Managing “Fixations” in Children and Teens on the Autism Spectrum

"How much should we allow our daughter [high functioning] to play video games? She would spend most of her time doing this if we let her. My husband and I are divided on this issue, which has caused a riff between us."

If you are the mom or dad of a youngster with ASD level 1 [High-Functioning Autism], you may have heard your youngster exclaim, "But I can't live without it!" on more than one occasion. You may also notice that the book bag you just saw him pack is suddenly filled with a few more Harry Potter books. Or perhaps that suitcase for the trip to grandma's house has a Gameboy in it, when he promised he would leave it at home this time.

Fixations or perseverations with certain topics or objects, ranging from books, video games, or trains to history, movies, or any number of other subjects, are a classic symptom of ASD. In addition to impairments in social functioning, the Diagnostic and Statistical Manual lists as a characteristic of the disorder restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
  • apparently inflexible adherence to specific, nonfunctional routines or rituals
  • encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • persistent preoccupation with parts of objects
  • stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

What's the harm? Well... while these fixations must be understood and accepted as part of the disorder, they are also coping mechanisms that kids with ASD use to escape social anxiety. For example, video games are a very common interest among children with the disorder. Although the virtual world and these games can be a great place for kids to practice social skills, make friends, and have fun, the interest in video games can quickly become an unhealthy and even dangerous obsession.

For kids who get bullied all day at school or feel ostracized and out of place in their everyday lives, it's soothing to come home and play video games for hours. In the safe haven of online gaming, children on the spectrum can isolate themselves from real-life people and the complexities of face-to-face interactions. However, the social setting in online gaming or chat rooms is unrealistic and far more predictable than real-life social situations. While social conversations in real life are highly complex and unpredictable, online gamers share a common and simple language for communicating.

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

Since most online interaction occurs through typing, there is time to think about a response, and the response can be given in symbols and phrases without regard for facial expressions or nonverbal cues. In addition, curse words, rude remarks, and hurtful jokes may be considered socially acceptable online, but they will not be welcome responses in the real world. This disjunction between socially acceptable interactions in the virtual world and the real world can be terribly confusing to kids with High-Functioning Autism who already struggle to understand basic social conventions.

Moms and dads of a youngster on the autism spectrum are thus faced with a dilemma: Do we limit our youngster's time spent doing the activities that interest her most and run the risk that she will withdraw even more, or do we allow her unfettered access to things like video games and science fiction/fantasy books and movies despite the obvious social repercussions?

According to many experts, it's important for moms and dads to find the balance between accepting their youngster's unique interests, and encouraging their youngster to develop social skills and additional interests that might take him outside of his comfort zone. By granting unlimited access to video games and other fixations, moms and dads offer their kids nothing more than a quick fix.

The perseveration may be a convenient coping skill for facing the hardship of a long, difficult day at school, but it will not be the healthiest path into adulthood. Kids with Autism need to be challenged to explore other interests and find healthier coping skills. It's easy to use video games and other antisocial outlets to cope, but easier isn't usually better.

If young people with ASD aren't encouraged and helped to develop social skills and independent living skills, there will be a direct impact on how many friends they have, and how successful they are in school and on the job later in life. They may be soothed in the short term, but that deep underlying desire to make friends will remain a source of constant dissatisfaction and further isolation.

Addressing fixations is difficult for moms and dads. On one hand, video games and other interests encourage more social interaction than kids with ASD would ordinarily have. On the other hand, it's NOT the kind of social interaction that prepares them for life. Moms and dads should encourage their youngster to develop interpersonal skills “off” of the computer, and set limits around how often the child uses or talks about his or her fixations.

Moms and dads should offer incentives to their youngster to balance his or her time spent focused on the fixation and time spent doing social activities. For example, if a youngster is passionate about video games, the mother could agree to allow the youngster a certain amount of time to play each week in exchange for the youngster's participation in an after-school activity.

Parents need to learn how to negotiate their youngster's fixations and find the appropriate balance. For example, if a youngster wants to take the entire series of Harry Potter books on an experiential learning trip, parents can explain that the books are too heavy and the youngster will be permitted to choose only one favorite book.

In this way, the parent acknowledges how important the particular interest is to the youngster and offers him a choice in the process, while setting clear and fair limits and ensuring the child will still get the social interaction he needs out of the program. Similarly, if a youngster insists on taking his portable video game or DVD player to summer camp, moms and dads can reach a compromise (e.g., “You can take it and use it on your way to the campsite, but when you arrive, the camp director will hold onto it for you).




