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Multiple Diagnoses in Kids on the Autism Spectrum

"We have been to many professionals over the years to get help for our son. It seems as though each therapist or psychiatrist we see comes up with a different diagnosis. First, our son had ADHD ...then he had OCD ...then it was ODD ...now it's autism (on the high functioning end of the spectrum). Who are we to trust? Can he really have all of these disorders? Help!"

When parents seek help for their youngster with High-Functioning Autism (HFA) or Asperger's (AS), they encounter varied opinions from family, friends, teachers, and even professionals. For example: "he'll outgrow it" ... "leave him alone" ... "he's just being lazy" ... "he's just being defiant" ... "it's no big deal" ... "he just wants attention" ... "he's probably got ADHD" ...and so on.

Many professionals try to work with the "special needs" 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 kids on the autism spectrum. 

For the inexperienced, recognizing the defining characteristics of the disorder can be difficult, and misdiagnoses are quite common. This is further complicated by the fact that an HFA or AS youngster 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, the youngster may receive many different diagnoses over time or from different professionals. 

For example, if a young person with HFA demonstrates a high degree of attention deficits and/or hyperactivity, ADHD might be the only diagnosis he receives. However, this is a common characteristic of kids on the spectrum. The same holds true if obsessive or compulsive behaviors are displayed – the youngster gets labeled with obsessive-compulsive disorder (OCD) instead of HFA. 

The following traits are also commonly seen in those on the spectrum 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 HFA:
  • Anxiety
  • Difficulty with pragmatic language skills
  • Hyperlexia (advanced word recognition skills)
  • Motor deficits
  • Oppositional defiant disorder (ODD)
  • Sensory difficulties
  • Social skills deficits

Professionals who do not have much experience with HFA or AS 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 child or adolescent appears to be having appropriate conversations with others or seems to be interested in other people. But with an HFA child, the conversations are not generally reciprocal, so the boy or girl must be carefully observed to see whether or not there is true back-and-forth interaction. 

Also, many kids on the autism spectrum 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 (e.g., repeated hand washing 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 child who has a meltdown when a rule is violated. In essence, there is no single profile of the typical HFA or AS child.

Because of these subtleties and nuances, the single most important consideration in diagnosis is that the clinician making the initial diagnosis be familiar with Autistic Spectrum Disorders (ASD). They should have previously diagnosed numerous clients who fall on the spectrum.

To make a proper, initial diagnosis requires the following:
  1. It is important to include a speech and language evaluation, as those with HFA or AS will display impairments in the pragmatics and semantics of language, despite having adequate receptive and expressive language. This will also serve to make parents 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 ASD.
  1. The youngster should see a neurologist or developmental pediatrician (one familiar with ASD) 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 (e.g., blood, urine, fragile X, hearing).
  1. Both parents and the "special needs" youngster should have sessions with a psychologist where the child 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 parents. The psychologist may ask parents to complete checklists or questionnaires to gain a better understanding of the youngster's behaviors at home and/or school. If the boy or girl is in school, the psychologist may call the student's teacher or ask her to complete additional checklists. The checklists or questionnaires used should be ones that are appropriate for young people on the autism spectrum. It is important to determine the IQ level of the youngster as well. An average or above-average IQ is necessary for a diagnosis of HFA or AS.
  1. An evaluation by an occupational therapist familiar with sensory integration difficulties may provide additional and valuable information.

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


COMMENT FROM A MOTHER:

My name is Kim and I am writing in regards to my daughter, Naomi, who is eleven and will be in the 5th grade. I apologize ahead of time if this becomes a bit lengthy. When Naomi was in first grade, her teacher mentioned that she thought Naomi could possibly have Asperger’s. I did some research and because Naomi shows emotions and can read emotions, I dismissed this notion Although she does misplace her emotions, laughing inappropriately a lot. However, I did at this time recognize some repetitive behaviors but thought well that’s not enough to search any further. Naomi has been in speech for language impairment (receptive and expressive) since first grade and this year was reevaluated to see if she still qualified for services. After 3 years, her scores dropped significantly. In addition, her 4th grade teacher toward the end of the school year mentioned to me she thought Naomi may have Asperger’s. The combination of these two events sent me on a tail spin. I started searching and studying and was totally astonished by what I was finding. Of course, I had a couple more years of observing more behaviors since I first looked up Asperger’s. 

