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Who should be responsible for helping teens and young adults with Asperger’s and HFA?

Jane, a 21-year old with Asperger’s, had worked as a secretary for her father when he was alive. But when he died and the company closed, she did not seek further work. She carried on living in the family home, which became more and more neglected. Jane enjoyed novels, and was reading Tolstoy's War and Peace when the author met her, but she did not know who to contact to change a broken light fitting or how to change it herself. So she read by candlelight.

Her neighbors thought her weird, and the various doctors who saw her found her uncooperative. They believed that she was simply unmotivated to change. Although none of them said it, there was a definite implication that she was lazy and difficult. Jane continues to be dismissed by professionals as having moral failings, but not impairments.



Adolescence and young adulthood are times of identity change and identity confusion. Understandably, teens and young adults do not want to define themselves in terms of impairments, but in terms of aspirations and desires. In telling a person that she has Asperger’s (AS) or High-Functioning Autism (HFA), it is important to make this an accommodating and not a restrictive intervention.

There is a balance to be struck between (a) being seen as a person with impairments and (b) being seen as someone with an unobstructed and sunny future. In other words, the AS or HFA individual needs to understand that she will have to work harder in certain areas (e.g., social skills acquisition) than her “typical” peers do, yet with appropriate interventions, she can thrive in most areas just as her peers can.

Who should be responsible for helping older teens and young adults with Asperger’s and High-Functioning Autism?

Parents—

The first answer to this challenge is “moms and dads.” Parents readily accept this responsibility because they have felt extraordinarily responsible for their AS or HFA youngster from the time that they realized that she was different, and was in some way vulnerable to others' exploitation and influence.

Parents can – and should – be their child’s greatest advocate. The road to becoming your child’s advocate begins by being as informed as possible about AS and HFA. There are dozens of books, some more scholarly than others, that parents can read to help themselves understand that the autism spectrum disorder was not their fault and to learn patterns of behavior they have come to see in their child, but didn’t know what they meant.

The second part about being an advocate for your child is to pay careful attention to him. Learn his idiosyncrasies and pay attention to the things that work for him, along with the things that don’t. For example, if your child has certain obsessions or compulsions, understand what they are and find out ways to get around them, if needed and if possible.

The Teenager or Young Adult Herself—

Another answer is “the AS or HFA individual herself.” It is true that more and more young people on the autism spectrum are discovering alternative methods to empowerment. The Internet has provided many of these, enabling these teenagers to get in touch with each other by email, discussion groups, or through web pages. Even more helpful, the net provides a means of communicating with others that emphasizes technology know-how and de-emphasizes the subtleties of social interaction, both of which are advantages for people with AS and HFA.

Self-advocacy is another way for young people with AS and HFA to help themselves. Self-advocacy teaches these individuals to identify issues that mean the most to them. It helps them prioritize their hopes and dreams – and to make certain that nothing gets in the way of achieving their goals. Autism is nothing to be ashamed of. It’s a part of who they are, but it does not define them. Once they realize this, and that they are capable and intelligent, young people on the spectrum should be able to step up and take on some of the responsibility of self-advocacy.

Self-advocacy is core communication skill. Being proficient at using this skill means that you express yourself effectively and stand up for your point of view, while also respecting the rights and beliefs of others. This skill can help with stress management, boost your self-esteem, and help earn others' respect.

One aspect of being a good self-advocate is to pay careful attention to yourself. Learn your idiosyncrasies and pay attention to the things that work for you, along with the things that don’t work.

Know your strengths. Young people on the spectrum are often gifted with an above average I.Q. It’s likely that you excel in one or more academic subjects. Also, you probably have an intense interest outside of academics (e.g., music or computers). Knowing your own strengths will help you gain much needed self-confidence.

Recognize and accept your weaknesses. Just as with your strengths, you must also be mindful of your weaknesses.

Psychiatrists—

There are clinical psychologists, counselors, educators, employment specialists, neuropsychologists, occupational therapists, psychiatrists and others who have made themselves into specialists. But there is no group that has accepted that AS and HFA is part of their mission. This means that parents and their “special needs” children are constantly the subject of turf wars in which they find themselves being referred back and forth until someone takes responsibility for their care, or until they give up and break contact with services altogether.

AS and HFA are neurobiologic disorders with a strong heritability. Twin studies suggest that genetic and environmental factors often may interact. In addition, outcome is influenced by social and emotional factors. Thus, AS and HFA would appear to be a psychiatrist’s “bread and butter” – disorders that require the combination of knowledge of brain development, environmental factors, and psychology.

Moreover, there is an association between AS/HFA and psychiatric disorder. One recent study showed that 32% of young adults with an autistic spectrum disorder had been diagnosed with another disorder, most commonly depression (56%). Although autism itself does not respond to medication, comorbid conditions do.

A range of medical disorders is reportedly more common in AS and HFA. These include epilepsy, disorders affecting brain development in childhood (e.g., hydrocephalus, tuberous sclerosis, neurofibromatosis), congenital perceptual disorders affecting early social interaction (e.g., congenital disorders of visual acuity and congenital causes of deafness), and disorders affecting motor control (e.g., myotonia and myopathy).

Given all these considerations, there is a strong case for psychiatrists to take responsibility for young people with AS and HFA. And not just any psychiatrists, but the same psychiatrists who deal with “neurodevelopmental disorders” (i.e., disorders that typically manifest early in development often before the youngster enters grade school, and those that are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning).

==> Launching Adult Children With Aspergers: How To Promote Self-Reliance

Communication Intervention and Social Skills Training for Kids on the Spectrum


"How can I help my child with high functioning autism to develop some important communication and language skills?"

