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Insomnia in Kids with High-Functioning Autism and Asperger's

“What do you suggest for my 4-year-old boy who has a hard time getting to sleep at bedtime, but can’t take melatonin? He has an allergic reaction to that supplement (gives him headaches). And why does it seem that so many high functioning autistic children have trouble going to sleep – even when they are exhausted?”

Researchers don't know for sure why HFA kids have problems with sleep, but they have several theories. Here are the main ones:
  1. Anxiety: Stress or anxiety is a possible condition that could adversely affect sleep. HFA kids tend to test higher than other kids for anxiety.
  2. Low levels of nighttime melatonin: Melatonin normally helps regulate sleep-wake cycles. To make melatonin, the body needs an amino acid called tryptophan, which research has found to be either higher or lower than normal in kids on the spectrum. Typically, melatonin levels rise in response to darkness and dip during the daylight hours. Studies have shown that some kids with HFA don't release melatonin at the correct times of day. Instead, they have high levels of melatonin during the daytime and lower levels at night.
  3. Sensory sensitivities: HFA and Aspergers kids may have trouble falling asleep or awaken in the middle of the night due to an increased sensitivity to outside stimuli (e.g., touch or sound). While most kids continue to sleep soundly while their mother opens the bedroom door or tucks in the covers, the youngster might wake up abruptly.
  4. Ignoring social cues: Most “typical” kids know when it's time to go to sleep at night thanks to the normal cycles of light and dark and their body's circadian rhythms. But they also use social cues (e.g., kids may see their siblings getting ready for bed). These kids may misinterpret or fail to understand these cues.



Sleep problems are some of the most common problems moms and dads face with their children. Most Aspies have sleep difficulties, and many are actually going through their days sleep-deprived. 
 

Here’s how you can help your child with Aspergers (High-Functioning Autism) get to sleep in a reasonable amount of time – even if he can’t take melatonin:

1. An hour before bedtime, avoid all physically stimulating activities (e.g., running, jumping, climbing, etc.).

2. An overnight sleep study may be recommended for your son, especially if he has excessive daytime sleepiness or problems staying asleep. The sleep study will help determine if he has a diagnosable problem (e.g., pure snoring, obstructive sleep apnea, restless legs syndrome, etc.). These disorders may require specific therapy that your son’s doctor will prescribe.

3. Avoid feeding your son big meals close to bedtime, and don't give him anything containing caffeine less than six hours before bedtime.

4. Avoid scary stories or TV shows prior to bedtime.

5. Establish a consistent and relaxing bedtime routine that lasts between 20 and 30 minutes and ends in your son's bedroom. Maintaining a predictable and soothing bedtime routine is critical with Aspergers children. Bathing, brushing teeth, singing lullabies, and reading books are some suggestions for a nightly routine.

6. Feed your son bedtime snacks that contain the amino acid “tryptophan.” Tryptophan helps the body to produce the sleep-inducing chemical serotonin. Tryptophan-containing foods include dairy products, whole grains, poultry, rice, eggs and sunflower seeds.
 

7. Give your son tools to overcome his worries. These can include a flashlight, a spray bottle filled with "monster spray," or a large stuffed animal to "protect" him.

8. Have him get used to falling asleep with a transitional object (e.g., a favorite blanket or stuffed animal).

9. If your son calls for you after you've left his room, wait a few moments before responding. This will remind him that he should be asleep, and it'll give him the chance to soothe himself and even fall back asleep while he is waiting for you.

10. If your son comes out of his room after you've put him to bed, walk him back and gently - but firmly - remind him that it's bedtime.

11. It's better to read a favorite book every night than a new one because it's familiar.

12. Keep the bedroom as quiet as possible for your son. If outside noise is unavoidable, use a sound machine or stereo to block noise.

13. Make sure your son has interesting and varied activities during the day, including physical activity and fresh air.

14. Make sure your son is comfortable. Clothes and blankets should not restrict movement or be too itchy, and the bedroom temperature shouldn't be too warm or too cold.
 

15. Put some thought into finding your son’s ideal bedtime.  In the evening, look for the time when he really is starting to slow down and getting physically tired. That's the time that he should be going to sleep, so get his bedtime routine done and get him into bed before that time. If you wait beyond that time, then your son may get a second wind.  At that point, he will become more difficult to handle and will have a harder time falling asleep.