When children with Aspergers and High-Functioning Autism have a clear structure around when they can engage in their particular interest, they are more willing to accept rules limiting its use. At some of the schools that specialize in “special needs” students, the kids are allowed to read their favorite book at designated times, but they are not permitted to bring the book to meals. In this way, the children learn that their interests are perfectly acceptable when explored in socially appropriate ways, places, and times.

The fixations and perseverations of kids on the autism spectrum fulfill a need in their lives that will likely never disappear completely. However, their usefulness in real life is extremely limited. Everyone needs an occasional break from the rigors of daily life, but kids with the disorder depend on their mother and father to set limits around these fixations and offer guidance in navigating the complex social world around them. By making a plan and following through with it, you accept your youngster for the unique being he or she is, while providing the child with the tools needed to live up to his or her full potential.

==> Need more tips on how to handle your child's fixations and obsessions? You'll find more than you'll need right here...


 
COMMENTS:

•    Anonymous said... Funny because I had this conversation with my 8 year old son's psychologist recently. He said as a clinician he knows his answer should be "yes" to limit the video games, but he also said that because my son doesn't just play video games, he researches videos about how to defeat levels and finds parody videos about video games (also his biggest game he loves is Minecraft) that the game he plays most and all his research are somewhat educational. He pointed out that if it wasn't that, it would most likely be something else. We do take time away for the rest of a day if he is acting up horribly or not getting schoolwork done. If we don't have anything going on, we let him play. If there are things, he is limited and given several warnings in advance so he can prepare himself to change gears and not have a meltdown over it.
•    Anonymous said... Garek loves Midievil 2......but since he is way ahead in his schoolwork, pulling down As and Bs, and researching .....ok....obsessing about world history......meh.....not a concern
•    Anonymous said... It causes a big riff between the two of us too....but I would limit her playing time for an hour or take the game away for an hour or so if she shows anger, frustration or just being aggressive to it.
•    Anonymous said... My AS son is 13 and gets roughly one hour of video game time each day during the week, right after school. This gives him a break between school and homework which he desperately needs. During the weekend, he may get more time, depending on what's going on in general. My son has a few really good friends in our neighborhood and he loves to be outdoors so as the weather gets better, he spends more and more time outside, which is great. Hope you guys can find a happy medium.
•    Anonymous said... My son loves history as well. Especially about the different wars. We limit video games a lot in our house. If we don't they become an obsession. He has chores around the house that earn his game times.
•    Anonymous said... My son plays video games more than he should. However, living in a small place with no known kids his age in the neighborhood it makes it hard to do much else. Our son does do some reading as well as schoolwork so we feel that some time is ok.
•    Anonymous said... we have same problem
•    Anonymous said... I agree once my lil guy is off the darn thing he becomes so creative and interested in other things
•    Anonymous said... I don't always agree with the 2 hour a day rule when it comes to Aspie kids. It also can help them with social issues, and helps them in reacting to challenging situations without melting down. My son does get more then the generic two hour a day rule suggested by All doctors. That two hours isn't just video game time, they also mean screen time period.
•    Anonymous said... We allow 1.5 hours per day using a timer. Breaks in between. The visual red yellow green light timer from Amazon is what works best for us. We enforce it religiously.
•    Anonymous said... We are in the same boat. During the summer ours plays a lot more but we have him In activities like springboard diving whi h he loves. I use the tablet to help enforce rules. We take computer and tablet time away when he acts out.
•    Anonymous said... We have set a two hour time period where our lad is allowed to play. It turns off when the time is up. He likes having a specific time and often finds himself having so much fun doing other things that he doesn't bother anymore.
•    Anonymous said... We saw a specialist yesterday with our 8 year old. She said to limit to no more than 2 hours a day.
•    Anonymous said... We use an egg timer......and take one, two, three hour breaks.......not while eating, finish priorities first, etc

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Bereavement Problems in Children on the Autism Spectrum

"We lost my father-in-law 2 years ago due to a virus. My 12-year-old son with autism [high functioning] was totally devastated. It is not helped by the fact that, before the schools closed, he was spending the time before school and after school at his Grandma’s house and is reminded of Granddad’s absence by his empty chair. Due to the fact that I have to work full time, my sons have spent much of their time from Monday to Friday with their grandparents, so it is like their second home - they even have their own bedrooms there! I am finding it very difficult to help him come to terms with Granddad’s death. He is OK most of the time, but will then fall into a black mood and will overreact to the slightest incident and go into a meltdown. Do you have any advice on what I can do to help him?"

