Concrete Thinking in Children with Asperger's and HFA

Numerous case reports suggest that children with Asperger’s (AS) and High-Functioning Autism (HFA) think concretely instead of abstractly. For example, when these children hear the word “dog,” they may have a vivid, detailed image of their first pet dog, then the second pet dog, and so on. Conversely, neurotypical children (those not on the spectrum) are more likely to have an image of a generic or conceptual dog without much detailed imagery.

Due to their concrete learning style, children on the autism spectrum tend to remember individual examples precisely without noticing common themes among examples. For instance, the child may store the details of specific animals he encounters together with labels (e.g., dogs, cats), but he may be poor at learning features that define dogs and cats (e.g., both dogs and cats are pets, furry, playful, etc.).

On the other hand, neurotypical children learn from specific examples, and then “generalize” those examples to other areas (e.g., throwing a rock is similar to throwing a baseball). Since generalizing is far more efficient than coding a large number of individual examples, the neurotypical learning style de-emphasizes coding details of individual examples unless there is a need to do so.



Language facilitates abstract thinking and communication. Even “concrete” words such as “fatigued” are really abstractions of many related examples. AS and HFA children’s poor ability of abstraction contributes to their social skills deficits and their preference of “thinking in pictures” to thinking in language.

How can parents help their AS and HFA children to think more abstractly?

Creative thinking and problem solving are necessary life skills for all children. The therapeutic benefits of creative outlets (e.g., drawing, writing, photography, storytelling, etc.) are well-documented in medical literature. To teach creative thinking to your concrete thinker, start with a very structured approach, and then gradually relax it as the child becomes comfortable.  Here’s how to get started:

1. Cook something with your child. Even when following a recipe very closely, there’s always some room for improvising in the kitchen.  Encourage your child to decide if a little more of this or that is needed, if the oven needs to be turned up or down, if the lasagna needs an extra 5 minutes to cook, and so on.

2. Repair something with your child. Whether it’s a flat tire on a bicycle or a cracked vase, there’s usually more than one way fix it.  Instead of using commands like “go find me a screw driver,” recruit your child’s help in ‘thinking things through’ (e.g., “I need something sticky to put these two pieces back together …got any ideas?” or “ I need to put this somewhere safe while the glue dries …any suggestions?”).  Allow your child to suggest or improvise each step of the process with you.

3. Help your child make a book. Creating a book on a favorite subject will give your son or daughter a sense of authority and expertise.  One Asperger’s child collected her doll pictures (cut from a coloring book all about antique dolls), stapled them together, glued a large photo of herself to the cover, and then gave copies of her book to her cousins.  This act of kindness opened up new conversations for her.


4. Teach your child how to paint. For example, introduce your concrete thinker to watercolors, and show him or her how to draw and paint landscapes. Start off by teaching your child about perspective. A good time to do this is when you are outside. Show your child that objects in the distance appear smaller than when they are close-up. To start out, you will need heavy weight water color paper (which you can get at any arts and craft store) and a small selection of brushes (e.g., one wide brush about 2 inches for filling in large details, and a couple fine point brushes for outlining shapes and filling in finer details).

5. Show your child how to take pictures. AS and HFA kids see the world through a special lens. There is a purity to their imagination that, at some point, most grown-ups lose. If you have never put a camera in the hands of your unique youngster, you will soon discover that what he or she views in life is very different than your perspective. Start with the basics. The most important concept in photography is universally known to be “Fill the Frame.” Emphasize that the “subject” must fill the frame to remove distractions (it’s ok to show examples of subjects quite literally filling the frame with very few other elements). Once your child practices and masters the idea of removing distractions, you can go on to explain that other elements can be in the picture to support the main subject.

6. Write poetry together. A sophisticated command of the English language is not a prerequisite for writing good poetry.  In fact, simple words often have a more lasting impact than complex ideas and metaphors.  The most important tool for writing poetry is probably the rhyming dictionary, which is a book that lists the words that rhyme with ‘end sounds’ of other words (e.g., if you want to find a rhyme for “cat,” you would look up “at” in a rhyming dictionary, because “at” is the ending sound of the word “cat” …the rhyming dictionary would then give you a list of words such as “bat,” “fat,” “sat,” and so on).

