Search This Site

The "Stepwise Integration" Method for Fine Motor Skills Deficits

“I need some advice on how to help my daughter with high functioning autism to dress herself. She is 6-years-old, and I still have to help her with the buttons on her sweater, tying shoes, etc. I would have thought she could be doing this on her own by now. Does anyone else have this problem?”

Stepwise integration is a good strategy to use in these circumstances. Kids with Asperger’s (AS) and High-Functioning Autism (HFA) often have difficulty with fine motor skills, which involve strength, fine motor control, and dexterity (e.g., the small muscles of the body that enable such functions as grasping small objects, writing, tying shoe laces, fastening clothing, etc.).

These skills are important in most school activities as well as in life in general. Deficits in fine motor skills can affect a youngster's ability to eat, write legibly, use a computer, turn pages in a book, and perform personal care tasks (e.g., dressing and grooming).

Dressing is a simple task for most kids, and most moms and dads expect their kids to be able to correctly dress themselves after a certain age. But for young people with AS and HFA, even the simple act of dressing is not stress-free. To help your daughter with a simple task like dressing, employ a stepwise integration method by breaking the task down while you do it for her. Then, gradually have her perform the steps by herself, giving her an extra step each time.

For instance, the first part of stepwise integration of dressing is helping your daughter get dressed while you explain every action (e.g., choose the sweater, lay it on the bed, put one arm through the hole, put the other arm through the hole, and button the sweater).

The next step (performed the next morning) is to have her choose the sweater, with you completing the remaining actions.

The following day, have her choose the sweater and lay it on the bed. Continue giving your daughter more actions until she is doing the entire process on her own.

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

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

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

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

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

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

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

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism


•    Anonymous said... Break down the steps of doing buttons. You do the first couple of steps and get her to do the last step. Eg. You hold the button, you take hold of button hole, you push button half way through button hole then get your daughter to pull the button through. As her skills get better, get her to do the 2 last steps and so on and so forth until she is doing it by herself. It may take time but it will happen. Do the same for shoe laces. Get her to do the first step of crossing the laces over and pulling down, then you do the other steps and as her skills get better she can tackle the other steps. Forget about her age, it should be about showing her in steps so she can gain the skills to be independent. There are many children and adults that are still learning those skills. Believe in your daughter because she believes in you.
•    Anonymous said... I was still helping my daughter with buttons, laces etc when she was 12. She's 15 now and apart from the odd teeth brushing prompt she's fine. These things take time but your daughter will get there. Have patience and don't make a big deal out of it.
•    Anonymous said... My sons 8 and just this year starred doing buttons on his shirts but not pants. We only buy him pull on pants. Thank goodness for Velcro shoes and squiggly laces. Might as well compromise now to save yourself the stress. They will be doing buttons and laces one day.
•    Anonymous said... Same problem with my 8 year old boy.
•    Anonymous said... took a very long time for my guy to master laces, maybe age 9, and that was a skill taught in OT.
*   I have same issues with my 7 year old son. He is HFA and Aspergers. I am going to try the Step Wise Intergration method and see where I get with my little man.

Please post your comment below…

Medication for Treating Aggression in Asperger's Children

“Are there any medications that can be used to treat aggression in a child with Asperger syndrome? Is it ever advisable to use medication for this purpose?”

Aggression is seldom an isolated problem and is particularly complex in kids with Asperger’s (AS) and High-Functioning Autism (HFA). Aggressive behavior is not always associated with just one condition and can have highly varied sources.

Many studies have been proposed to understand aggressive behavior in young people with AS and HFA. There are promising biologic models that suggest the behavior arises from alterations in dopaminergic reward mechanisms, and cognitive models suggesting that such acts are an outcome of conditioned learning.

Tantrums and aggression are often responses to an array of circumstances and occur in the context of varied emotions. Circumstances preceding and following aggressive outbursts should be observed and documented before selecting a particular medication (e.g., when aggression is a response to anxiety or frustration, the most helpful interventions target those symptoms and the circumstances that produce them, rather than exclusively focusing on the aggressive behavior itself).

Unfortunately, the request for medication typically follows a crisis. The press for a rapid, effective end to the unwanted behaviors may not permit the gathering of much needed data or discussion. Nonetheless, it is not appropriate to “always” begin with one medication or another. Moving to a more “surefire” medication too quickly may mean that the AS or HFA child takes on cardiovascular, endocrinologic, and cognitive risks that may be otherwise avoided.

There are studies in support of using serotonin reuptake inhibitors, alpha-adrenergic agonists, beta-blocking agents, mood stabilizers, and neuroleptics for aggressive behavior. When the doctor has the (a) luxury of time, (b) support of the child’s parents, and (c) collaboration with school staff where the child is attending school, then a medication that is safer, but perhaps takes a longer time to work (or is a little less likely to help) can be tried.

As a side note, it does appear that medications with a greater likelihood of success pose greater risks (e.g., evidence supports use of dopamine blocking agents for aggressive behavior; however, the side effects and long-term risks from these medications are greater than others listed earlier).

Behavioral and Cognitive Rigidity in Children with Asperger’s

Behavioral rigidity refers to a child’s difficulty maintaining appropriate behavior in new and unfamiliar situations. The opposite of rigidity would be flexibility, which enables children to shift effortlessly from task to task in the classroom, from topic to topic in conversation, from one role to another in games, etc.

Rigidity can also affect thinking. Cognitive rigidity occurs when the child is unable to consider alternatives to the current situation, alternative viewpoints, or innovative solutions to a problem. The child with rigid thinking tends to view things in “either-or” terms (e.g., things are either right or wrong, good or bad). He or she wants concrete, black and white answers. The “gray areas” of life are very uncomfortable (e.g., often has an exact way of doing things with no variations).

Children with Asperger’s (AS) and High-Functioning Autism (HFA) often demonstrate extreme forms of rigidity or inflexibility. This may manifest itself as (a) difficulty ending an intense emotional feeling, (b) making transitions during the school day (e.g., from lunch back to the classroom), and (c) tolerating changes in schedules or everyday routines. 

==> Here is a 3-step process for helping your AS or HFA child with his/her rigidity issues...

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.

Click here to read the full article…

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.

Click here for the full article...

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.

Click here to read the full article…

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."

Click here to read the full article…

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.

Click here
to read the full article...

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.

Click here for the full article...

My Aspergers Child - Syndicated Content