I always knew Naomi was different and we have struggled for years with her but really kept most of these struggles to ourselves and close family members. I kept thinking her maturity level would get better but found this year it had seemed to plummet and my concerns for her only having one more year before middle school really hurt my heart for her. I wanted to get help this summer hoping that we could get something in place this school year to prepare her for middle school. Our family doctor referred us to a pediatric psychiatric. He spent an hour with my husband and I the first visit and the second visit was suppose to be the same for Naomi. He only spent 30 minutes with her. I think this is because she does not elaborate on anything with others, sort of like school she shuts down. I had prepared and reflected back for weeks before going and made extensive notes on behaviors we have observed. When my husband and I returned for the 3rd visit, we were told she had generalized anxiety disorder. He noticed our faces drop and said, “I can sense you are not satisfied with what I’ve said.” I didn’t want to seem unappreciated of his professional opinion but in my hearts of all hearts I know my girl and I just feel like there is more to it.

Reflections of Naomi

Very Literal-

Naomi’s uncle tells her she has grown a foot. She looks very puzzled and sadly a little scared and looks down at her feet.
I tell her that I ran into someone at the store. She replies “Oh, did you hurt them.”
I was explaining to Naomi that we would be having these appointments because her teacher felt she was having some trouble….before I could explain with her language skills, she burst out crying saying she never gets in trouble and only pulled a card one time in first grade when she didn’t know that she wasn’t suppose to look at other people’s papers.
Eye appointment-Couldn’t read the smallest line after being ask several times because she didn’t see a line on the chart.

Routine-

Naomi is compelled to dress in a certain order. She gets upset if her shoes are in the bathroom and a sibling is showering. I have worked with her and she is beginning to realize that she can eat or brush her hair while waiting on her shoes but it is like she still has this need to do it.
She knows this certain route we take to the orthodontist and if it changes she letting me know we are going the wrong way.
When she was younger she wanted us to repeat back everything she said before going to bed. After we would leave the room she would keep saying goodnight and wait and if we didn’t repeat it back she would yell it out louder. Then she would say, “see you in the morning” and wait for us to repeat. This was over and over for a long time. We would tell her she had to stop and go to bed. She would get very upset. This was every night probably for a couple of years.
This last school year for the first six weeks, Naomi would ask me every day before getting out of the van “am I a car rider today?” I would reply, “Yes, you are a car rider every day and have always been a car rider.” She has been a car rider for 4 years.
About five years ago, several family or friends passed away. Every night for at least a year she would ask me “Are you going to be here in the morning?”
Still tells me and she is 11 that she’s got to use the bathroom (it’s almost like because I told her when she was potty training: “make sure you tell me if you need to use the bathroom” that it has become ingrained into her and even if I tell her she doesn’t need to tell me anymore she can’t stop. NOT every time but still a lot of the time-and I mean at home.

Dates and Times-

If Naomi knows when any appointment is she will remind you constantly. I had to schedule her appointments so she didn’t hear because she would tell me every day or every other day for a month until that appointment time.
One teacher told me that she always would remind her about certain dates or times.
If we have company coming and she knows what time that are suppose to come and they are late; Naomi will ask every few minutes where they are at until they arrive and tension mounts the later it gets.
If the time clock at a basketball is not started or the period doesn’t get changed she gets very anxious. Once at team camp, they forgot to start the clock for 3 minutes. That was the longest 3 minutes EVER!!!!!!!!!!!!! She doesn’t play sports we were watching her sister.

Emotionally-

No middle ground with Naomi
She is either extremely happy or very upset
Still cries over a bunny that died 2 years ago (sometimes not sure if she is just trying to get attention)
Laughs inappropriately a lot of the time
Very small things that seem like nothing can set her off. She could go on and on and on for an hour sometimes (having a tantrum or meltdown?).
Doesn’t want anyone to be upset with her
She worries about everybody. If someone is hurt she has lots of compassion. (if someone her daddy knows at work father dies, she will cry and she doesn’t even know them)
She cries over people on biggest loser being so over weight (she feels sorry for them)
She comes home from school upset. She will say “Mommy, I never get a card pulled.” I will tell her that’s good Naomi. She repeats and I ask her if someone got a card pulled and she starts crying. Same thing if someone gets pebbles taken out of the jar. She gets upset and tells me.
Along this same line, she tells on her brother and sister all the time for everything under the sun. If they didn’t say thank you or if they didn’t carry their dishes over to the sink or if they don’t answer when I call them she yells and tells them they need to answer me.
There was a field trip I could not attend this school year. She said the night before she couldn’t sleep because her heart was beating so hard.
Crying and throwing a fit for 30 minutes and out of the blue she starts laughing
Makes random noises a lot.
Especially when she was younger would go outside and be singing songs with words that didn’t make sense or going from one subject to another
If she is upset and you ignore she gets louder and louder (screams answer me or listen) If you answer her and it’s not what she wants to hear or she doesn’t understand the answer she keeps on and on and on