7. Tell stories to your child. Storytelling is an ancient tradition across all cultures, and it’s an important part of cognitive development.  Aside from the fact that a story does a better job than anything else of capturing the essence of value, people in general like to hear stories, especially when they are told well. Children like stories because, when they hear them, they have the chance to learn, to be enlightened and entertained. Stories, more than anything else, capture the essence of our lives. That is why we like to hear them.

8. Show that creativity is always an option. It may not occur to your concrete thinker that there might be more than one way to do something.  Thus, ask him or her for alternative solutions to everyday problems.  Since all children learn through play, play therapy is the ideal way to practice exploring multiple solutions to a challenge.

9. Demonstrate that you value creative expression and “thinking outside the box.” Valuing creative expression is more than visiting art fairs, museums and theaters.  It means being curious about the world and constantly asking questions (e.g., What is this made of? How does that work? Why is this moving like that?).  It also means looking for the answers in unusual places (e.g., through a telescope, in the mirror, under a rock, up in the attic, etc.).




10. Try drawing and /or sketching. Drawing and sketching help with attention, fine motor skills, visualization skills and anxiety reduction.  This is exactly the type of activity your AS or HFA youngster may try to avoid!  Here’s a good method to teach drawing:
  • Explain that drawing ability comes with practice and that there is no right or wrong answer when it comes to a finished art piece.  Encourage the child to practice drawing his intended picture in the air with his finger first. This allows him to get an idea of how he will draw his picture. 
  • Teach the child by using a simple object that you can place in front of her. Visuals are super important for kids on the autism spectrum and their learning process. Find a simple object such as a cereal box, and point out the separate shapes your child will need to draw in order to make the full box. By breaking down the drawing process into steps, she will be able to pause from her work and return later. Also, she will learn to become more detail-oriented. 
  • Split up the drawing process into small portions (e.g., with a cereal box, point out the face of the box being a rectangle, the sides being smaller rectangles, etc.).
  • Continue to have your child draw the object chosen as many times as possible. Repetition is vital in learning to draw, just as it is in learning the alphabet or how to count.
  • Always encourage your child, and never point out a "mistake" in his drawing.
  • Never draw on your child’s papers. She will only improve her drawing ability through practice. AS and HFA children are easily discouraged. If they see your drawing and think it is better than theirs, they may shy away from their desire to improve.
  • For the child that can’t recognize shapes, still have him attempt to draw by breaking down the object into sections. This method will help him with shape recognition as well as improve his drawing ability.

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

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

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

 ==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

How To Write Social Stories for Your Autistic Child & Why They Are Super Important

"What exactly is a social story, and how do you write an effective one for children with autism?"

A social story is a frequently used method to teach social skills to kids with ASD Level 1, or High-Functioning Autism. A social story is a non-coercive technique that presents social concepts and rules to kids in the form of a brief story. This method can be used to teach a number of social and behavioral concepts (e.g., making transitions, playing a game, going on a field trip, etc.). 

There are four major components that are crucial to a successful social story. The story should:
  1. be commensurate with the child’s ability and comprehension level
  2. be something the youngster wants to read on his or her own 
  3. be written in response to the youngster’s personal needs
  4. use less directive terms (e.g., “can” or “could”) rather than more directive terms (e.g., “will” or “must”). 

Making sure the story has all four components is especially important for kids who tend to be oppositional (i.e., a youngster who doesn’t decide what to do until parents tells him/her to do something, then he/she does the opposite). 

A social story can be paired with pictures and placed on a computer to take advantage of the youngster’s tendency towards visual instruction and interest in computers.

Kids with ASD seem to learn best when social stories are used in conjunction with role-playing and used as a social primer (i.e., after reading the social story, the youngster then practices the skill introduced in the story).