16. Remove the television from your son's bedroom. Television stimulates the brain, making sleep difficult to achieve.

17. Set up a reward system. Each night your son goes to bed on time and stays there all night, he gets a star. After three stars, give him a prize.

18. Talk to a sleep psychologist about bright-light therapy. Exposing your son to periods of bright light in the morning may help regulate the body's release of melatonin.

19. To prevent sensory distractions during the night, put heavy curtains on your son’s windows to block out the light, install thick carpeting, and make sure the door doesn't creak.

20. Warn your son that bedtime is in five minutes or give him a choice, for example, "Do you want to go to bed now or in five minutes?" …but do this only once.

How To Help Other Family Members Accept Your Child's Diagnosis

"I'm a stay-at-home mom. My husband works out of town and is only home on weekends. My question is how can I get my husband and in-laws to accept our daughter’s diagnosis (high functioning autism)? They claim I am just 'making this up' and that it's really a behavior problem with her – not a 'disorder'."

This is not surprising, and you're not alone. High-Functioning Autism (HFA) and Asperger's (AS) is hard to see if you don’t live with it every day like you do. Also, some family members are simply in denial. Either way, the truth should come out.

Accepting the presence of this high functioning form of autism can lead to the best possible support and treatment available for your daughter. It’s crucial that all family members are on the same page. You could survive handling everything on your own, but life will be much easier for the whole family when everyone is working together to care for your daughter.

Some family members will choose to stand on the outside. You can’t do much about that. Nonetheless, you can equip them with information about autism spectrum disorders so they can make a choice regarding the position they plan to take.

Here are some tips on how to accomplish this:
1. Contact your local Autism support groups. Without family support, it is crucial that you find encouragement elsewhere. Tell your husband about community events or group meetings so he has the opportunity to stay informed.

2. Find books, eBooks, videos, and other media sources that you can share with your family. A great place to start is with one of the resources listed below this post.

3. If you haven’t done so already, involve your daughter in therapy with a professional who works with children on the autism spectrum. Hopefully, your daughter’s therapist will offer parent-training sessions. These sessions allow you to ask questions about your daughter’s program and her progress, while also educating you on her new goals and coaching you on how to meet these goals. Invite your husband and in-laws to attend this parent training. They can ask questions that will help them understand your daughter’s disorder.

4. Network with other parents raising children on the spectrum. Listening to the stories of those parents who are ahead of you in the journey can give you and your husband insight into the disorder. Here are our two Facebook support groups:

5. Maybe your in-laws simply need to hear the truth from a doctor. Official paperwork containing your daughter’s diagnosis is available from your doctor, neurologist, or therapist. You can request copies of any Early Intervention assessments, private therapy evaluations, and school system evaluations. Explain to your in-laws that these individuals are professionals who see autism spectrum disorders every day. You can also mention that the assessments and evaluations rely on much more than your input, removing any possibility that you are “making this up.”

6.Lastly, get the support you need to help yourself and your daughter. Try not to worry about how the other family members are dealing with this. Always encourage their participation, but concentrate on your daughter’s needs.

Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> 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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.


PARENTS' COMMENTS:

Anonymous said…  I think the acknowledgment is there, the trouble is, most people do not know the true difficulties and how it effects everyday life Every day is a struggle and every day brings new challenges. People who are not with your child day in and day out may think it is not a big deal and is easy... it is NOT. Also, that Aspies cannot be disciplined and treated the same as average children to get results.

Anonymous said…  From my personal experience, my son's Aspergers was not as apparent in the home setting in isolation from his peers. Once I saw him at school and noticed the stark difference between him and the other kids and how he did or did not interact with them it was much more obvious. Family members don't always get to see that, so it can be harder to make believers out of them.

Anonymous said…  My sister, who also has a degree in education, babysat my son along with his same aged cousin when they were both 2. She also taught a couple days per week at a Mother's Day Out day care setting. She noticed that my son was very different and often kept him with her because some of the other teachers were less able to handle him. Though my son is good at heart, his bad social judgment often resulted in issues at school each year. It was very frustrating! So when an insightful teacher recommended testing for him in 4th grade, resulting in the diagnosis, we finally had an explanation that made perfect sense to all of us! And I felt better about the future because his teachers could now better understand him instead of writing him off at just "passive aggressive" or simply "difficult." I think if people realize that a diagnosis can yield better understanding and teacher training gives teachers tools for better working with kids, then family can feel better about the child's prognosis and outcome.