Seems to be obsessive-

List making over and over of the same thing at times even erased and rewritten over the top. List of foods. List of people at her school. People in the world. Same list over and over on different paper. I started saving and have a file folder full (This has slowed down)
When she was younger she would work the same puzzle over and over and over
Colored same picture probably 100 times would copy it over and over


Maturity level-

She talks really small (like she is 4 ) It has gotten to the point (especially at home that I am wondering if it has almost become the normal and I can’t remember her regular voice.
Fixated on princesses
Poor hygiene (not wanting to wipe) putting dirty under clothes in drawers
Wetting clothes at times
Been wearing a bra for over a year and can’t put it on correctly

Socially-

Very inward at school
If a teacher request Naomi to do errands like going to get something from the office or take something to the classroom across the hall –she will not
Doesn’t want to get in trouble at all and makes sure she tells me when she gets home if anybody else gets in trouble
Doesn’t play kickball on playground (ask her why)-she says she’s afraid she won’t understand what to do and will be embarrassed. With this being said, I really feel like she would want to deep down. Her brother and sister both play basketball and at times I think she would have liked to but she doesn’t want the coaches to yell at her and is afraid to be out in front of everybody.
All teachers have loved her and students seem to be protective especially knowing she as peanut allergy
Gets behavior awards at school
LOUD AT HOME
Hangs on to me if others approach and we are out in public
Whispers if she wants to tell me something and others are around (at a ballgame or even at her Nana’s)
Tells on everybody all the time no matter how big or how small
Gets along with children who are younger than her because they like the same things

Miscellaneous-

When Naomi was younger and I would be talking to her and the expression on her face would be as if she just didn’t get what I was saying as if it was going over her head. She will use words inappropriately (let me tell you a question) and say words that are not words
Ask her what 77 minus 1 is equal to and she is most likely will not be able to verbally tell you.
Recently, I owed her $10. Gave her a twenty and was showing her I was taking $10. She did not understand this at all. No matter how I showed her. She thought I was giving her too much. Finally, she just agreed she understood but I knew she didn’t.
She will agree a lot of the times if she doesn’t understand. This concerns me because she could easily be taken advantage of.
For two years I have had to walk to the sink at the orthodontist with Naomi (even if I am sitting 2 feet away) and finally the last few times she has gone by herself.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 More comments:

•    Anonymous said... We often focus so much energy on finding a diagnosis that we forget at the end of the day the label does not define what our child needs or who they are. Figuring out how your going to help your child reach their maximum potential is what matters!
•    Anonymous said... They are all very similar and intertwined. I just think teaching them how to cope with the umbrella of symptoms is the most important part. They are just labels that's all. Each kid is unique and different and we as parents just need to help them along the way.
•    Anonymous said... My son has them all plus sensory disorder and he has Aspergers
•    Anonymous said... I have been through same problem. Some things you mentioned are misdiagnosed because they are similar to parts of aspergers. Main thing I keep in mind is no one knows my son better than me and just because someone has letters behind their name doesnt mean they know everything.

Post your comment below…


How to Change Stubborn Thinking in Kids on the Autism Spectrum

"Once my son (high functioning) has an idea in his head, he won't budge. For example, somewhere he heard that looking into the sun will blind you (which is true). But he has taken this to a whole new level by refusing to go anywhere without his sunglasses. If he doesn't have them before we walk out the door - it's meltdown city! I've told him countless times that as long as he isn't staring directly into the sun, he's not going to lose his eyesight. This discussion goes in one ear and out the other, and this is just one of dozens of examples. My question is: how do you change the mindset of a stubborn child who refuses to listen to reason?"

