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40 Crucial Strategies for Parents of Defiant Teenagers with ASD [level 1]

Parenting teenagers is hard enough...right? But throw ASD (high-functioning autism) into the equation, and now you really got a mountain to climb. Do not despair!

Here you will find 40 ways to effectively parent, nurture, and discipline your defiant teen with an autism spectrum disorder:

1. Writing Assignments - Education sometimes alters unwanted “autism-related” behavior. Examples include:
  • learning about a particular culture, religion or disability in order to develop understanding or tolerance
  • researching the long-term effects of smoking or drug usage
  • talking with teen parents to learn what sacrifices they have made

Such an assignment should include considerable thinking, learning, and dialogue with moms and dads, rather than simply writing a certain number of words without much independent thought.

2. Tolerating Behavior - When establishing a relationship or dealing with multiple behaviors, it may be necessary to tolerate some behaviors temporarily. This is a purposeful, thought-out choice on the part of the mother/father based on:
  • age and developmental level of teen involved
  • current situation
  • priorities
  • relationship
  • specific treatment issues
  • values

This is not to be confused with passivity, avoiding conflict, letting the youngster "do whatever he wants," inconsistently enforcing expectations or other methods that don't work.



3. Temporarily Removing One or More Privileges - It is not meaningful or realistic to "remove all privileges." This generally leads to resentment towards the parent and a lack of understanding or personal responsibility. When this technique is chosen:
  • it must be made clear to the adolescent exactly which privilege(s) will be removed
  • why it is being removed
  • exactly how it will be handled
  • for what time period

If there is something they can do to get the privilege(s) reinstated sooner, that should also be clearly explained. Note: this requires more thought and explanation than simply saying, "You’re grounded."
 
4. Teaching Interactions - Effective parenting of teens with high-functioning autism requires frequent interactions. Situations, both dramatic and mundane, present themselves continually. Moms and dads, who recognize the golden opportunities in routine living tasks, capitalize upon them by turning them into teaching interactions, build solid relationships, have fewer behavior problems, and receive daily rewards. Problems = teachable moments. Teaching interactions can take several forms such as:
  • teaching a concept (e.g., negotiation)
  • processing dynamics (e.g., "Have you noticed that when someone doesn't fulfill their responsibility, others become resentful?")
  • demonstrating a skill

The point is that on-duty moms and dads should always be interacting with their teens, and the nature of those interactions is teaching; rather than:
  • becoming friends with the teen
  • criticizing
  • doing things for the teen
  • judging
  • lecturing
  • punishing

5. A regular bed time at a reasonable hour is more important than ever, if you can put/keep it in place. Regular routines of all kinds—familiar foods, rituals, vacations—are reassuring when the adolescent’s body, biochemistry, and social scene are changing so fast.

6. Teaching Alternatives - A good way to teach the teenager personal responsibility is to spend time brainstorming together about all the possible responses, and predicting the reactions to each response. Instead of telling them what to do and what not to do (which can elicit dependency or oppositional responses), it is useful to spend time exploring different options. For example, instead of saying, "Don't say that to your father" …it is better to say something like, "That's one way you could handle it. How do you think he would respond to that?" … "Is that the response you want from him?" … "How else might you phrase that idea?" …etc. If they have trouble coming up with alternatives, you can help out by saying, "Do you want to know what some other people have tried?"

7. Establish verbal codes or gestures to convey that one or both parties need a time out: a chance to cool down before continuing a difficult discussion at a later time.

8. Substitution - It is never enough to tell teens what they can't do or what behaviors they must stop doing. We must always add what they CAN do instead. Some examples might be ideas such as, "You cannot hit your classmate when you are angry, but you can go for a brisk walk, write in your journal, talk about how you feel, etc." The goal is to replace or substitute an unacceptable behavior with one that is acceptable and still meets the same need. The message should always be, "Your needs and feelings are normal and okay and we are here to help you express them in ways that will allow you to be successful and responsible."

9. Go with the flow of your youngster’s nature. Simplify schedules and routines, streamline possessions and furnishings. If your adolescent only likes plain T shirts without collars or buttons, buy plain T shirts. If your kid likes familiar foods, or has a favorite restaurant, indulge her. 
 
