AS and HFA kids understand difficult situations) may be particularly helpful for teaching about appropriate and inappropriate behaviors. Because kids on the autism spectrum often process information slowly, repeat your preventative instructions numerous times.

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

8. Develop an appropriate format for instructing your youngster about behaviors that are unacceptable and that will result in a negative consequence. Because the symptoms of the disorder often include difficulty processing information, the list may need to be verbalized, written down and displayed in picture format. Copying the list and placing it throughout the house may also be helpful.

9. Do not reward your AS or HFA child after a meltdown for calming down. Some kids will learn that a meltdown is a good way to get a treat later.

10. Don't expect your child to “act his age.” Children on the spectrum are usually emotionally immature compared to their same-age peers, so parents should make some allowances for this.

11. Establish routines and traditions that add structure. AS and HFA children LOVE – and even crave – structure.

12. Give your AS or HFA youngster control over little things whenever possible by giving choices. A little bit of power given to the child can stave-off the big power struggles later (e.g., “Which do you want to do first, brush your teeth or put on your pajamas?”).

13. Implement a consequence plan. For each negative behavior you have identified as inappropriate from your youngster, decide the consequence. Discipline needs to be clear, concise, consistent and calm. If your youngster misbehaves, tell him in a few words what he did wrong and tell him the consequence (e.g., "Hitting your brother is inappropriate. Go sit in the timeout chair for 5 minutes").

14. In some younger AS and HFA kids who appear not to listen, the act of “singing” your words can have a beneficial effect.

15. Increase your tolerance level. Are you available to meet your child’s reasonable needs? Evaluate how many times you say, “No.” Avoid fighting over minor things.

16. Keep a sense of humor to divert your youngster’s attention and surprise him or her out of the meltdown.

17. Kids with AS and HFA often have trouble both understanding communication and comprehending tone of voice. Sometimes a visual instruction is more effective than a verbal one, since your youngster can review the action as often as needed. Visuals can be used to suggest schedules, chores, and even processes (e.g., the correct way to use public restrooms). Use pictures, photographs and cartoons to help your AS or HFA youngster understand what is expected.

18. Kids with AS and HFA thrive on clear rules, therefore posting a list of unacceptable behaviors and their consequences can be immensely helpful. For younger kids who can’t read yet, the rules should be reviewed periodically, and the list could also have visual illustrations to demonstrate the bad behaviors and consequences associated.

19. Make sure your child “understands” what he is doing wrong! For example, do you talk back to him? Why, then, is it inappropriate for him to talk back to you? Maybe he has an issue with the other person's mind. This lack of “other awareness” or “Theory of Mind” is common in AS and HFA. Maybe he said something that was insulting, but didn't realize it. At that point, try and explain why it is that he said something wrong. Make sure you have explained to him what it is that he did, and why you are angry. It's not always easy, but sometimes reasoning it out in a logical way will help you vocalize what's wrong and will help your child realize what “the rule” is and what he has to do to follow it.

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

20. Moms and dads need time-outs too. If one parent is home with an AS or HFA youngster all day long, that parent may need a break later. Moms and dads should pay attention to one another and give each other time to decompress when necessary. Develop a hand signal or other visual clue that lets the other know when these moments arise.

21. Moms and dads need to be in agreement when applying discipline to any youngster, but especially for kids with AS and HFA. If one parent thinks spanking is the appropriate punishment while the other feels that time-outs will be more effective, this will be confusing for the youngster. Time-outs, loss of privileges (e.g., video games, TV, weekly allowances), a fair-fining structure (as in police ticketing) with a cost associated with each offending behavior, or additional chores can all be used effectively.

22. Moms and dads should list the behaviors that they feel are most deserving of attention. This is an important step because some behaviors may need intervention or therapy in order to be eliminated rather than simple disciplinary tactics. For example, running in circles or humming may be habits that the youngster is using to self-soothe, even though these behaviors might drive moms and dads crazy. Odd self-soothing behaviors are common in kids on the autism spectrum with sensory processing (integration) issues, and they can be easily replaced with more appropriate ones (e.g., swinging on a swing, chewing on a healthy snack).

23. Pre-warn your child of any changes, and give warning prompts if you want her to finish a task (e.g., “when you have colored that in, we are going shopping”).