For example, immediately after reading a story about joining-in an activity with friends, the youngster would practice the skill. Then, after reading the story and practicing the skill, the youngster would be exposed to a social situation where he or she would have an opportunity to perform the skill.






There should be a specific pattern to a social story, which includes several descriptive, perspective, and directive sentences:
  • A descriptive sentence describes what people do in particular social situation, and defines where a situation occurs, who is involved, what others are doing – and why (e.g., “Sometimes at school, the fire alarm will go off. It is a loud bell that rings when there is a fire or when students are practicing leaving the building. The teachers help us to line up and go outside as fast as we can. The alarm is very loud so that all the students can hear it.”).
  • A perspective sentence describes people’s reactions to a situation so that the child can learn how they perceive various events. It describes the internal states of others (i.e., their thoughts, feelings and mood). For example, “The fire alarm may bother some students. Teachers don’t understand how much it bothers me. Sometimes the teacher gets upset if I do not move fast enough or get confused. Her job is to get me outside as soon as possible so I am safe in case there is a real fire.”
  • A directive sentence directs the child to an appropriate response. It states (in positive terms) what the desired behavior is (e.g., “A real fire is dangerous and can burn people. This is why it’s important for me to exit the building with the other students as quickly as possible, even though the alarm hurts my ears”).

So, this social story about fire alarms could read like this:

Sometimes at school, the fire alarm will go off. It is a loud bell that rings when there is a fire or when students are practicing leaving the building. The teachers help us to line up and go outside as fast as we can. The alarm is very loud so that all the students can hear it. It may bother some students. Teachers don’t understand how much it really startles me. Sometimes the teacher gets upset if I do not move fast enough or get confused. Her job is to get me outside as soon as possible so I am safe in case there is a real fire. A real fire is dangerous and can burn people. This is why it’s important for me to exit the building with the other students as quickly as possible, even though the alarm hurts my ears.
 

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

==> Videos for Parents of Children and Teens with ASD
 
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Comprehending Emotions in Others: Help for Kids on the Autism Spectrum

"How can I help my 5-year-old AS child (high functioning) to have a better understanding of other people’s feelings? He often seems oblivious to some of the hurtful things he says and does, but I don’t think he does this intentionally."

Recognizing and understanding the feelings and thoughts of self and others is often an area of weakness for kids with Asperger’s (AS) and High-Functioning Autism (HFA) – and is essential to successful social interactions.

“Neurotypicals” (i.e., children not on the autism spectrum) continually modify their behavior based on the non-verbal feedback they receive from others. For example, they may elaborate on a story if their friend is smiling, looking on intently, or showing other signs of genuine interest. Conversely, if the other person repeatedly looks at her school book, sighs, or looks otherwise disinterested, most neurotypical children notice this non-verbal cue and stop talking or cut the story short.



Kids with AS and HFA often have difficulty recognizing and understanding these non-verbal cues. Because of this, they are less able to modify their behavior to meet the emotional and cognitive needs of their peers.

When kids with AS and HFA appear rude, aloof or unresponsive, it doesn’t mean that they don’t experience any emotions, or that they don’t have empathy for others. However, they do tend to express their emotions differently than neurotypical kids do. Also, studies have shown that AS and HFA kids do not always recognize facial expressions, which is part of the difficulty in reading the emotional responses of others.

The most basic technique used to teach “feelings skills” involves showing the child pictures of people exhibiting various emotions. Pictures can range from showing basic emotions (e.g., happy, sad, angry, scared) to more complicated ones (e.g., embarrassed, ashamed, nervous). Begin by asking the youngster to point to an emotion (e.g., “point to happy”), then ask the youngster to identify what the character is feeling (e.g., “how is he feeling”).


Most AS and HFA kids will pick up the ability to identify emotions quite easily. When they do, it is time to move on to more advanced instructional techniques, such as teaching them to understand the meaning (or “why”) behind emotions. This requires the youngster to make inferences based on the context and cues provided in the picture (e.g., “based on the information in the picture, why is this little girl sad?”). The pictures should portray characters participating in various social situations and exhibiting various facial expressions or other nonverbal expressions of emotion. You can cut pictures out of magazines, or download and print them from the Internet. You can also use illustrations from kids’ books, which are usually rich in emotional content and contextual cues.