10. Shaping - Shaping behaviors is an approach that breaks skills down into steps and rewards small movements in the right direction. For example, if you are trying to teach the skill of greeting a visitor, you would ultimately want your teenager to go through the following series of behaviors:
  • stop what they are doing
  • stand up
  • look at the visitor
  • walk over to them
  • make eye contact
  • smile
  • say "hello"
  • extend your right hand to shake
  • say “my name is ___”

To ask for all of that from someone who has never done it before, or who is shy, is asking too much. So at first they would be rewarded if they momentarily stopped what they were doing when someone new cam in. After a few times they would need to stop what they were doing, stand up and look in the direction of the visitor in order to be praised, and so on. In other words new skills are not all or nothing but are a series of steps to be learned.

11. Sequencing - Desirable behaviors can be used as motivating for less desirable ones. For example, "You may watch one hour of approved TV as soon as your book report is satisfactorily completed" –or- "You may make that phone call as soon as you have finished cleaning up the kitchen." This type of statement helps the mother/father avoid power struggles because they did not say, "no." It puts the struggle and control back with the youngster, where it belongs. They can then choose whether or not they will watch TV today and when (within limits). A version of this can be re-stated calmly and compassionately as often as necessary while your teenager struggles with his choice.

12. Have realistic, modest goals for what the adolescent or the family can accomplish in a give time period. You may need to postpone some plans for career goals, trips, culture or recreation.

13. Some adolescents on the autism spectrum adjust o.k. to middle/high school with appropriate supports and accommodations, Others, however, just cannot handle a large, impersonal high school. You may need to hire an advocate or lawyer to negotiate with your school system to pay for an alternative school placement, tuition, and transportation.

14. Role Playing/Rehearsing - This technique can be used to practice for an upcoming situation that may be difficult, foreign or anxiety producing or to re-create a situation that already occurred to experience alternative responses. Examples should include role-playing a situation in which the teen was angry and became physically or emotionally abusive, or one in which they demanded or sulked instead of negotiating. The purpose of the role-play is to practice more acceptable styles of self-expression while still making their intended point. Practicing of this sort will make the desired responses more likely in future similar situations. Role playing can also be used to practice saying something that is difficult or anticipating a variety of responses in order to reduce anxiety.

15. If you can afford it, you may prefer to pay private school tuition rather than paying a lawyer to negotiate with a financially strapped or resistant school system. However, a private school may not be the best choice. Some families move to a community with a better high school. Residential schools may be worth considering for some. The right fit can build tremendous confidence for the adolescent, give the parents a break, and prepare everyone for the independence of the post high school years.

16. Role Modeling - Most of what kids learn from grown-ups comes from simply observing. All moms and dads are role models to their kids and need to be very conscious of their own behavior. Kids are astute observers of how we treat them, how we relate to each other and how we take care of ourselves.

17. Impersonal, written communication is easier for the adolescent to absorb (e.g., lists of routines and rules, notes, charts, or calendars). E-mail may become a new option.

18. Your Teen's Rights - Food, clothing, therapy, medical attention, education, spiritual activities are NEVER withheld as a consequence. Privileges (e.g., television, telephone, radio, some activities, free time, visiting with friends, hobbies, walking around the grounds, etc.) may be temporarily withheld as logical consequences and can be powerful incentives for some adolescents.
 
19. Teens on the spectrum need structure, down time, soothing activities, and preparation for transitions.

20. Rewarding/Reinforcing - Rewarding positive behavior is the best way to ensure its continuation. A common error in parenting is to spend so much time and energy dealing with crises and negative behaviors that kids who are being responsible can either get "lost" or are tempted to act less responsible to become part of the action. Rewards can take many forms from simple a comment: "I noticed that you..." or "I really appreciated it when you..." to special time and attention or more concrete things such as a special treat or privilege. For every negative interaction the teen experiences, it takes four positive interaction to overcome the effects. Moms and dads need to be very deliberate about maintaining at least a 4:1 ratio of positive to negative interactions every day with every teenager.

21. Look for volunteer activities or part time jobs at the high school or in the community. Be persistent in asking the school to provide help in the areas of career assessment, job readiness skills, and internships or volunteer opportunities. They probably have such services for intellectually challenged adolescents, but may not realize our teens need that help, too. They may also not know how to adapt existing programs to meet our teenagers' needs.