24. Promises and threats you make will have to be kept – so try not to make them too lightly.

25. Remain calm and do not argue with your AS or HFA youngster. Before you manage her, you must manage your own behavior. Punishing or yelling at the child during a meltdown will make it worse.

26. Review your discipline plan regularly. Consider your consistency regarding implementation of the plan. Evaluate your youngster's behavior and determine if the plan needs revisions based on her age, development, or behavioral changes.

27. Reward AS and HFA kids for positive attention rather than negative attention. During situations when they are prone to meltdowns (e.g., interacting with peers), catch them when they are being good and say things like, “Nice job sharing with your friend.”

28. Signal AS and HFA kids before you reach the end of an activity so that they can get prepared for the transition. For example, say, “When the timer goes off 5 minutes from now, it will be time to turn off the TV and get ready for bed.”

29. Social skills and the ability to communicate are often lost when a child has to deal with his disorder. He may have trouble observing the way others behave. In addition, he will have trouble reading and reacting correctly to another person's emotions, which could lead to a lack of relationship success. Despite this, the AS or HFA child can be taught social skills and effective communication techniques. He can learn how to read nonverbal communication techniques and properly socialize if his learning occurs in an explicit and rote manner through social skills training.

30. Talk with your child after he has calmed down from a meltdown. When he stops acting-out, talk about the frustration the he has experienced. Try to help solve the problem if possible. For the future, teach the child new skills to help avoid meltdowns (e.g., how to ask appropriately for help, how to signal an adult that he needs to go to “time away” to “stop, think, and make a plan” ...and so on). Teach your AS or HFA youngster how to try a more successful way of interacting with a peer or sibling, how to express his feelings with words, and recognize the feelings of others without hitting and screaming.

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

31. Teach AS and HFA kid that anger is a feeling that we all have, and then teach them ways to express anger constructively.

32. Teach them some strategies for coping (e.g., telling peers who are teasing perhaps to “go away,” or to breathe deeply and count to 20 if they feel the urge to act-out in public).

33. Think before you act. Count to 10, and then think about the source of your youngster’s frustration, her characteristic temperamental response to stress (e.g., hyperactivity, distractibility, moodiness, etc.), and the predictable steps in the escalation of the meltdown.

34. Trouble can arise from friends who take advantage of your AS or HFA youngster. While your youngster may enjoy friendships, his unique situation may become a cause for concern when he is not able to properly communicate with friends or allows friends to take advantage of him. Only allow your youngster to spend time with other kids that you know and trust, under a parent's supervision. Once you become more comfortable with his friends and social situations, you can slowly allow him more freedom.

35. Try to build in some flexibility in their routine. If they learn early that things do change – and often without warning – it can help.

36. Try to get confirmation that they understand what you are talking about/or asking. Don't rely on a stock “yes” or “no” that they like to answer with.

37. Try to identify stress triggers. Avoid them if possible, and be ready to distract with some alternative. For example, if your youngster thrives on a schedule, but you need to change it for some reason, let your youngster know – and watch for signs of a meltdown during the change. You can then bring along a favorite item to distract your youngster from becoming upset.

38. Try to intervene before your AS or HFA youngster is out of control. Get down at her eye level and say, “You are starting to get revved up, so let's slow down.” Now you have several choices of intervention.

39. Use turn-taking activities as much as possible, not only in games but at home too.

40. When visiting new places or unfamiliar people, explain to the child beforehand what to expect. For example, say, “Stay with your assigned buddy in the museum.”

Remember, AS and HFA children are kids just like the rest, they have their own personalities, abilities, likes and dislikes. They just need extra support, patience and understanding from everyone around them. 

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

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

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

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

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

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

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

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

 

All About Aspergers

Aspergers is a developmental disorder on the Autism spectrum. It affects verbal and non-verbal communication (body language) social interaction, a dislike of change, an aversion to noise, inflexibility of thought and, quite often, an obsession with a certain interest.

Kids with Aspergers (Aspies) usually have excellent memories, especially in the area of facts, figures, dates, times and statistics. Math and science are subjects of interest and kids usually excel in these areas.

There is a large range of severity of symptoms with Aspergers. Kids who have very mild symptoms often go undiagnosed for years. It is not unusual for kids with medium severity to go undiagnosed until they start school, at which time the disorder is seen in behavior problems and lack of social skills. Although females do sometimes suffer from the disorder, it is far more prevalent in males.