* Anonymous said...  Love these articles. A lot of us deal with things similar. This is definitely something that happens with this diagnosis. Even I as the parent of a kiddo that has these tendencies, sometimes would question whether it was just a "behavior problem" or not...whether it was my parenting style or not. If you aren't with the child 24/7, you don't see the whole picture at all. Being education is so important. When one is educated on this particular diagnosis...so much falls into place. 

* Anonymous said... i am now a single-mom to one ASD son & one non_ASD daughter. I lived out of state for 3 years. I couldnt wait to get back hom with my kiddos (& then husband). But noone welcomed us....not even my own mother (this was before the autism diagnosis). Even after, no one wanted to learn about it...we were just too much inconvience for their lives. I also kicked my husband out for various reasons....but "failure to understand autism" was a big one. It's a lonely life. Me & my 2 kids usually stay home & do the same routine everyday. I try to avoid public...because no one understands, & i dont want my children hurt :o( i'm from a state who fears "different people"...i've always been alternative myself. But, God, if you can at least help your husband "get free" & love you all like you are..that would be awesome for you guys. Who cares what in-laws (or even your own folks think!) let them learn! Or stay away. The world needs to be more open-minded not in "words at church" or "words on social media"
 
•    Anonymous said… I had this a lot with some friends & family and what I did was sent them a link to the National Autistic Societies website and asked them out of Respect to please read it, take it in and that the very fact they are choosing not to Learn more and accept our child for the way he/she is - hurts us more than our child's Diagnosis! Some really made the effort to read more and some didn't bother! This is very common and I have to be honest and say I chose to close the door on those that would not accept my son for who he is! You are not alone! Keep your head up and just always put your child before others
 
•    Anonymous said… Thankfully most people in my life are accepting and understanding, but I have this problem with my sons father... He refuses it completely, and during the long process of getting a diagnosis of Aspergers, he tried to make me stop taking our son to the appointments completely. I would like to say things are getting easier, but since my sons diagnosis, his father and I have actually split up, after 22 years together, and sadly this was one of our major issues that caused it. It's exhausting.. It's all on my shoulders.. I work day after day with my son..And then he goes and spends a weekend with his Dad and comes back to me in turmoil because his Dad refuses to learn how to properly deal with a child with Aspergers. I've tried everything to get him to face reality unsure emoticon I think there are some people who will just never get it..
 
•    Anonymous said… Unfortunately a lot of the symptoms are typical of "normal" kids but when you add them all together they spell Aspergers. I think this website has a concise list that might help those who don't want to read much. My son pretty much had all the symptoms but most of them were fairly mild. Had we not had him in a daycare setting where his caretakers would notice his interactions, we may have just written him off as quirky. Early intervention is the key. He is now seven and was diagnosed between 2 and 3 and it's made a HUGE difference. He has "outgrown" most of his issues but still has social problems to a degree. 
 

*   Anonymous said... My parents and siblings clearly think my kid's diagnosis is bogus (they haven't said in so many words, but keep hinting at it). It used to annoy me, but I actually don't care; they love and appreciate him as he is, quirks and all; so I don't feel the need to shove a diagnosis down their throats. 

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High-Functioning Autism and Associated (Comorbid) Disorders

“We’re in the process of having our son assessed for high functioning autism. We’ve had numerous problems in the past that have brought us to this point. The doc said he believes our son may have several ‘comorbid’ conditions as well. What other conditions might there be?”

When a youngster has one or more conditions along with the main disorder, it is defined as comorbid and comorbidity. High-Functioning Autism (HFA) – also called Asperger’s (AS) – is listed as an Autism Spectrum Disorder and rarely travels alone. Nearly 100% of the time, the child will have other issues that will need to be addressed.

Here are some of the common comorbid conditions associated with HFA and AS:

1. Attention Deficit Hyperactivity Disorder (ADHD) is a very common comorbid condition of HFA and AS. Here the youngster is unable to concentrate and becomes impulsive to a great degree.