Once mastery is achieved on the pictures, you can move on to television programs or videos of social situations. Many of the programs that air on some of the kids’ channels are excellent resources for this teaching technique since they portray characters in social situations and display clear emotional expressions. You can use the same procedure as for the pictures, only this time the youngster is making inferences based on dynamic social cues. Simply ask the youngster to identify what the characters might be feeling – and why they may be feeling that way. If the scenario moves too quickly for the youngster, press pause, and ask the question with a still frame. 

Other ways to teach “feelings skills” include the following:

• Applied Behavioral Analysis (ABA): ABA therapy uses positive reinforcement to encourage desired behavior. ABA can also be used to teach an AS or HFA youngster about emotions by generally providing examples of appropriate emotional behavior for her to model, and then rewarding her when she gives the correct emotional responses.

• Online Games: Most AS and HFA kids enjoy playing computer games, and these games can be an effective learning tool for teaching about emotions. The Internet has many games and activities to help these kids learn about emotions in a way that engages them.

• Play therapy: Play therapy strategies can help AS and HFA kids emotionally connect with their mom, dad and siblings. The simple act of “child-led” play to teach new ideas is quite effective for kids on the spectrum.

• Social Stories: Social stories help teach social skills to AS and HFA kids through stories that provide examples of common social situations. The stories outline how to respond to the situation. Stories about feelings and appropriate emotional responses can help the youngster learn how to understand emotions in context.




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

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

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

 ==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism



COMMENTS:

  • Anonymous said... He is probably not thinking what he is saying is rude. My son is full of fun truths as he sees them. You have to help teach him what kinds of things are not "appropriate" to say, without making him feel he's done something bad because he probably really hasn't. It's just how he sees it. Just because something may be a fact doesn't make it ok to say to someone's face and that can be hard to manage. Danny has learned a lot but still hasn't gotten it all down yet, plus part of him lives the shock factor of it all.
  • Anonymous said... Just keep talking to him about it. That is what we do with our 8 year old. They do start to at least think about it but its not easy. We are thinking about getting a therapy dog. My son connects with animals and hope to be chosen to get a dog. On the bright side my son was able to form a friendship with a classmate and this year they have become best of friends. Unfortunately they maybe moving to Japan (Military family) in the fall. Secretly hoping orders fall through.

 Please post your comment below...

Preferring Objects over People: The Autism Mystery



"Why is it that children on the autism spectrum seem to prefer objects (e.g., toys, games, digital devices, machines, etc.) rather than relationships with people?" 

To answer this question, we must first look at the concept of "weak predictive ability"...

If one has the ability to predict, he or she can come up with an educated guess about what may happen in the near or distant future (i.e., some outcome is expected), but this ability is not necessarily based on experience or knowledge.

Prediction is a skill that allows us to “generalize” (i.e., since the occurrence of “situation A” resulted in “outcome B,” then a situation similar to “A” will likely result in an outcome similar to “B”).  For example, after observing enough moving objects, a child can understand momentum and, through generalizing, predict the position of a moving target in the near future. Likewise, after seeing enough human faces, a child can generalize (or predict) that human faces all have similar parts in a nearly fixed spatial layout. 



Prediction not only affords quicker and more accurate reaction, but also more efficient neural coding. For instance, after learning the common face structure of human beings, a child’s brain can store an average face and encode individual faces only as deviations from the average. This is more efficient than encoding individual faces fully.

Children with autism spectrum disorder have poor predictive abilities (i.e., they have great difficulty predicting future events). However, the impairment from a weak predictive ability is not limited to time. Autistic kids also have difficulty with face-processing (called “face-blindness”). In other words, they have difficulty recognizing the faces of those they don’t know well. Face-blindness is a neurological disorder that makes facial recognition difficult or impossible. Research suggests that up to two-thirds of ASD kids have difficulty recognizing faces until they have interacted with a particular person on a number of occasions.