In all discussions with a High-Functioning Autistic or Asperger's child about a challenging situation, there will be two aspects:
  1. the selling of an idea (your part)
  2. the buying of an idea (your son's part)
Both parts must always be considered together. The best "sales pitch" is incomplete if the new idea is not accepted or "bought." This process requires constant monitoring of progress by the "salesperson," who should look and ask for feedback from the "buyer" regarding this step-by-step approach. A cardinal rule is to never move ahead to the next step without checking to see if the "buyer" is moving with you. If he is not, repeat the last step in another way.

For your son with HFA, this means that you need to convince him that there is a better way to look at - and react to - a situation than what he has shown you. He needs to hear what you are saying, maybe even see it, and then accept it if a better behavior is to occur. 

But you must realize that new thinking doesn't occur easily, because your son is not a blank slate. He already has a competitive version of your idea. Different stories and interpretations are present in his mind that will compete with your new story or mindset. If the new mindset or thinking is to succeed, it must replace, suppress, complement, or outweigh every other story or competing version or idea. Only the most powerful argument will win-out when it comes to changing the opinion of a child on the autism spectrum.

Your prior history with your son is a very powerful force in this equation. All previous unproductive discussions and interventions that you have had with him will make your job that much harder, and must be replaced as well. To deal with these factors, you must be persistent, stick to the point, not allow irrelevant items to be brought into the conversation, and provide GOOD reasons for the new thinking (in this case, being outdoors without eye protection is not likely to lead to blindness).


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

==> Preventing Meltdowns and Tantrums in Asperger's Children

==> Discipline for Defiant Asperger's Teens

==> Teaching Social Skills and Emotion Management

==> Launching Adult Children with Asperger's: How to Promote Self-Reliance

==> Everything You'll Ever Need to Know About Parenting Asperger's Children

==> Parenting Children and Teens with High-Functioning Autism

==> AudioBook: Unraveling The Mystery Behind Asperger’s and High-Functioning Autism



COMMENTS FROM PARENTS:

