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Oppositional Defiance in Kids on the Autism Spectrum

"My 8 y.o. has been diagnosed with autism (high functioning) recently, and before that was diagnosed with ODD. When we have behavior problems with him, it's hard to know if the particular 'misbehavior' is driven by autism or by ODD. How do we tell the difference, and how do we approach the multitude of behavior issues we are having with him?"

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Popular Screening Tools for Aspergers and Autism

Question

What kind of assessment tools do clinicians use when they are trying to determine whether or not a child or teen has Aspergers or Autism?

Answer

There are many (with new ones coming along all the time) …so I have listed the “most used” screening tools to date. These include:

1. Aspergers/High Functioning Autism (HFA) Screening Tools
2. Autism Screening Tools
3. Developmental and Behavioral Screening Tools

Aspergers/HFA Screening Tools (4 years to adult) —

Most Aspergers/HFA screening tools are designed for use with older kids, and are used to differentiate these disorders from other ASDs and/or other developmental disorders (e.g., mental retardation and language delays). These tools concentrate on social and behavioral impairment in kids four years of age and older (up to adulthood), who usually develop without significant language delay. Qualitatively, these tools are quite different from the early childhood screening tools, highlighting more social-conversational and perseverative-behavioral concerns.
  • Australian Scale for Asperger Syndrome (ASAS) by Michelle Garnett, M. Clinical Psychology, Anthony Attwood, Ph.D. (for kids 5 and older)
  • Autism Spectrum Screening Questionnaire (ASSQ) by Stephen Ehlers, Ph.D., Christopher Gillberg, Ph.D., Lorna Wing, Ph.D. (Published in 1999 in the Journal of Autism and Developmental Disorders, 29,129-141) (for kids 7-16)
  • Social Communication Questionnaire (SCQ) by Catherine Lord, Ph.D., Sir Michael Rutter, Ph.D., et al. (for kids 4 and older)

Autism Screening Tools (4 years to adult) —

Most autism screening tools are designed to detect ASDs specifically, concentrate on social and communication impairment in kids 18 months of age and older, and focus on all three DSM-IV criteria for autism. Their limitations lie in the lack of highly validated autism screening tools available for kids under 18 months of age. Since autism screening ideally would follow a developmental screening that has indicated concerns, the administering clinician should directly observe the youngster in addition to using an autism screening tool questionnaire.
  • Modified Checklist for Autism in Toddlers (M-CHAT) by Diana Robins, M.A., Deborah Fein, Ph.D., et al. (for kids 16-30 months)

Developmental and Behavioral Screening Tools (Birth to 36 Months) —

Most developmental and behavioral screening tools have a wide application with kids of varying ages, allow flexibility to capture “parent report’ with minimal assistance, ask less threatening and more universal questions of mothers and fathers, and coordinate with hallmark developmental milestones. Because of their broad use, developmental and behavioral tools often lack the sensitivity to screen specifically for autism and therefore require follow up with an autism screening tool when a developmental screening raises concerns.
  • Ages and Stages Questionnaire (ASQ-3) by Jane Squires, Ph.D. & Diane Bricker, Ph.D. et al. (for kids 1-66 months)
  • Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) by Jane Squires, Ph.D. & Diane Bricker, Ph.D. & Elizabeth Twombly, M.S. (for kids 6-60 months)
  • Brief-Infant-Toddler Social-Emotional Assessment (BITSEA) by Margaret Briggs-Gowan, Ph.D. and Alice Carter, Ph.D. (for kids 12-36 months)
  • Child Development Inventory by Harold Ireton, Ph.D. et al. (for kids 0-6 years)
  • CSBS DP Infant-Toddler Checklist by Amy Wetherby, Ph.D. & Barry Prizant, Ph.D. (for kids 6-24 months)
  • Parents Evaluation of Developmental Status (PEDS) by Frances Page Glascoe, Ph.D. (for kids 0-8 years)
  • Parents Evaluation of Developmental Status-Developmental Milestones (PEDS:DM) by Frances Page Glascoe, Ph.D. (for kids 0-8 years)
  • Social-Emotional Growth Chart by Stanley I. Greenspan, MD (for kids 0-42 months)
  • Temperament and Atypical Behavior Scale (TABS) by Stephen J. Bagnato, Ed.D., John T. Neisworth, Ph.D., et al. (for kids 11-71 months)
The Aspergers Comprehensive Handbook

Aspergers and American Idol

During one of the episodes of the TV program “American Idol,” producers saved a “thriller” for the final audition spot. The “tough-luck” story told by James Durbin, 21, was almost too much to believe.

James grew up barely knowing his bass-playing father, who was always on the road, and was raised by his mother after his dad died of a drug overdose. Durbin reveals that he was never able to spend much time with his father, who was always away touring. James stated, “People say that I get my musical talent from my dad. Well, I’ll never know.”

Later diagnosed with both Tourettes and Aspergers, James turned to music to help deal with his stress. Both Tourettes and Aspergers are extremely debilitating neurological disorders that can result in behavioral tics and extreme social awkwardness. Durbin is classified as "high-functioning” (i.e., his symptoms are milder, he's able to handle social situations with more tolerance than others with Tourettes or Aspergers, and his facial and vocal tics should become more manageable with time).

Tourettes and Aspergers are lifelong conditions, but experts say that adults "can learn to understand their own strengths and weaknesses." As living proof, James Durbin says he does his best to "suppress" the negative effects and play up what he's best at – “singing.”

Durbin hasn’t let his disorders slow him down as a performer. He’s gone on to star in productions of Singing in the Rain, Grease, Beauty and the Beast, West Side Story, Sweet Charity, Fiddler on the Roof, and My Fair Lady. He was also the lead singer for the band Hollywood Scars and jammed alongside a teen music ensemble known as Guitarmy.

James views “the stage” as a form of therapy, a place that allows him to put aside his tics and obsessions. He went on to meet his fiancĂ©, Heidi, and the two went on to have a son. The singer credits his family for helping him turn his life around.

James Durbin has a pitch-perfect voice and a hard rocker’s attitude. American Idol footage shows James ‘tearing-it-up’ with Led Zeppelin’s “Whole Lotta Love.” Another clip has him floating his way through the Beatles’ “While My Guitar Gently Weeps” with equal power. His versatile voice has already earned him comparison to American Idol favorite Adam Lambert.

On the show, James stated, "I have Tourettes and Aspergers, but Tourettes and Aspergers don't have me. I'm doing what I can to suppress it. I don't let it take advantage of me. It's not who I am. You need to give it 210 percent. The reason why I can be the next 'American Idol' is because I believe. From day one, all I've been doing is believing …believing that I can …believing that I have the power to do something real.”

So, what does this mean for Aspergers awareness? Clearly, as was dramatically demonstrated on American Idol, Durbin has talent. American Idol truly found a genuine San Francisco rocker in the form of James Durbin.


James Durbin performing While My Guitar Gently Weeps:

My child has been rejected by his peers, ridiculed and bullied !!!

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

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How to Prevent Meltdowns in Children on the Spectrum

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

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Parenting Defiant Teens on the Spectrum

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

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Older Teens and Young Adult Children with ASD Still Living At Home

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

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Parenting Children and Teens with High-Functioning Autism

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

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Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

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

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