As you know, High-Functioning Autism (Asperger's) is a neurobiological disorder. Kids with autism spectrum disorder (ASD) have difficulties with transitions, social interaction, and responses to social situations. With regard to the emotional aspects of death and grief, your son may react, as you have seen, by getting upset or angry. These reactions occur because he doesn’t fully understand what has happened and why it happened, and due to his ASD, doesn’t know how to ask for help in handling the death of his grandfather. Many people without the disorder react to a death with anger and despair, too.

Many kids with ASD feel that if a beloved relative dies, a “rule” has been broken (i.e., good people should not die), and they feel very hurt. So, when it happens, the child feels betrayed. This can lead to anger and outbursts. In addition, any unexpected event is particularly difficult. You son finds it hard to grieve and doesn’t know how to handle his feelings of despair and sadness. He may not be able to express his grief through tears or talking.

Even if your son can’t ask for help, it is definitely called for in this situation. Patience, understanding, and support on your part are required. Be sensitive to his need to talk if he exhibits one, and don’t put up barriers to it, such as telling him he’s too young to understand what happened. If he doesn’t show a need to discuss the death, you should open a discussion anyway. It may be wise to ask a counselor or psychologist to talk with him, too.

Kids and teens with ASD have average or higher levels of intelligence and will appreciate honest, simple explanations about death and grief. Explain that birth is the beginning of life, and death is the end of life, and that when someone dies, we feel bad because we loved the person, didn’t want him to die, and we will miss him. Don’t tell him his grandfather “went to sleep,” “went away,” “got sick,” that only old people die, or that the death was “God’s will.” All of these are open to misinterpretations, such as “If I go to sleep when I’m sick, will I die?” Or, “Will God make me die?” At his age, your son is able to understand that death is irreversible and that he will die eventually, but he needs reassurance that he will most likely live a long time.

Some questions your son asks may seem insensitive, for example, “Are you going to die, Mom?” He may show curiosity about dead animals or ask about what happens physically to dead things. These questions may seem gruesome, but they are a way of learning about death. Children should not be made to feel guilty or embarrassed about their curiosity.

Your son may feel that the death of his grandfather, who was a good person, was unfair. This is the time to gently explain that many things that happen in life are not fair and that we should try to help each other cope when unfair things happen. Perhaps, discussing some nice things to do for his grandmother would help him feel needed. Many of the kids respond very well to being needed by others.

Your son will need a lot of time to accept this death and may react with anger at unexpected times. Be understanding. Time will help ease the pain. Use books to help him understand and provide a good model of acceptable behavior for him. Also, keeping a journal of his thoughts about his grandfather may help.

Moms and dads should be aware of normal childhood responses to a death in the family, as well as signs when a youngster is having difficulty coping with grief. It is normal during the weeks following the death for some kids to feel immediate grief or persist in the belief that the family member may “come back” someday. However, long-term denial of the death or avoidance of grief can be emotionally unhealthy and can later lead to more severe problems.

Once kids accept the death, they are likely to display their feelings of sadness on and off over a long period of time, and often at unexpected moments. The surviving relatives should spend as much time as possible with the youngster, making it clear that the youngster has permission to show his feelings openly or freely.

The person who has died was essential to the stability of the youngster's world, and anger is a natural reaction. The anger may be revealed in boisterous play, nightmares, irritability, or a variety of other behaviors. Often the youngster will show anger towards the surviving family members.

Kids who are having serious problems with grief and loss may show one or more of these signs:
  • acting much younger for an extended period
  • an extended period of depression in which the youngster loses interest in daily activities and events
  • excessively imitating the dead person
  • inability to sleep
  • loss of appetite
  • prolonged fear of being alone
  • repeated statements of wanting to join the dead person
  • sharp drop in school performance
  • refusal to attend school
  • withdrawal from friends

If these signs persist, professional help may be needed. A child and adolescent psychiatrist or other qualified mental health professional that specializes in ASD can help children accept the death of a loved one and assist parents in helping children through the mourning process. 