•    Anonymous said... Books books books! I could tell my girl something a dozen times and its like talking to a wall. Once its written down, for some reason it sinks in almost instantly.
Why not go to an *eye* website and find something that you can print off .. maybe you can find something that says *prolonged exposure to sub can damage eyes* ... maybe just seeing it like that will make it *click* that it will just damage the eye instead of blinding him.
•    Anonymous said... Doctors and nurses can help too. My son refused to wear socks despite my every attempt to get them on his feet. Finally last year I had the school nurse call him in with her white jacket on and explain to him how socks were necessary, especially with stinky snow boots. She gave him "scientific" hygiene tips and a pair of socks that I provided and wrote him a "prescription" to wear them every day. I haven't had a problem since getting him to wear them.
•    Anonymous said... First of all, I'd like to let you know that i totally understand your own frustration with the unflexibility of your child, it can be so frustrating to us as parents who just want our child to listen to reason. At times my son would get an idea in his head and to me it sounded so unreasonable but in his mind seemed so logical. It does get easier when they get older because you can just let them do the research themselves, when they are younger they tend to not understand idioms. I focused on teaching the understanding that all things people say are not always exact, and if they have a doubt do research... Im pulling for you, it gets easier, i promise!
•    Anonymous said... Having this same problem, I try to let the small battles go. But once my son has an idea formed, there is no letting it go. I have noticed that if someone else tells him, besides his Father or I, he does have more of a tendency to believe them.
•    Anonymous said... HUGS. I have had some success with having my son research the topic on the internet, and then write a couple of ideas down, such as things he can/should do, and things he can't/shouldn't, based upon the research. He won't believe what I tell him, but he will listen to "scientists." And yes, pick your battles! Some things are important in the long term (for self-esteem, education, etc) and some are not.
•    Anonymous said... I allow mine to have his individuality.. When we go through these stages I always make sure I have backup.. ie an extra couple pair of sunglasses in the vehicles in my purse etc etc..
•    Anonymous said... I can empathize & I agree that showing him the info in written form can help since visual cues often work where talking doesn't . Having teachers, etc. reinforce it would be good as long as it's not all at once, just when it naturally comes up. Otherwise, he might feel overwhelmed/ganged up on. Not sweating "small" stuff is good too
•    Anonymous said... I don't try to change my child's mindset, instead for the time being, I let him continue to have what he needs, as long as it doesn't harm him, and continue to let him know that it works a particular way. I also encourage other adults around him (Scouting Leaders, Teachers, Parents of friends, etc) to tell him the same thing, thus showing him it's not just Mom or a Parent in general who is telling him this. You will run into this more and more as he learns more at school and his mind runs wild with the knowledge. My son is now 13 and is doing much better with understanding that everything he hears isn't 100% true, that there are other ways to look at things, although sometimes it doesn't come quickly. Hang in there!
•    Anonymous said... I think some of this gets easier with age and your continual teaching and instructing. Mine used to cry and meltdown even if the diversion in the schedule was getting ice cream something she loves. Now she is 9 and says it is still very hard to deviate the plan but she does it with no meltdown because she is beginning to understand this world is always changing. I always try to give her a list of where and what we are doing so this helps and if I think a change will happen I express it up front. She still has these at times but way less than before.
•    Anonymous said... My aspie son does the same but I let it take its course providing it does not cause him harm. Anyway wearing sunglasses is not a bad thing as it protects the eyes from harmful uv rays and cuts down on wrinkles. I try so hard to get my son to wear them.
•    Anonymous said... my heart goes out to you and to your son. No one can understand that for all of us there are just no easy answers. Keep strong and keep connected.
•    Anonymous said... My son does that occasionally and then we start reasoning with him. In this case, I would say "so many people go outside and their eyesight is fine" if they lost their vision would they still be going outside?" He will think about it for a minute and then say "okay, that sounds ridiculous". There still are some things that he is very stubborn on though.
•    Anonymous said... My son is 14 and, for me, it's getting more difficult with age. I'd love to just "enjoy him" and I find I'm enjoying him less. Much of it has to do with this exact poster's question. At 14 people (and I so I realise I need to work on myself) expect him to b able to reason and understand and agree to cultural norms. It truly is like talking to a brick wall and its crazy making for me (and him). These things don't seem to ease his anxiety if I 'allow' them to run their course. His perseverating actually increases his anxiety and ensures he's even more isolated and depressed once he becomes aware he doesn't fit in or is liked (something else that's increased with age - his awareness of his 'situation'). He understands that he doesn't understand cultural norms and it actually devastates and/or angers him, and definitely alienates him more. I worry for his future and for our relationship. We r desperate for advice in this area!
•    Anonymous said... My son is 16 and, when he was younger, his ideas needed to be everybody's ideas and he didn't understand why they weren't. He took (and still does depending on what it is) everything so literal that when somebody said it was raining cats and dogs outside, he cried and cried and looked out the window thinking he was going to see cats and dogs falling from the sky. What Lori and Angela say is 100% correct and sometimes the only thing that you can do. Now that my son is in his mid-teens, he still has moments where his ideas need to be everybody else's ideas, but I just gently tell him that he needs to do or think what he thinks and not force those things on others because everybody is going to have their own mindset, just as he does. Whether he thinks what others think is right or wrong, he still needs to respect other's way of thinking just as others respect his. Once he is able to process through what I say, it seems to make sense to him but it is just giving him the time to identify those certain mindsets for himself and come to his own conclusions, whether they are right or wrong.
•    Anonymous said... My son wore a bike helmet for months bc he was convinced the sky was going to fall. We just went with it. I've found that most of these fixations run their course if you reinforce a positive outcome and Not focus too much on it unless its a danger or harmful in any way. Wishing you luck and patience in these situations. I hope it gets easier for you both.
•    Anonymous said... One lesson I learned was to try and invade their thoughts with them and then redirect to something else.Example I heard was a little girl would not go sit at restaurant with family,as she was ocd about tracing letters on a sign in the building.The mom had to go to the sign and trace the letters with her hand on her daughters,and then gently break away from it with her. If you can figure out how,getting inside his thoughts and going thru it to another alternative may help. Good luck.
•    Anonymous said... Pick your battles carefully. Put your foot down about the important things, not wearing sunglasses. I do, however, also like the idea of looking up reference info to show him in hopes it could lower his anxiety.
•    Anonymous said... The child's reasoning is sound reasoning for him at that time. My son would have an absolute fit when his early elementary class (regular class) would deviate from the "literal" instructions the teacher would give- of course, as you all know, the instructions were not to be taken literally but rather idiomatic. He will learn for himself when he sees the thousands of people walking around without sunglasses that he doesn't need to wear them all the time. We take so much solace that now our son, now 12 years old, asks for clarity when he senses that there may be something he is not quite understanding the way everyone else is.
•    Anonymous said... You don't. You just have to deal with it. My son is now 23 and those ideas he got into his head somehow long ago are still with him.
•    Anonymous said… My son is an adult now. Asbergers was not a thing when he was younger. I would have given anything for someone to tell me the following when he was a child: your son lives in an exceptional world. I can almost promise you that he is never going to adapt to your world because he simply cannot. You, however, can adapt. It will be a lifelong journey, but to adapt...you have to REALLY listen without your own agenda or itinerary. Listening without expectation or judging based on our truth. Listen without arguing. Your son will begin to feel that talking to you is SAFE and you will be introduced into a world thst will surprise and challenge you. It is amazing. As you begin to understand how and why he thinks like he does...you will learn how to teach him truths that matter to him because you are speaking his language. I promise you will never convince him that you sre right through any amount of reasoning.
•    Anonymous said… science, really, if you can find information on the retina in an (almost) age appropriate format (usually aimed at a slightly older age group as aspies are often ahead intellectually) and show it to him, I always find my boy feels safer when he has as much information as possible, and a safe boy has less meltdowns x
•    Anonymous said… That is an amazing insight. My son is 5yo. On the end of the diagnosis stage. I really appreciate your view. Thank you. It will help me immensely!