22. Requesting - When there is a good relationship between the mother/father and youngster, a simple request to do, or stop doing, something or a re-stating of the expectations is often enough. If over-used, however, it may become less effective, may be experienced by the HFA of Aspergers youngster as overly controlling, or can slow the process of responsible growth and decision-making skills. Example: "We don't use that type of language here, could you please find a different word?"

23. Make sure thorough neuropsychiatric re-evaluations are performed every three years. This information and documentation may be critical in securing appropriate services, alternative school placements, transition plans, choosing an appropriate college or other post secondary program, and proving eligibility for services and benefits as an adult.

24. Refocus - A defiant teen may be asked to spend time thinking about something (e.g., a recent run-away or self mutilation) and express their feelings and thoughts in some way. This could be writing, poetry, drawing, etc. Whatever format is used, it then needs to be processed with the adolescent. They can then be assisted in identifying early clues and practicing alternative responses. The purpose of this type of activity is to encourage thinking, self-awareness, communication, and planning for different choices in the future.

25. Schedule regular monthly educational team meetings to (a) monitor your adolescent’s progress and (b) ensure that the IEP is being faithfully carried out (and to modify it if necessary). Because adolescents can be so volatile or fragile, and because so many important things must be accomplished in four short years of high school, these meetings are critical.

26. Side by side conversations (e.g., walking, in the car) may be more comfortable for the adolescent than talking face to face.

27. Special interests may change, but whatever the current one is, it remains an important font of motivation, pleasure, relaxation, and reassurance for the adolescent.

28. Redirecting - Commonly used with younger defiant kids or those with short attention spans, this technique simply stops one behavior by substituting another or diverting the attention of the Aspergers teen or group to a different subject or activity.

29. Teach laundry and other self-care/home care skills by small steps over time. Try to get the adolescent to take an elective such as cooking or personal finance at the high school.

30. Pre-Teaching - It is easier to prevent negative behaviors than to deal with them after they occur. A very effective tool is to pre-teach behavior prior to an event or potentially vulnerable situation. This involves talking with the person or group in detail about what will be happening, why, and what their role and expected behaviors will be. Pre-teaching reduces anxiety, clarifies expectations, builds confidence, sets up success, and can add to the fun of anticipating an event.
 
31. Physical Proximity - Sometimes a defiant adolescent who is beginning to become anxious, irritable or overly active will be calmed down by eye contact, a special "look" or signal, moving next to them or a reassuring hand on the arm or shoulder. Along with physical proximity it is important to be calm and reassuring.

32. Observing and Commenting - A mother/father may choose to comment on a behavior in a non-threatening, non-judgmental way to bring it to the attention of the youngster. This may be new information for the teen to think about. What they choose to do with that feedback will provide further opportunities for discussion and teaching. For example, "I notice you tend to be critical of others when they are taking about a success" –or- "You seem to only break the rules when you are in a group" etc.

33. Tell your adolescent just what s/he needs to know – one message at a time – concisely.

34. Natural Consequences - Sometimes consequences occur through the natural course of events (e.g., a teen coming home late from school and missing a phone call from a friend). If the natural course of events makes an impact by teaching a lesson, moms and dads need not intervene further. They can be sympathetic to the teen's plight (this must be genuine however, and never patronizing or sarcastic).

35. Logical Consequences - Logical consequences may be necessary when no natural one occurs, or when the natural one is insufficient to make a change in future behavior. An example would be a defiant teen causing a disturbance at an event, not being allowed to attend the next one.

36. Ignoring Behavior - Moms and dads may consciously decide to ignore certain behaviors of their defiant adolescent at times in an effort to extinguish the behavior by not reacting to it. The behavior may be inconsequential, may be designed just to "get a reaction," or may be masking another, more important, issue which is what really needs attention. Ignoring a behavior should not stop communication or relationship building. It is a specific behavior that is being ignored, not the person. Examples might include using certain words, attempts to provoke or annoy moms and dads, making personal comment to or about moms and dads, saying "I won't" or "you can't make me," etc.

37. Encouraging/Coaching - Encouragement, praise, and coaching are all effective ways to make pro-social behaviors more likely and more frequent. The stronger the relationship between mother/father and a given youngster, the more powerful this method becomes.