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==> Has your child on the autism spectrum been experiencing a lot of sadness lately? If so, here are a bunch of suggestions to assist in the matter...
 
 
Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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ASD Teen Goes Crazy Over Women’s Feet

"My teenage son [with ASD] goes crazy when he sees women’s feet. He likes to touch them. I can’t go out anywhere because I always have this problem. When I try to stop him, he turns violent and tries to hit me or hits himself. What can I do to help him?"

Teens with Aspergers and high-functioning autism have a difficult time understanding sexual feelings and appropriate actions regarding sexual activities. Many times, the sexual interests of people with ASD at your son’s age, are one-sided, not reciprocal, as it is when he touches the feet of women he doesn’t know.

As you have seen, this results in some terribly difficult situations. Your son is unable to understand the rules that govern this type of behavior; he only knows that he must (as far as he is concerned) touch those feet! He misunderstands the situation and acts too intense and very inappropriately. His frustration when you try to stop him results in violence.

If all sense of proportion is lost, a fetish/obsession like his can lead to a criminal offense. A lack of concern for others can result in an assault that is damaging. People with ASD often lack insight into the feelings of others and deny responsibility for their actions; this is an inability to see inappropriate behavior as others see it.
 
==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

This situation is very serious because of the potential for arrest and prosecution. Sit him down and explain to him very graphically how the women feel when he approaches them and touches them. He must understand that they are terrified, don’t know what to do, and upset because this type of behavior in public is illegal. Tell him he could be arrested and put in jail. Repeat this – over and over.

Adults on the spectrum who have average or above IQs, report a high frequency of obsessions and compulsions that are intrusive, upsetting, and overwhelming.

People with ASD tend to be obsessive about their interests, so it’s no surprise that a lot of them are obsessed with sex. Reports have been made regarding these obsessions, but they haven’t been studied much. Sexual obsessions are more commonly reported by people on the spectrum who also were diagnosed with OCD. Compulsions occupied at least one to three hours per day in 26%, and 56% reported anxiety if prevented from performing their rituals.

It’s difficult to determine if your son’s behavior is distinct as a sexually offensive behavior or one that is a manifestation of ASD, or both. The two are merged. He will continue this behavior unless intensive treatment is provided. His insight and ability to stop is extremely limited and you are not able to control him at his age and size.

Your son may well need professional counseling support. Consult with a psychotherapist familiar with both sexually offending behaviors and pervasive developmental disorders. Family psychotherapy and careful supervision are warranted.

The therapist may recommend that he participate in group social skills training and group treatment for adolescents with sexually offending behaviors and pervasive developmental disabilities. A therapeutic, highly structured and supervised educational program would seem necessary.

Individuals with ASD who have obsessive-compulsive symptoms may benefit from standard treatments for OCD such as serotonin reuptake inhibitors as well as cognitive and behavioral therapies. Serotonergic drugs can reduce obsessions, although finding the right drug may take time and, once found, its effect may be partial and temporary. Also as ever; be mindful of any side effects.



 
==> Are you parenting a teenager on the spectrum who is struggling to cope? Then these articles will help you, the parent, to help your teen...

 
Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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COMMENTS:

Anonymous said... This is a great article and very helpful. As an educator of children with Asperger's, I am always looking for innovative techniques to teach social skills. I think one of the first steps is for parents to recognize that problem solving skills that may come naturally to some, need to be taught and broken down for those with Asperger's. It can be a challenge, put with practice and consistent support, skills can be taught, retained, and generalized. 

Anonymous said... I have read that giving them free access to whatever causes the stim will eventually cause them to get tired of it. if you know a million ladies who need a foot massage you might be able to wear him out. Sorry it's causing you huge problems.

Anonymous said... It might also be the start of a passion for selling shoes, sandals, everything for feet. Girls love their feet & shoes we need people passionate to work in businesses to cater for that. The passion just needs a bit of direction & channeling. Best wishes.  

Anonymous said… There are many ways to embrace a foot fetish, and I'm sure he'll find a way to channel that passion, cuz it's life long. I also pray that someday he will find a woman who understands.
 
Anonymous said… Me too!! Because There are not that many good women out there and I hope he doesn't end up with the wrong one. :( He has autism and foot fetish just like ms, So I'll pray for him.
 
Anonymous said… I have an 30 year son with severe foot fetish and will get violent if you don't let him touch your feet .
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