Aspergers Traits—

Kids who have Aspergers have trouble interacting with their peers, but can carry on an intelligent and often animated conversation with adult. They use language differently than non-Aspergers sufferers and are often labeled odd and eccentric. Kids with Aspergers take verbal and written communication literally. They are happier when schedules are consistent and when they are in a rigidly structured environment. If bored, they may touch, talk out, or make noises to occupy themselves; most often they will concentrate on the activity or hobby of their preferred choice.

Kids who have Aspergers have traits that make them appear to be perfectionists. They love being the first and the best at things and find imperfection, losing and criticism very frustrating. Their ability to communicate their feelings often results in inappropriate behavior. Aspies experience emotions that are overwhelming, which causes them to have a high anxiety level. They need to be around people who are patient, understanding, loving and supportive. Tender loving care (TLC) is needed to help them reach their goals. These kids flourish in this type of environment.

Problems—

Problems coping will become less as the youngster matures, but as with all kids, new ones will appear. Adolescents find the lack of friendship perplexing. They continually try to their best to cultivate new friendships only to find they don’t last. Moms and dads need to teach Aspies social skills that come naturally to non-Aspies. If social skills are taught from a young age, it makes life easier for Aspergers adolescents.

Many skills can be taught to Aspies. However, keep in mind that each youngster is an individual with his own personality and characteristics. Difficulty levels, as well as levels of achievement will vary.

Aspergers vs. Autism—

Aspergers is more common that Autism, though it is quite rare. Few people including health care professionals have ever heard of it. Fewer still have had any experience dealing with it and even fewer understand it. Most health care professionals have some knowledge of Autism, though most refer kids who suffer from it to specialists in the Autism field of expertise.

Aspies have been described as having a dash of Autism. Expert’s opinions differ greatly on whether Aspergers should remain on the Autism spectrum, or if it should be in a classification of its own. Autism has been defined as a withdrawal from reality. Though this is not what Autism is, thousands of people, including some health care professionals, still view it as such.

The severity of Autism is much greater than that of Aspergers. Many times kids with Autism cannot speak and only make sound. Classic Autism brings many learning problems with it. The language of those with Aspergers is most often clear, intelligent and usual. Their cognitive ability is almost always at least average and more often above average.

At the present time, the similarities and characteristics of Autism and Aspergers are enough to put them on the same spectrum of developmental disorders. It is important that any diagnosis be perfectly clear, though this can change as the youngster matures. Traits of kids on the high end of the Autistic spectrum appear less severe as the youngster matures and learns to cope with his disorder and difficulties.

Areas Affected by Aspergers—

• Communication

• Narrow interests

• Repetitive routines and inflexibility

• Social interaction

Communication—

Aspies will experience both verbal and non-verbal communication problems. Though they often have very advanced verbal skills, spoken language is difficult for them to understand. Keep conversation simple and precise. Metaphors have to be explained to be understood, as do similes. Aspies tend to take your words literally and make interpretations concrete. Some Aspies may experience delayed speech, but most do not. They tend to use phrases they have heard and committed to memory, although they frequently use them out of context. Moms and dads of kids with Aspergers may need to translate phrases in order to decipher exact meanings.

Aspies can, at times, speak in an odd way. They may be loud, speak very formally, or even in a monotonous tone. They may talk incessantly about an area of interest without realizing that the listener is experiencing intense boredom. Often they have trouble finding the right words to express what they are trying to say. They have the same problem expressing their feelings and may appear to speak “at you” instead of “to you.”

The Aspergers youngster does not make direct eye contact, nor do they understand body language and facial expressions, though these things can be taught successfully. These kids tend to have odd facial expressions and find the reading of facial expression and body language in others to be beyond their comprehension abilities. This tends to initiate further problems, including frustration and anxiety.

Teaching Body Language—

The easiest and simplest way to teach body language and facial expressions is through a fun game. Make a face and ask the youngster to guess its meaning. Continue playing this game for a few minutes each day until the youngster learns what you are communicating. Some examples are sad, happy, surprise and frowns. Once the youngster has mastered facial expressions, play the same game to teach body language. Knowledge of basic facial expressions and body language gives the Aspergers youngster a definite advantage when interacting with others.