38. Consequences - Consequences may be used to discourage unacceptable behavior of defiant adolescents. Usually this will occur after other techniques have been tried unsuccessfully. Discipline should not be confused with punishment; nor should they ever be given in anger. They should be applied consistently. That means that the behavior disciplined today, will again be disciplined next week. Also, behavior disciplined for one teen will not be allowed for others. This consistency lowers anxiety by making the environment predictable. Remember:
  • A mother/father who is angry with their son or daughter should calm down before deciding a consequence, and if applicable, should consult with the other parent before doing so.
  • Consequences are given to help teenagers establish boundaries.
  • Consequences are more effective when discussed matter-of-factly from a caring and controlled point of view.
  • Consequences should be clearly explained, related to the behavior, and completed as soon as possible.
  • Moms and dads should regularly discuss the effectiveness of consequences for the specific teen and should always support each other in the positive discipline process.

39. Active Listening - Some “autism-related” behaviors are bids for attention or expressions of frustration at not feeling understood. Moms and dads can reduce problem behaviors when each defiant youngster feels genuinely cared about, understood, and paid attention to. Active listening is hard work and takes energy and practice. It cannot be done when thinking about or attending to other things, or when distractions occur. Active listening need not last a long time, but attention must be focused completely on the teen and the message must be communicated back to them in the listeners own words in a way that lets them know they really were heard. Body language, facial expressions, tone of voice, eye contact, respect for personal space, and choices of words are all important in communicating the desired message. It may take two or three attempts to really understand the message, and that is okay, as long as it is finally understood accurately and that is clearly demonstrated. A few brief exchanges of this sort for each youngster every day are necessary.

40. Patience – Your ASD teen has this thing called “mindblindness.” In other words, he may not understand some of the social norms that other children and teens learn automatically. Thus, be able to distinguish between “misbehavior” (which is intentional) and “autism-related” behavior (which is never intentional).

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

15 Ways to Bully-Proof Your Child with ASD

Over 25% of public schools report that bullying among students occurs on a daily basis. Also, one in five middle school students with ASD (high-functioning autism) report being bullied in the past 3 months.

The good news is that, since bullying has made national headlines, schools and communities – and even celebrities – are taking a strong anti-bullying stance. Parents can do their part at home, too.

Bullying Facts:
  • Bullies - and victims of bullying - have difficulty adjusting to their environments, both socially and psychologically.
  • Bullies are more likely to smoke and drink alcohol, and to be poorer students.
  • Bullying occurs most frequently from sixth to eighth grade, with little variation between urban, suburban, town and rural areas.
  • Females are more likely to be verbally or psychologically bullied.
  • Males are more likely to be physically bullied.
  • Males are more likely to be bullies - and victims of bullying - than females.
  • Students who are both bullies - and recipients of bullying - tend to experience social isolation.
  • Victims of bullying have greater difficulty making friends and are lonelier.

Here are 15 anti-bullying strategies to keep your ASD child from becoming a target – and to stop bullying that has already started:

1. Avoid the bully. There are some situations where bullying is worse because it is an ideal situation for a bully to go after their victim without any consequences. If there is no grown-up around, then he can bully without fear of getting caught. So, avoid these situations. For example, on the playground, stay where other kids can hear and where the playground monitor is around.

2. Buddy up for safety. Two or more friends standing at their lockers are less likely to be picked on than a youngster who is all alone. Remind your child to use the buddy system when on the school bus, in the bathroom, or wherever bullies may lurk.

3. Confront the bully. Ask him why he is bullying you. Ask him what the problem is. Ask him to stop. Bullies are rarely asked to face the reality that they are being a bully, so make them face it.

4. Control your feelings. Bullies look for reactions, don’t give them one. Soon they will grow bored and move on.

5. Don’t bully back. It is good to say “stop it” – but don’t bully in return. You don’t want to be on the same level. Instead, tell someone that the bully is bullying you, and then do your best to ignore.

6. Don't try to fight the battle yourself. Sometimes talking to a bully's mom or dad can be constructive, but it's generally best to do so in a setting where a school official (e.g., a counselor) can mediate.

7. Make friends with one of the bigger guys in your school (some 8th graders, for example, may stand nearly 6 foot tall). Bullies are reluctant to go after someone who has backup. Bullies usually pick out the weakest person they can find, and there is strength in numbers. So, stop a bully by having a tall friend on hand most of the time.

8. Ignore bullies. A lot of what bullies do is for a reaction. They say or do things to see what you will do. If you want to stop a bully, just ignore their efforts, soon they will find someone else. Whether it is bullying online or in person, ignore, ignore, ignore.