2. Depression and anxiety are the two most common disorders found in a youngster with AS or HFA. Adolescents on the autism spectrum often suffer from depression, which may be caused by (a) being bullied and teased, and (b) coming to the realization that they are different from their “typical” peers. Some of these young people have been known to turn to drugs and alcohol as a way to deal with their plight.

3. Dyspraxia is when a youngster is not able to coordinate or perform certain acts in spite of having the prior plan for it. This disorder is one reason why kids with HFA and AS have always been described as clumsy.

4. Meltdowns are “tantrum-like” behaviors in HFA and AS children. Yelling, hitting, screaming, or a complete shutdown (e.g., covering the face and becoming withdrawn) are common during a meltdown.

5. Obsessive Compulsive Disorder (OCD) is something that is found in most kids on the autism spectrum. The child adheres to strict routines, and she likes to keep every particular object in one particular way – and when changed, she may get very distressed. This is one habit which later on leads to OCD.

6. Oppositional Defiant Disorder (ODD) is a condition in which a youngster displays an ongoing pattern of uncooperative, defiant, hostile, and annoying behavior toward people in authority. The youngster’s behavior often disrupts his normal daily activities within the family and at school.

7. Sensory Processing Disorder (SPD) is common among those that have AS or HFA. In this case, the youngster becomes overly-sensitive to the various sensory stimulations (e.g., forms an intense dislike of loud noises, is easily irritated when dealing with unusual textures, avoids certain foods because they taste bitter, etc.).

8. Tourette’s syndrome is when a youngster exhibits repetitive vocal or motor tics. Most kids diagnosed with Tourette’s also have AS or HFA.


Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> 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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.
 
 
PARENTS' COMMENTS:

•    Anonymous said… A friend of mines son is 14 with aspergers. He wants to interact but has so much trouble. We were all introduced to him as a wonderful child who has an interesting view on life. Our group of friends are great. The 14yr old likes to shake everyones had when they arrive and then walks off. We are glad that despite the fact that he knows how different he is he trys to make an effort. I hope that I am blessed to still have this group of friends when my 7yr old is that old.
•    Anonymous said… Good luck to all - its just who they are, and we just have to adapt and continually educate others so they can too. I just keep up my own mantra: "it's all good" and smile broadly at the fact that while he may be socially challenged, my son is smart and has a heart of gold, despite the fact that he doesn't verbalize it.
•    Anonymous said… He must be high functioning. Aspergers is on the high functioning side of autism anyway - but some are higher than others. So, "uncommon"? I would say yes.
•    Anonymous said… I do think the gap gets bigger as they get older. My son really gets along better with either younger children or adults because of this. He used to quote star wars too, btw, lol! Now he is constantly talking about Final Fantasy 7, and most kids don't even have a clue what that is since it is an old playstation game. Thankfully my hubby is a huge gamer and can carry a conversation with him. lol
•    Anonymous said… I will add my vote to that of the other commenters. My son is the same way - playing 'next to' not with, or fully directing the game choices, character choices, rules and all else whenever he does attempt to play 'with' someone - and forbid they don't want to play along by his rules, then we have arguments and meltdowns because he can't tolerate "that's not how you play". His poor sister - she feels like she can't win; its all about him!
•    Anonymous said… My 7 year old is high function Aspergers. He is overly social but has no boundaries. He hugs and has no personal space. We are often told that there is no way he could have Aspergers but they don't realise that this behavour is only one aspect of Him. When he meltdowns over getting dressed or getting in the car I have no doubt. At the end of the day you are his parent and see Him for who he is and everything he does trust yourself.
•    Anonymous said… My aspie is very social in that he loves being around other kids, but he isn't popular. He highly lacks in social skills despite his "socialness". It's like he wants friends but making friends is hard and he doesn't realize whenever someone is being mean.
•    Anonymous said… My son is almost 8 and the "social rules" have gotten a lot more complicated from when he was 5.
•    Anonymous said… My son is is the same as far as boundaries, when he plays with other kids we have to remind him to back up because he will talk (very loudly) into their face instead of to it. @ Jessica, you're absolutely right, what is accepted at 5 won't be at 8. I know my son also won't understand when someone is being mean to him. You guys gave me lots of food for thought and I really appreciate your input :).
•    Anonymous said… My son loves being with other children but just doesn't seem to know how to play WITH them. He orders them around and expects to play all games his own way. Every year seems to get harder as the social gap between the kids getts wider. In his defense he is starting to learn more and more social ideas though doesn't seem to understand why we do them.
•    Anonymous said… Ryan was diagnosed HFA/Asperger's and he is how you guys describe. He loves people, but has no social "skills" -- he can't tell when people don't want to play with him or talk to him. He tries to hug on perfect strangers in stores and such. He is bossy with HOW games are played (everyone has to follow his rules or they can't play anywhere near him). I don't think that this type of social behavior is uncommon at all for Aspies. Many areas of documentation explain this as fairly typical Asperger's behavior... it's one of the determining factors that separates it from other areas on the spectrum. They generally WANT friends, they just don't know HOW to make them, where other auties are more or less oblivious to everyone else around them. What seems to happen as the children get older and the social gap becomes larger and your Aspie son is still quoting comic books and Star Wars characters when all the other boys are chasing girls, they become less social. They learn that the other kids don't want to do the things they want to do, and then they begin to focus less on the social interaction.
•    Anonymous said… This summer we sent them to "social skills camp" for the summer (so they could both learn), where the whole focus was on learning those skills - they are teaching the "how to" very systematically. Rome wasn't built in a day, but after 6 weeks we've seen improvement. 