Please post your comment below…


Tips for Teachers: Understanding Your “Difficult” Students with ASD

"My daughter was diagnosed with high functioning autism recently. What critical details can I provide to her 5th grade teachers to help them understand her cognitive, emotional and social characteristics? (I am a teacher as well, 7th grade, different school). She apparently is not doing so well in the current situation."

Most children with Asperger’s (AS) and High Functioning Autism (HFA) are impaired socially. They often do not detect social clues and are frequently unaware when they irritate others. Since they miss these social clues, they miss the lesson associated with the experience. As a result, they tend to repeat the irritating behavior since they are unaware of its effects.

Many of the traits of AS and HFA are "masked" by average to above average IQ scores. This often results in the student being misunderstood by teachers. They assume the child is capable of more than is being produced. This lack of understanding may result in teachers treating the "special needs" student just like a "typical" student.

Another misunderstanding is the relationship between the classwork and social education. For instance, an AS or HFA youngster may find a social setting overwhelming and distracting. If kids are placed in a small group to work together on a project, this could become a social setting to the AS/HFA child. As a result, the child may be over-stimulated by the social aspect to the point where he or she can’t focus on the project itself.
 
The typical school environment is often very stressful for AS and HFA students, for example: (a) enduring “socialization hell” in the form of recess, lunch, gym, and the bus ride to and from school; (b) regular noises from alarms, bells, schoolmates, band practice, and crowded hallways; (c) periods of tightly structured time alternating with periods lacking any structure; (d) numerous daily transitions with a few surprises thrown in here and there; and (e) an overwhelming number of peers to contend with. Little wonder why AS and HFA students have the proverbial “meltdown” on occasion. All of these stressors should be taken into consideration when evaluating what types of teaching techniques to use with these youngsters.



Taking the above challenges into account (and there are many more than those listed), let’s now look at some specific techniques to employ with students on the high-functioning end of autism:

1. Although AS and HFA kids have difficulty figuring out most principles of social interaction, they are usually pretty good at understanding “cause-and-effect” principles. This suggests that, although these young people may be unaware of another person’s desires or emotions, they usually are aware of theirs. This can be useful in education if the teacher takes the time to figure out what is pleasing to the youngster. Once this pleasure has been discovered, the teacher can request the desired behavior and reinforce the behavior with the object or activity of desire.

2. AS and HFA children, like all others, change teachers each year. Additionally, there is the requirement of moving from elementary to middle school, and then on to high school. Thus, it’s important to have a "transition-planning meeting" scheduled prior to such transitions. This meeting allows the previous teacher to inform the incoming teacher on successful techniques, as well as provide general education on the traits of AS and HFA. The child should be orientated as well. Allowing the child extra time to become familiar with a new environment will prevent unnecessary stress during transitional periods.