9. Improve your self-esteem. Bullies usually pick on kids who have low self-esteem. They look for students who are weak, isolated, that feel alone, and have few friends. There is less chance of them being caught that way. Work on your self-esteem, and you won’t be picked on long.

10. Keep calm and carry on. If a bully strikes, a kid's best defense may be to remain calm, ignore hurtful remarks, tell the bully to stop, and simply walk away. Bullies thrive on hurting others. A youngster who isn't easily ruffled has a better chance of staying off a bully's radar.

11. Put on a brave face. When you let a bully know that you are afraid of him, it is like giving him power. If you give him a little power, you will find that the bullying gets worse. So, put on a brave face, and never show your fear.

12. Remove the bait. If it's lunch money or gadgets that the school bully is after, you can help neutralize the situation by encouraging your child to pack a lunch or go to school gadget-free.

13. Report the bullying. Bullies can’t bully for long if they are getting caught. The beginning of getting a bully to stop has to start with an authority figure. So, each time someone bullies you, tell a grown-up. If it happens at school, tell a counselor, a teacher, or the principal.

14. Stand up for yourself when it gets really bad. If a bully is physically harming you, ruining your reputation, or something else, then don’t put up with it. Instead, say the words like, “Stop” or “Don’t” and make sure they know you are done taking their bullying.

15. Talk about it. Talk about bullying with your children and have other family members share their experiences. If one of your children opens up about being bullied, praise him for being brave enough to discuss it and offer unconditional support. Consult with the school to learn its policies and find out how staff and teachers can address the situation.

Undiagnosed and Misdiagnosed ASD [Level 1]

ASD manifests in many ways that can cause difficulties on a daily basis.

Here are some examples of what to look for:

• Being naive and trusting
• Confusion
• Delayed motor milestones
• Delighting in fine details such as knobs on a stereo
• Difficulty in conversing
• Difficulty with multitasking
• Extreme shyness
• Lack of dress sense
• Mixing with inappropriate company
• Not understanding jokes or social interaction
• Quoting lists of facts
• Unusual and obsessional interests

One of the worst problems is that you can never really understand what is going on inside your youngster's head. This makes it so difficult for you to understand his behavior. This can leave you feeling emotionally beat-up and completely useless as a parent. You may have to cope with crisis on a daily, hourly or even minute-by-minute basis.

Undiagnosed ASD—

Undiagnosed ASD is an issue that concerns me because so many kids have the disorder and are struggling to make it in this world with very little help or resources. Just today, I met someone who said that it was suggested that their youngster had Oppositional Defiant Disorder (ODD) without anyone recognizing the other behaviors that are just as relevant.
 

There are many characteristics for autism spectrum disorder, but one thing that goes unnoticed is that there can be a secondary diagnosis clouding the picture and causing undiagnosed ASD. Many kids on the spectrum also have ADHD, for example. ADHD can cause behaviors that draw an excessive amount of attention, thus the undiagnosed ASD can be overlooked.

Commonly undiagnosed conditions in related areas may include:

o ADHD -- Undiagnosed
o Adult ADHD -- Undiagnosed
o Alzheimer Disease -- Undiagnosed
o Bipolar Disorder -- Undiagnosed
o Concentration Disorders -- Undiagnosed
o Epilepsy -- Undiagnosed
o Migraine -- Undiagnosed
o Schizophrenia -- Undiagnosed
o Stroke -- Undiagnosed

Undiagnosed ASD Leads To Life as an Outsider

For most of his life, Michael felt like an outsider. Restless and isolated, he was over-stimulated and uneasy around others. Finally, when he was 45, he was diagnosed with ASD, a syndrome that falls within the autism spectrum. The diagnosis came as a relief: Here, finally, was an objective explanation for some of my strengths and weaknesses

People on the spectrum often struggle to interact with groups and understand social norms. Michael describes himself growing up as a "very lost little kid" who acted out in school by making faces at teachers and being aggressive with the other students. His ability to connect to others didn't improve with age.

Music — particularly the repeating patterns of melody — provided him with a refuge from an early age. He remembers listening to his mother's record collection and experiencing a "passage into a world where everything made sense." He compares listening to music to watching clouds change slowly over the course of an afternoon.

