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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

Developmental Coordination Disorder in Children on the Autism Spectrum

 "Are children with ASD usually late in developing fine and gross motor skills?"

Initial accounts of Asperger’s (high functioning autism) include descriptions of Developmental Coordination Disorder (DCD). Kids on the autism spectrum are often delayed in acquiring motor skills that require motor dexterity (e.g., bicycle riding, hand writing, tying shoe laces, opening a jar, etc.) and may appear clumsy.

Many of these young people exhibit an odd gait or posture, poor coordination, problems with conceptual learning, difficulty with visual-motor integration, and trouble with visual-perceptual skills.

DCD is a chronic neurological disorder beginning in childhood that can affect planning of movements and coordination due to brain messages not being accurately transmitted to the body, and is diagnosed in the absence of other neurological impairments (e.g., Parkinson's disease, muscular dystrophy, multiple sclerosis, and cerebral palsy). DCD is more common in boys than girls (approximately 4 males to every 1 female).



In addition to physical impairments, DCD is associated with memory problems (e.g., problems with organizing one's time and remembering deadlines, problems carrying out tasks that require remembering several steps in sequence, increased tendency to lose things, and difficulty remembering instructions).

Other problems that Asperger’s children with DCD may experience include:
  • struggling to distinguish left from right
  • problems with balance 
  • poor sense of direction 
  • moderate to extreme difficulty performing physical tasks 
  • low muscle tone
  • fatigue due to so much extra energy being expended while trying to execute physical movements correctly
  • difficulty moderating the amount of sensory information that their body is constantly sending them, and as a result, they are prone to sensory overload and panic attacks

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

In the preschool youngster with DCD, common traits reported by moms and dads include a history of delayed developmental milestones, especially crawling, difficulty making friends, difficulty with dressing, immature art work, poor ball skills, speech, and walking.

In the elementary school youngster, common traits include difficulties in copying from the blackboard, slow/immature/laborious handwriting, and persistence of (and no improvement in) the problems noted in the preschool years.

DCD affects both fine and gross motor control. Let’s look at each of these in turn:

Fine-motor problems can cause difficulty with a wide variety of tasks (e.g., brushing one's teeth, doing chores, fastening buttons, locking and unlocking doors, brushing one's hair, using a knife or fork, etc.). As mentioned previously, there tends to be problems with handwriting (e.g., the acquisition of graphemes such as letters of the alphabet and numbers, learning basic movement patterns, establishing the correct pencil grip, developing a desired writing speed, etc.).

Gross motor control is the ability to make large, general movements. Body image issues, motor coordination, and whole body movement mean that major developmental targets (e.g., climbing, jumping, running, walking, etc.) can be affected. The problems vary from child to child and can include:
  • bumping into people accidentally
  • clumsiness to the point of knocking things over
  • cross-laterality, ambidexterity, and a shift in the preferred hand 
  • difficulty combining movements into a controlled sequence
  • difficulty in determining left from right
  • difficulty remembering the next movement in a sequence
  • poor balance 
  • poor muscle tone and/or proprioception
  • poor timing
  • problems with chewing foods
  • problems with spatial awareness
  • tripping over one's own feet
  • trouble picking up and holding onto simple objects

Developmental Verbal Dyspraxia—

Developmental Verbal Dyspraxia (DVD), sometimes referred to as “childhood apraxia of speech,” is a type of DCD that can cause speech and language impairments. The key difficulties include: 
  • controlling the speech organs
  • making speech sounds
  • sequencing sounds within a word or forming words into sentences
  • controlling breathing
  • suppressing salivation and phonation when talking or singing 
  • slow language development

Research has found that children with DCD and normal language skills still experience learning difficulties despite relative strengths in language. This means that for a student with DCD, her working memory abilities determine her learning difficulties. Any strength in language that she has is not able to sufficiently support her learning.

Assessment—

When the issue is raised, the child’s doctor is likely to make a referral to a physiotherapist and/or occupational therapist to help in the diagnosis of DCD, and may involve educational, clinical or neuropsychologists in the assessment of associated problems.

The two main questions to be answered when assessing a child with possible DCD are, first, does he or she have significant coordination difficulties compatible with DCD and, second, is there an underlying neurological or physical disorder? An underlying neurological or medical disorder should always be considered and excluded.

Assessments for DCD typically require a developmental history, detailing ages at which significant developmental milestones occurred (e.g., crawling, walking, etc.). Motor skills screening includes activities designed to indicate DCD (e.g., variations on walking activities, touch sensitivity, physical sequencing, and balancing). Screening tests that can be used to assess DCD include:
  • Bruininks-Oseretsky Test of Motor Proficiency
  • Movement Assessment Battery for Children
  • Peabody Developmental Motor Scales
  • Test of Gross Motor Development

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

Therapists use a range of activities to assess the youngster's level of ability in certain crucial areas (e.g., body awareness, cerebral integration, kinesthetic awareness, limb girdle stability, and motor skills).

Treatment—

In general, therapists use two main methods of treatment: process orientated and task orientated. Process‐orientated therapy concentrates on developing sensory modalities involved in motor performance (e.g., the sensory integration approach). The task‐orientated approach aims to improve specific tasks through practice.

Other approaches have focused on improving the child’s self‐esteem rather than the core problems of coordination. Some clinics offer transitional programs to help kids with DCD meet the increasing physical and educational demands when moving from primary to secondary education.

Although kids with DCD usually benefit from physical therapies, many receive as much benefit from psychological support to help them develop compensatory strategies, and cope with their motor impairment and loss of self‐esteem.

Although there is currently no cure for DCD, early intervention may help to reduce the physical, emotional, and social consequences that are often associated with this condition. Without intervention, Asperger’s kids with DCD will continue to exhibit poor motor skills – and show deficits in other areas as well. These young people can - and do - learn to perform certain motor tasks, but they have difficulty when faced with new, age-appropriate ones and are at risk for secondary difficulties that result from their motor challenges. Also, it is important to note that kids with DCD often experience considerable difficulties at school; therefore, it is necessary for parents to educate their child’s teachers about this disorder.


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

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...

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