For most children with Asperger’s (AS) and High-Functioning Autism (HFA), the most important treatment strategy involves the need to enhance communication and social competence. This emphasis on social competence does not reflect a societal pressure for conformity, and it does not attempt to stifle individuality and uniqueness.

Instead, it reflects the clinical fact that most children with AS and HFA are not loners by choice, and that there is a tendency (as these kids develop towards adolescence) for hopelessness, pessimism, and oftentimes, anxiety and depression due to the child’s (a) increasing awareness of personal inadequacy in social situations and (b) repeated experiences of failure to make and/or maintain friendships.

The typical limitations of insight and self-reflection often preclude spontaneous self-adjustment to social and interpersonal demands. The practice of communication and social skills does not imply the eventual acquisition of communicative or social spontaneity. However, it does prepare the child with AS or HFA to cope with social and interpersonal expectations, therefore enhancing his or her attractiveness as a conversational partner or as a potential friend.

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

Below are some crucial suggestions intended to foster relevant skills in this area. These suggestions can be used by parents, teachers and therapists:

1. Encounters with unfamiliar people (e.g., making acquaintances) should be rehearsed until the AS or HFA child is made aware of the impact of his behavior on other’s reactions to him. Certain important strategies (e.g., practicing in front of a mirror, listening to his recorded speech, watching a video of his recorded behavior, etc.) should all be incorporated in a social skills training program. Social situations manufactured in a therapeutic setting that usually require reliance on visual-receptive and other nonverbal skills for interpretation should be used, and techniques for deciphering the most salient nonverbal dimensions inherent in these situations should be offered.

2. Explicit verbal instructions on how to interpret other’s social behavior should be taught and exercised in a rote fashion. The following should be taught in a manner not unlike the teaching of a foreign language (i.e., all elements should be made verbally explicit and appropriately and repeatedly drilled):
  • facial and hand gestures
  • non-literal communications (e.g., humor, figurative language, irony, sarcasm and metaphor)
  • the meaning of eye contact and gaze
  • various inflections and tone of voice

The same principles should guide the training of the child’s expressive skills. Concrete situations should be exercised in a therapeutic setting and gradually tried out in naturally occurring situations. All those in close contact with the AS or HFA child (e.g., teachers, coaches, scout leaders, etc.) should be made aware of the program so that consistency, monitoring and contingent reinforcement are maximized.

3. The effort to develop the child’s skills with peers in terms of managing social situations should be a priority. This should include:
  • ending topics appropriately
  • feeling comfortable with a range of topics that are typically discussed by same-age peers
  • shifting topics
  • the ability to expand and elaborate on a range of different topics initiated by others
  • topic management

4. The child with AS or HFA should be helped to recognize and use a range of different means to interact, mediate, negotiate, persuade, discuss, and disagree through verbal means. In terms of formal properties of language, the child may benefit from help in thinking about idiomatic language that can only be understood in its own right, and practice in identifying them in both text and conversation. It is important to help the child to:
  • anticipate multiple outcomes so as to increase the flexibility with which she both thinks about - and uses - language with others
  • develop the ability to make inferences
  • explain motivation
  • predict



5. The child with AS or HFA should be taught to monitor her own speech style in terms of adjusting, depending on proximity to the speaker, context and social situation, naturalness, number of people, background noise, rhythm and volume.

6. Spoken language may be odd. Sometimes, AS and HFA kids don't have the local accent, or they are too loud for a situation, overly formal, or speak in a monotonous tone. If the youngster has a good level of spoken language, parents and teachers should not assume his or her understanding is at the same level.

7. Metaphors (e.g., “food for thought”) and similes (e.g., “as fit as a fiddle”) have to be explained, because these “special needs” kids tend to make literal and concrete interpretations.

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

8. In some cases, language acquisition (i.e., learning to speak) can be delayed. These children make much use of phrases they have memorized, although they may not be used in the right context. A certain amount of translation may be needed in order to understand what they are trying to say.

9. Both verbal and nonverbal communications pose problems for children with AS and HFA. Spoken language is often not entirely understood, so it should be kept simple to a level they can understand. Take care to be precise.

10. Lastly, here are a few additional tips parents and teachers can employ to help the autistic youngster better understand the world - and in doing so - make everyone's lives a little easier:
  • Try to get confirmation that the child understands what you are talking about or asking. Don't rely on a stock ‘yes’ or ‘no’ answers.
  • Limit any choices to two or three items.
  • Keep instructions simple. For complicated jobs, use lists or pictures.
  • Keep all your speech simple to a level the child can understand.
  • Explain why the child should look at you when you speak to him. Give lots of praise for any achievement - especially when he uses a social skill without prompting.
  • Don't always expect the AS or HFA child to “act her age.” These kids are usually immature, so parents and teachers should make some allowances for this.

One of the most significant problems for young people on the autism spectrum is difficulty in social interaction. But AS and HFA also create problems with "mind reading" (i.e., knowing what another person may be thinking). “Typical” children can observe others and guess (through a combination of tone and body language) what is "really" going on. Without help and training, AS and HFA kids can't. This "mind blindness" can lead even the highest-functioning child to make social blunders that cause all kinds of relationship difficulties.

Without knowing why, the child can hurt others’ feelings, act oddly, ask inappropriate questions, or generally open himself up to teasing, bullying, hostility – and eventual isolation. But, by using the suggestions listed above, parents, teachers and other professionals can help AS and HFA children to develop some much needed communication and social skills that will alleviate a lot of these problems.

More resources for parents of children and teens 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

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

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


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

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