As for his diagnosis with Aspergers, Michael says it has helped him accept the parts of his nature that are "not very changeable." Wearing eyeglasses, for instance, makes him feel like he is "being intimate with everybody on the street." As a result, he rarely wears them now — even though he received his first prescription for glasses when he was in kindergarten.

Misdiagnosed ASD—

Many kids with ASD [high-functioning autism] are misdiagnosed as having ADHD with no investigation by medical professionals of the possibility of ASD. In one case, a child was treated for ADHD for years before anyone mentioned autism. 
 

ASD can be a difficult diagnosis to make because there is no single test to detect it. An accurate diagnosis generally requires the evaluation of a team of professionals who are specialists in developmental disorders. In addition, the symptoms of ASD are similar to some symptoms of some other disorders. This can result in a delayed or missed diagnosis. Kids and adults with ASD may be misdiagnosed with other conditions with some similar behaviors, such as obsessive-compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD).

The other conditions for which ASD is listed as a possible alternative diagnosis include:

• Schizoid Personality Disorder
• Schizotypal Personality Disorder

Other Common Misdiagnoses:

• ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in kids is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA).

• Bipolar disorder misdiagnosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist.

• Blood pressure cuffs misdiagnose hypertension in kids: One known misdiagnosis issue with hypertension arises in relation to the simple equipment used to test blood pressure. The "cuff" around the arm to measure blood pressure can simply be too small to accurately test a youngster's blood pressure. This can lead to an incorrect diagnosis of a child with hypertension. The problem even has a name unofficially: "small cuff syndrome".

• Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH.

• Kids with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in kids.

• Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia. 
 

• Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked.

• Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis.

• Mesenteric adenitis misdiagnosed as appendicitis in kids: Because appendicitis is one of the more feared conditions for a youngster with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for kids with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

• Mild worm infections undiagnosed in kids: Human worm infestations, esp. threadworm, can be overlooked in some cases, because it may cause only mild or even absent symptoms. Although the most common symptoms are anal itch (or vaginal itch), which are obvious in severe cases, milder conditions may fail to be noticed in kids. In particular, it may interfere with the youngster's good night's sleep. Threadworm is a condition to consider in kids with symptoms such as bedwetting (enuresis), difficulty sleeping, irritability, or other sleeping symptoms. Visual inspection of the region can often see the threadworms, at night when they are active, but they can also be missed this way, and multiple inspections can be warranted if worms are suspected.

• Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury.

• MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury. 

• Parental fears about toddler behavior often unfounded: There are many behaviors in infants and toddlers that may give rise to a fear that the youngster has some form of mental health condition. In particular, there is a loss of fear of autism or ADHD in parents. However, parents should understand that the chances are higher that it's part of normal development, and perhaps just a "cute behavior" rather than a serious condition. Although parents should be vigilant about monitoring all aspects of their child's development and mental health, they should also take care not to over-worry and miss out on some of the delights of parenthood. For example, a young child that screams when you open his car door to take him out, then makes you put him back into the car to repeat it, so that he can open the car door himself, is not necessarily showing signs of autism or OCD, nor indeed any mental illness. There is a small possibility that it's an abnormality (a chance that increases with age of the youngster), but it's also the type of behavior seen in many normal kids.

• Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury.

• Undiagnosed anxiety disorders related to depression: Patients with depression may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression.

• Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

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

Autism Spectrum Disorder in Kids and Teens: FREQUENTLY ASKED QUESTIONS from Parents

 1. Are individuals with ASD more likely to be involved in criminal activities?

Some individuals with ASD have found themselves before the criminal justice system for a variety of offenses that are usually related to their special interests, sensory sensitivity or strong moral code. If a person's special interest is of a dangerous nature it can sometimes lead them into unusual crimes associated with that interest. The courts are becoming increasingly aware of the nature of ASD and are responding accordingly. More often than not, individuals with the disorder are more likely to be victims than offenders. Their naivety and vulnerability make them easy targets.

2. Can ASD occur with another disorder?

The simple answer to this question is YES. The symptoms of ASD have been recognized in individuals with other conditions and disorders. Once a single diagnosis of ASD is confirmed, it is wise to continue the diagnostic process to see if there is another specific medical condition.

3. Can ASD occur with ADHD?

These are two distinct conditions, but it is possible for a youngster to have both. They have specific differences, but there are some similarities, and a youngster can have a dual diagnosis and require treatment for both conditions.