Reading—

It is not unusual for kids with Aspergers to acquire outstanding reading skills at a very young age. The trick here is to assure the youngster understands what he is reading. Take time to read to and with your youngster and allow her to read to you in return. Talk about the meaning of the story and explain to the youngster how to get the most out of a good book.

Narrow Interests—

A definite symptom of Aspergers is the youngster’s obsession with certain topics. Examples are trains, cars, trucks, airplanes and all other modes of transportation. Dinosaurs, science, computer and maps also are subjects of high interest. Kids with Aspergers want to know how things work and how they are made. They tend to become preoccupied and obsessed in all things intellectual. These things will change as the youngster matures, but the intensity level is always extreme.

Social Interaction—

All Aspies have poor social skills. They do not read social cues, so cannot give a proper social response. They have no desire to share their experiences with others. These problems tend not to be as severe around moms and dads or grown-ups, but cause very definite problems when the youngster is interacting with peers. This causes difficulties when trying to make friends their own age and results in high anxiety, frustration and behavioral problems.

Kids with Aspergers often find themselves alone. Many are happy as loners; others are not. They are noticeably different when interacting with their peers in an unstructured environment such as a park or school playground. They are very naïve, which causes them to be bullied and teases unless protected by an assistant, buddy or sibling. They focus on small areas of detail and almost always fail to see the overall picture of situations. This lack of skill can be likened to a tapestry. Where non-Aspies see the entire tapestry, Aspies tend to focus on each individual thread. This causes them to overlook certain aspects of situations, which can cause more frustration and anxiety.

Repetitive Routines—

Aspies tend to limit themselves and those around them to rigidly structured routines. They want things done in a certain way and often, though not always, pick certain foods that they like to eat and insist on one of them at every meal time. As they mature, these routines change and the youngster is more likely to listen to reason.

Because of their inflexibility kids with Aspergers often limit their own creativity and imagination. The same things are done in the same way every time. They often memorize details and have a great rote memory, but learn without understanding. Aspies need everything to be explained simply and in great detail. For instance, instead of telling the Aspergers youngster to set the table, you need to be much more specific. Tell her to put knives, forks, spoons, plates, cups and glasses on the table. This allows her to know exactly what is expected of her.

Never assume that an Aspergers youngster understands instructions just because he can repeat them back to you. Be certain to follow through and ascertain that the youngster knows exactly what you want her to do. This makes it much easier for all involved and keeps the youngster’s frustration and anxiety to a minimum.

Education—

If an Aspergers youngster is to attend a public school, it is important that he have lots of support available. The best way to assure this is by supplying the school with a Statement of Special Education. This will give school officials advice on the needs of the Aspergers youngster. This advice should be supplied by the moms and dads and a health care professional who specializes in Aspergers. Obtaining a Statement of Special Education is a stressful and confusing process that can take more than six months. Contact anyone who may be able to help you with this process. It is important that the Aspergers youngster have this support in place before attending school, or as soon as possible after he is diagnosed.

The school that the Aspergers youngster attends must be willing to learn about Aspergers and the difficulties that both the youngster and educators will face. Aspies need a very structured environment if they are expected to excel. The more structured the school environment, the less behavioral problems will become evident. Check with several schools to find out what support is available.

A teacher with a specific knowledge of the Autism spectrum should be assigned to give support to the Aspergers youngster, the educators and the school. Each youngster who has Aspergers should also be assigned a Special Support Assistant (SSA,) or, in Canada, an Educational Assistant (EA.) Other specific professions support, such as language and speech therapists should be assigned if applicable to ensure the youngster develops proper language and speech skills.

If you plan on home schooling your youngster, speak to your Aspergers health professional. A diary should be kept for communication, achievements and problems. Home schooling is not always the answer for kids with Aspergers, as they do need a lot of social interaction with kids their own age in order to develop communication skills. Only your Aspergers health care professional can tell you if home schooling your youngster is the right for her. After all, the youngster’s well-being is the top priority.

Life Issues—

Aspies often have high stress levels. Things overwhelm them easily and they don’t have the skills they need to control their emotions. Music may be nothing more to than noise to the Aspergers youngster and can cause emotions to reach out of control levels. Overwhelming situations can result in meltdowns immediately or hours or even days later.