3. AS and HFA students are visual learners. Thus, a visual schedule of the day's activities, a visual depiction of the type and length of the work expected, and instructions presented visually in addition to verbally can be very helpful. Visual instructions and schedules help these children to feel more secure and less stressed.

4. Because AS and HFA children have difficulty learning in a traditional manner, mild to severe depression can occur. These children have the capability to acquire information, but their performance is hindered. A depressed child will undoubtedly have some academic struggles. For AS and HFA children, depression is just one more barrier to education. Thus, teachers should be on the lookout for signs of depression in these “special needs” students and make a referral to the school counselor when needed.


5. Imagine nails scraping on a chalk board. It sends a chill down your spine – right?! To a youngster with AS or HFA, every day sounds can have a similar affect. Thus, it’s important for the teacher to take inventory to determine sounds difficult for the child to hear. Consider allowing him or her to listen to soft music with headsets during class times when there is a lot of distracting noise. Earplugs are another solution.

6. In middle and high school, passing periods are a desirable time of socializing for most “typical” children. For the AS or HFA child, passing periods are a social zoo. Thus, allowing the child to leave 5 minutes early in order to avoid the overwhelming social interaction is recommended. Without such an option, the child may spend most of the next class trying to recover from the distressing sensory overload experienced during the previous passing period.

7. Many students with AS and HFA are impulsive.  You may have a child who loves class participation, but has trouble sensing when he or she should stop talking and give someone else a chance.  Thus, work out a signal that only the two of you know (e.g., tapping your chin with your index finger, standing in front of that child's desk, etc.) that cue him or her that it's time to stop talking.   If you have an AS or HFA child who is especially eager to participate, you may want to routinely call on that child first so he or she isn't jumping out of the chair in an eagerness to contribute.

8. Minimizing the stress and worry AS and HFA children face is critical to education. Frequent changes in routines make it difficult for these kids to focus on the schoolwork due to preoccupation concerning what will come next in the day. Teachers should try to minimize transitions and insure the environment is predictable. When there are changes in the routine, these children should be prepped ahead of time in order to help them avoid excessive anxiety.

9. Oftentimes, “teacher frustration” can develop from a lack of understanding that an AS or HFA child is unable to generalize the skills that he or she learns. For instance, the teacher may give instructions on “how to address me as your teacher” (e.g., raising your hand first, saying “Mrs. Johnson” rather than “Hey teacher”). Typically, this skill would then be generalized to any adult in a position of authority. However, the child with AS or HFA is likely to only apply the skill to the teacher initially used as the target of respect in the learning process. The child will probably not apply this behavior to the principal, school counselor, school police officer, etc. Thus, teachers may need to repeat a particular “social skills lesson” several times so that all the possible scenarios are covered (i.e., addressing the teacher, addressing the principal, addressing the dean, and so on).

The inability to generalize can also pose a problem in classroom assignments. For example, giving instructions to open an arithmetic book to a certain page does not communicate to additionally begin solving the problems. Thus, teachers should verbally give all the steps necessary to complete an assignment rather than assuming the AS or HFA child will automatically know what to do next.
 
==> The Complete Guide to Teaching Students with Aspergers and High-Functioning Autism

10. There is another critical aspect of learning that is not obvious to AS and HFA children. This aspect of learning includes the basic “how to’s” of living. These are things that “typical” children seem to just know. The social know-how that tells most kids what is inappropriate conversation material may be foreign to an AS or HFA child. Thus, teachers instructing children struggling in this area should make use of social stories and role-playing. Social stories and role-playing give examples of proper actions in given public settings.

Teachers need to understand what the disorder is – and how it hinders affected children. Without a clear understanding of this disorder, teachers will not understand the "special needs" child. Actions that are clearly a part of the disorder can be confused with behavioral issues and dealt with inappropriately. Also, teachers must educate themselves on effective teaching techniques for students on the spectrum. 

The basic principles that prove effective with “typical” children work for those with AS and HFA. Every “special needs” youngster needs to be evaluated, and have a plan established addressing areas of weakness – as well as acknowledging areas of strength. Perhaps most importantly, teachers should “believe in” the child and expect him or her to reach appropriate grade level requirements.




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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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.

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My Aspergers Child - Syndicated Content