4. Can the person develop normal relationships?

In early childhood, a youngster with ASD may need to be given instructions on the different ways of relating to family members, to a teacher, to friends and to strangers. Teenagers on the spectrum can be delayed in their social/emotional maturity compared to the other kids in their class. It may be necessary to repeat some school programs on human relationships and sexuality when the person with ASD has reached that stage of their emotional development. 
 
With a prolonged emotional adolescence and delayed acquisition of social skills, the person may not have a close and intimate relationship until much later than their peers. Many individuals with ASD have loving relationships, but the partners may need counseling on each other's background and perspective. One could describe these relationships as similar to those between individuals of two different cultures, unaware of the conventions and expectations of the other partner.

5. Could a difficult pregnancy or birth have been a cause?

Some studies state that quite a high percentage of cases had a history of natal conditions that might have caused damage. But, in general, pregnancy may well have been unremarkable. However, the incidence of obstetric abnormalities is high. No one factor can be identified, but labor crises and neonatal problems are recorded with a significant number of kids with ASD. There is also a greater incidence of babies who are small for gestational age, and mothers in the older age range. It is recognized that there are three principal causes of ASD - genetic factors, unfavorable genetic events, and infections during pregnancy or early infancy that affect the brain.

6. Could ASD be a form of schizophrenia?

These are again, two distinct conditions. The chances of a person with ASD developing schizophrenia are only marginally greater than for any individual. Some individuals with the disorder are wrongly diagnosed with schizophrenia, when they have extreme stress, anxiety and depression related to their ASD. A false diagnostic trail is easily created and it is important to re-trace the steps and see what is causing the stress and anxiety for the person with ASD.

7. Could ASD be inherited?

Some research shows that there are strikingly similar features in first- or second-degree relatives on either side of the family, or the family history includes "eccentric" individuals who have a mild expression of the disorder. There are also some families with a history of kids with ASD and classic Autism. Should a relative have had similar characteristics when younger, they have a unique advantage in helping the youngster - they know what they are going through. There is no formal identification of the precise means of transmission if the cause is genetic, but we do have some suggestions as to which chromosomes may be involved. As our knowledge of genetics improves, we may soon be able to predict the recurrence rate for individual families.
 
==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

8. Could the pattern be secondary to a language disorder?

If a young child has difficulty understanding the language of other kids and cannot speak as well as their peers, then it would be quite understandable for them to avoid interactions and social play, as speech is an integral part of such activities. However, the youngster with autism has more complex and severe social impairments, which identify the disorder from other disorders.

9. Could we have caused the condition?

ASD is not caused by emotional trauma, neglect or failing to love your youngster. The research studies have clearly shown that ASD is a developmental disorder due to a dysfunction of specific structures and systems of the brain. These structures may not have fully developed due to chromosomal abnormalities or may have been damaged during pregnancy, birth or the first few months of life.

10. Do girls have a different expression of the disorder?

The boy to girl ratio for referrals for a diagnostic assessment is about ten boys to one girl. However, the evidence indicates that the actual ratio of diagnosed kids is four boys to one girl (this is the same ratio as occurs with classic autism). Why are so few girls referred for a diagnosis? In general, boys tend to have a greater expression of social deficits, whereas girls tend to be relatively more able in social play and have a more even profile of social skills. Girls seem to be more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of ASD.

11. How can you reduce the person's level of anxiety?

A person with ASD is especially susceptible to high levels of anxiety, and this can only be reduced by practical strategies to cope with the issues causing the anxiety. Sensory issues, social skills and the need for structure and routine can cause unbearable stress and anxiety and this increases the expression of their ASD itself, thus causing a vicious circle. Stress management programs can help minor levels of anxiety - providing a sanctuary without social or conversational interruption and using relaxation techniques.

If a person becomes increasingly anxious or agitated, it may help to start an activity that requires physical exertion (e.g., a trampoline or swing). Offering a youngster an alternative to the playground at break-time can be invaluable, and using specific ways (such as sending the youngster to the school office with a message) to give the youngster a break from the classroom. It helps if the teacher can establish a special code with the youngster with ASD, so that they can signal their anxiety without drawing attention to themselves. We recommend Cognitive Behavior Therapy as an excellent way to reducing anxiety for individuals with ASD.
 