Meltdowns—

Meltdowns can result in the Aspergers youngster going out of control. He may cry, scream, cry and scream, kick, throw things, pound on walls, or engage in other inappropriate behavior. It’s very difficult to determine when, where or why a meltdown will occur. When you ask the youngster what the problem is, they may give an off the wall reply, such as “I have no green toys,” when he has hundreds of green toys in his room.

Never punish an Aspergers youngster for having a meltdown, which appears to be nothing more than an intense temper tantrum. Allow her a quiet time and once he is again in control, try to find out what the real problem is. It could be something that happened immediately before the meltdown, yesterday, or even last week. It’s very difficult to determine why a meltdown occurs unless the youngster learns to communicate his feelings.

Meltdowns often occur after a rough day at school, a disagreement with a sibling, a lost game, a sporting event or other activity. Be patient and supportive. Don’t shout. Let the youngster know that you support her and love her. It is not unusual for Aspies to meltdown upon arriving home from school. A school day is very structured and they try to be on their best behavior, so venting when they get home is quite natural.

Aspies and the Holidays—

Aspies 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. This brings a lot of stress into the life of the Aspergers youngster.

Some Aspies may not want to join in when the family opens presents. She may be checking out the lights on the Christmas tree, trying to figure out how they work, or she may sit in a corner participating in one of her obsessive hobbies. Let her be. If you pressure her to join in, she will 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 her presents in her own time.

Aspergers Stress Factors—

• 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.

Coping—

• 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.

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

• Have a quiet breakfast on Christmas morning.

• 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.

Strategies for Coping—

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

• Aspies 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 her. Use simple language that she can understand.

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

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

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

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

• Limit choices to keep the youngster from being overwhelmed.

• 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 Aspies find a stress ball beneficial.

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

• Use social stories to prepare Aspies 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, Aspies 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 some extra love, support and patience from family members.

My Aspergers Child: Preventing Meltdowns

Behavior-Management Techniques for Children with High-Functioning Autism

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

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

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

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

     

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

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

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



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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

The Role of Environment in the Psychiatric Difficulties of Kids on the Spectrum

In a multitude of ways, the environment affects children with Asperger’s and high-functioning autism (HFA), and is a major factor that influences the severity of comorbid psychiatric disorders (e.g., anxiety, depression, OCD, bipolar disorder, ADHD, Tourette Syndrome, personality disorders, ODD, etc.).

Undeniably, the varied expression of psychiatric problems in kids with Asperger’s and HFA is directly related to environmental factors, which suggests the opportunity for planning various interventions. For example, family and daily routines should be considered as environmental factors that can lead to exacerbation (i.e., an increase in severity) or amelioration (i.e., a decrease in severity) of comorbid disorders.



The challenge of understanding the special needs of Asperger’s and HFA kids, and the problems associated with building a close relationship with them, often contributes to increased stress in their moms and dads. Parents of kids on the autism spectrum have been shown to have a reduced sense of happiness and security, and tend to display a general lower quality of life – even in comparison with parents of kids with other disorders (e.g., cerebral palsy or mental retardation). Furthermore, moms were found to experience a higher level of stress than dads, and this higher stress is often related to unusual behavioral traits of the youngster (e.g., hyperactivity, conduct problems, etc.).

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


Other research reports elevated rates of anxiety-related personality traits among the relatives (e.g., siblings, grandparents, etc.) of kids on the spectrum. Moreover, elevated anxiety levels in the moms and dads of these young people can be considered an important environmental factor that can trigger genetically-determined personality traits that are eventually shared with other family members and constitute a genetic family-loading for psychiatric disorders.

The importance of environmental factors in the expression of psychiatric symptoms was investigated in a sample of young people with Autism Spectrum Disorders (ASD), including children with Asperger’s and their siblings, with an evaluation reported independently by parents and educators. Reports by educators showed a much lower prevalence of comorbidity in these children (in particular for somatic, oppositional, conduct, attention, anxiety, and affective problems) as compared to the reports by their moms and dads. These results support the idea that the expression of psychiatric problems in kids with Asperger’s varies depending on the environmental context, and that their identification depends on the type of observer (in this case, teacher versus parent).

There is often a lack of consensus between the reports of parents and educators regarding the behavioral characteristics of kids with Asperger’s and HFA, hence suggesting that caution should be used when making conclusions about the presence of comorbid psychiatric difficulties based simply on the environmental context or a single informant source. Instead, information should be gathered from multiple sources and settings, including direct observation by therapists.