*    Anonymous said... My 5 year old Aspie has all the tell tale signs of Asperger's syndome, to the point where it seems like everything I've ever read was written with him in mind. Except for one key difference...my son is extremely social. He is very popular among other kids, they almost fight for his attention. They love the fact that he can recite comic books word for word, and remembers the names of even the most obscure Star Wars characters, and because he is a people pleaser he will share anything he has to maintain the friendship. He worries very much about how other kids see him and trys obsessively to fit in. I know all children with Asperger's syndrome are different, but my question is, is this very uncommon in Asperger's? I feel people "don't believe" he is on the spectrum because of his social skills.
 

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Why Teens on the Autism Spectrum Can Suffer from Depression

“I’m concerned that my son is depressed (17 y.o.). Is this something that happens along with high functioning autism? If so, why? How can I know for sure if he is really struggling with depression? He has made some off-handed comments about wanting to kill himself. How seriously do I need to be taking these comments?”

Depression seems to be common among teens and young adults with High-Functioning Autism (HFA) and Asperger’s (AS). Many of the same deficits that produce anxiety often unite to produce depression.

The relationship between serotonin functioning and depression has been explored in detail in this population. There is good evidence that serotonin functions may be impaired in kids and teens on the autism spectrum, which suggests that depression is a common comorbid condition.

In addition to impaired serotonin functioning, (a) deficits in social relationships and (b) poor coping-strategies that allow the teenager to compensate for disappointment and frustration may fuel a vulnerability to depression. (As a side note, there is some genetic evidence suggesting that depression and social-anxiety are more common among first-degree relatives of autistic kids, even when accounting for the subsequent effects of anxiety.)

Because some features of depression and autism spectrum disorders overlap, it is important to track that the changes in mood are a departure from baseline functioning. Therefore, the presence of social withdrawal in a teen with the disorder should not be considered a symptom of depression unless there is an acute decline from his or her baseline level of functioning.

Another important point is that the core symptoms of depression should arise together. Therefore, the simultaneous appearance of symptoms would point to depression (e.g., decreased energy, further withdrawal from interactions, irritability, loss of pleasure in activities, sadness, self-deprecating statements, sleep and appetite changes).

An additional point is that teens who display “affective” (i.e., relating to moods and feelings) and “vocal monotony” (i.e., a droning, unchanging tone) are at higher risk for having their remarks minimized by peers, which often gives the HFA or AS teen the impression that he “doesn’t matter” – which in turn can fuel depression.

Some teens on the autism spectrum can make suicidal statements in a manner that suggests an off-hand remark, without emotional impact. When comments are made this way, parents may underestimate them. The content of such comments may be more crucial than the emotional emphasis with which they are delivered. Thus, comments around “wanting to die” should be taken very seriously.

Medications that are useful for treatment of depression in kids and teens on the spectrum are serotonin reuptake inhibitors, although no medications have been shown to be particularly more beneficial for depressive symptoms in people with the disorder. Therefore, the decision as to which medications to use is determined by side-effect profiles, previous experience, and responses to these medications in other family members.

==> Discipline for Defiant Aspergers & High-Functioning Autistic Teens

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.

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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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