==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

12. How do you share the news?

This varies according to each youngster and their circumstances. For some it may help if the diagnosis becomes public, while for others it may be preferable that they are not distinguished from other kids. A principle of who needs to know is considered to be useful. There are classroom activities that can be used to help other kids to understand the condition, and how to help their classmate with ASD. At home, it will become apparent to siblings that a diagnosis has been reached, and it is important to explain things properly to them. There are some useful books on this topic; also, local help groups may run workshops for siblings. How do you tell the youngster themselves that they have ASD?

The answer may be to tell the youngster when they are emotionally able to cope with the information and want to know why they have difficulties in situations that other kids find so easy. It is important to give the person with ASD a sense of their many positive qualities, and to give examples of the many scientists and artists who have the disorder and have used these qualities for great achievements. Once the person knows they have ASD it can provide a sense of relief and understanding.

13. Is the person likely to become depressed?

Clinical evidence shows that there is a greater risk of depression in individuals with ASD. In early childhood the person may be less concerned about their differences to other kids. During adolescence they start to become more interested in socializing with others and become acutely aware of their difficulties. The most common cause of depression is the person with ASD wanting to be like others and to have friends, but not knowing how to succeed. Should one suspect that the person with on the spectrum is depressed, it is essential that they obtain a referral to a psychiatrist who is knowledgeable in autism spectrum disorders and obtain treatment. Treatment for depression involved conventional medicine, but should also include programs to deal with the origin of the depression.
 
==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

14. Is there a specific area of the brain that is Dysfunctional?

There is increasing evidence to suggest that the frontal and temporal lobes of the brain are dysfunctional.

15. What are the advantages of using the term ASD?

If the term ASD-Level 1 is used, it can avoid misunderstandings in relation to the use of the term autism. Many individuals have a negative association with the term autism, so it is good to use a different one. When a youngster is said to have ASD-Level 1, the usual response is "I've never heard of that. What is it?" The reply can simply explain that the youngster has a neurological condition which means that they are learning to socialize and understand the thoughts and feelings of other individuals, have difficulty with a natural conversation, can develop an intense fascination in a particular area of interest, and can be a little clumsy.

16. What are the changes we can expect during adolescence?

The physical changes of adolescence are likely to occur at the same age as for their peers, but young people with ASD may be confused by such changes. During the hormonal changes and increased stress associated with adolescence, the teenager may have a temporary increase in their expression of ASD. Moms and dads need to be supportive and patient, and remember that this is a difficult time for virtually all kids.

Some of the emotional changes of adolescence may be significantly delayed in teens with ASD, and while other teenagers are intent on romance and testing the rules, the teenager with ASD still wants simple friendships, has strong moral values and wants to achieve high grades. They can be ridiculed for these qualities, but it is important to explain that they are valuable qualities, not yet recognized by others. Some traits of adolescence can occur later than usual and extend well into a person's twenties; thus, the emotional changes of adolescence are often delayed and prolonged.

17. What is the difference between High-Functioning Autism and classic autism?

Some kids have the features of autism in early childhood and then develop the ability to talk using complex sentences, develop basic social skills and an intellectual capacity within the normal range. This group was first described as having High- Functioning Autism. It is most likely to be used as a term for those who had a diagnosis of autism in their early childhood. It is less likely to be used for kids whose early development was not consistent with classic autism. Both autism [level 3] and ASD [level 1] are on the same seamless continuum, and there will be those kids who are in a diagnostic "grey area", where one is unsure which term to use.

18. What is the difference between the disorder and the normal range of abilities and personality?

The normal range of abilities and behavior in childhood is quite extensive. Many kids have a shy personality, are not great conversationalists, have unusual hobbies and are a little clumsy. However, with ASD, the characteristics are qualitatively different. They are beyond the normal range and have a distinct pattern.

19. What should we look for in a school and teacher?

What are the attributes of a good school? Most important is the personality and ability of the class teachers and their access to support and resources. It is not essential that the teacher has experience of similar kids, as each youngster with ASD is unique and a teacher uses different strategies for each individual. It is very important to find as small-sized a class as possible, to have a quiet, well-ordered classroom, with an atmosphere of encouragement not criticism, and to have practical support from the school administration. It is important to maintain consistency for the youngster with ASD, so try not to change school unless absolutely necessary once a youngster is settled.

 

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

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