The problems that the youngster experiences in terms of social relationships are even greater outside of the home environment (e.g., school, church, scouts, etc.). The lack of adequate teacher-parent communication, coordination among social service providers, and social support often leaves the parents alone with the burden of providing a more intensive level of care and any additional support.

Unfortunately, schools are not always equipped to deal with the unique needs of the Asperger’s or HFA student, and this often drives him or her to develop feelings of low self-esteem, sadness, and self-blame, which often leads to other problems (e.g., meltdowns, depression, hyperactivity, conduct problems, etc.).

Research has also reported that negative events (e.g., parental discord, frequent changes of own residence, death of a family member, etc.) have significant influence on the youngster’s mood and functioning – and have been associated with clinical depression. These children tend to react to negative life events more severely (and in a different way) than “typical” children do. HFA students are also more vulnerable to developing mood disorders and depressive symptoms than other children (which may be correlated to a genetic predisposition).

Since environmental factors appear to substantially influence the expression of psychiatric comorbidities in children on the spectrum, more attention should be focused on the interactions between these children and their diverse everyday life events. Parents, teachers, and professionals can develop coping strategies and provide a better social support that may contribute to a decrease in the incidence of psychiatric disorders in Asperger’s children.

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


There are numerous accommodations that parents can make to help their child cope effectively with his or her environment. Here are just a few:

1. Allow more time to complete chores, homework, etc.
2. Avoid being critical and negative toward your youngster.
3. Avoid over-scheduling him and allow him free time to play, read, listen to music, or just relax.
4. Avoid placing unrealistic expectations on your child.
5. Break tasks down into a few small steps (no more than 5) that can be completed one at a time so that your youngster does not feel overwhelmed with the task. For example, “It’s time to clean your room. So, put your clean clothes in this drawer. Pick up your dirty clothes off the floor and put them in this laundry basket. Then take the basket to the laundry room.”
6. Create a special signal (e.g., tapping the tip of your nose) that you can use with your youngster to redirect his attention back to what you are saying whenever necessary.
7. Demonstrate active interest in your youngster’s school progress and support her with her learning and homework.
8. Encourage physical activity and healthy eating habits.
9. Have a crisis plan in place in the case of meltdowns (e.g., due to your child’s sensory sensitivities, due to his inability to cope or interact with siblings, etc.). This plan may include providing a quiet place for your youngster to go when needed.
10. Help build your youngster’s sense of self-worth by recognizing his achievements.
11. Listen to your youngster and encourage him to talk about his feelings and worries.           
12. Manage your own stress, and be a positive role model.
13. Monitor their youngster’s access to media and ensure she is aware of safe online practices.
14. Prepare your child in advance for any changes in routine or other unexpected activities. For example, use this 3-stage warning: “In 15 minutes, we are going to the grocery store.” Then after 5 minutes have passed, repeat your instruction and say “In 10 minutes, we are going to the store.” Then after 5 minutes, say “We are leaving in 5 minutes.”
15. Provide a written, predictable schedule of events (e.g., “On school days, you get dressed, brush your teeth, eat some breakfast, get your school bag, and then get on the bus”). Remember, Asperger’s kids thrive on routine.
16. Regularly spend calm and relaxing time with your youngster.
17. Set firm expectations regarding house rules. In many cases, Asperger’s kids may not want to follow a rule that holds no interest for them (e.g., “Be sure to wash your hands before you come to the dinner table”). It is important for parents to establish and maintain control – even when their child has an Autism Spectrum Disorder.
18. Show active interest in your youngster’s activities and hobbies, and participate when possible.
19. Support your youngster if he is exposed to bullying.
20. Use less verbal instruction, and replace it with visual instruction. For example, use drawings, pictures, or other images to create a “chores chart” or a “house-rules chart.”
21. Use positive reinforcement for good behavior as often as possible!

When environmental stress becomes too much to handle, the youngster can develop a range of physical, emotional or behavioral symptoms, and can even be at risk of developing other mental health problems. Also, he may find it difficult to recognize and verbalize when he is experiencing stress. Thus, it is important for moms and dads to teach their “special needs” child to recognize and express his emotions, and to use healthy ways to cope effectively with the environment.

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

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

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

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

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



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