Weak predictive ability can also contribute to ASD kids’ sometimes dangerous behaviors since they can’t fully “predict” serious consequences of certain actions (e.g., running their heads into walls, running out into a busy street, wandering off alone, etc.). In addition, poor prediction of bodily movements (and sensory consequences of such movements) can contribute to their weak sense of “body boundary” (e.g., they may violate other’s personal space by standing too close to them).

Another function of prediction is to fill-in missing information (e.g., if the driver in front of you veers his car sharply to the left and then to the right, you might “predict” that he swerved in order to avoid hitting something in the road). Thus, autistic kids’ impaired predictive ability means impaired filling-in of missing information for perception and action.

So, what does “weak predictive ability” have to do with preferring objects to people?

Since children on the spectrum have to live everyday with the uncertainty inflicted by their poor prediction skills, they tend to favor relatively predictable and precise events and tasks. Wouldn’t you? As a result, they like to play with objects (which are more predictable) instead of with people (which are less predictable – and I think you would agree that people are very unpredictable). Objects like computer games, trains, bridges, and spinning wheels that autistic children are attracted to represent stimuli that are both interesting AND predictable.

Due to difficulties with generalization skills, kids with ASD have a lower tolerance for unpredictability and complexity. They argue that objects are predictable and simple, whereas people are not. Thus, they gravitate toward objects. 


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

==> Videos for Parents of Children and Teens with ASD
 
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==> Pressed for time? Watch these "less-than-one-minute" videos for on the go.

What are peer-mediated interventions, and how do they work?

"What are peer-mediated interventions, and how do they work?"

A peer-mediated intervention is a technique that has demonstrated effectiveness in teaching social skills to kids with Asperger's (AS) and High-Functioning Autism (HFA). The use of peer mentors is an example of an effective strategy for kids with AS and HFA. Peer-mediated interventions allow parents and teachers to structure the physical and social environment in a manner to promote successful social interactions. 

In this approach, peers are systematically trained to make social initiations or respond promptly and appropriately to the initiations of kids with AS and HFA during the course of their school day. Peer mentors should be classmates of the AS or HFA youngster, have age-appropriate social and play skills, have a record of regular attendance, and have a positive history of interactions with the AS or HFA youngster.

The use of peer mentors allows the teachers to act as facilitators, rather than participate as active playmates. The use of peer mentors also facilitates generalization of skills by ensuring that newly acquired skills are performed and practiced with classmates in the natural environment.



COMMENTS & QUESTIONS [for 6/2013]

Since we can not financially go back to the Dr who diagnosed Chance who is 11 with ADD and high functioning autisum we were wondering what natural things a behavioral books we could study until we can go for therapy and maybe medication! The normal person would probably not be able to tell that Chance has a problem but his unruly behavior at home and bad sleeping problems are getting worse ! He loves school and sports and does well in both. He passed into the 6th grade without ever doing his homework or studying at home with a C average. He loves to read and of course loves video games and is very good at them. However his off again on again wild behavior that he can control if he wants to is beyond belief and only a very sturn hand by his father is almost the only thing he respects ! sometimes I think this is food related because of the crazy outbursts ! He bad mouths his Mom and me but never in front of his father. Like I said most of the time you would never know he has a problem unless he is in one of his wild moods ! He also has a problem making and keeping friends . His 8 year old sister is his best friend and how she tolerates him sometimes is beyond me. Chance has been this way from birth but we just thought he was a difficult kid to handle.He was born in a emergency C Section and half of his body was blue when he came out  the umbilical cord was wraped around his neck .Last night he was up all night and just now woke up and it is 8pm.

I am sure your trained eye would have recognized this problem sooner but we just had this diagnosed a couple of months ago. My daughter in law heard them taking about his blood test but they could not see the dr because they did not have the money for the visit ! We found out his diagnosis from the school. The nurses said they might not be able to give him medication because of the blood tests . It will be awhile before we can get back in to this same Dr and we are really in need of help now !

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My middle son ( almost 9) has been diagnosed with the combined type of ADHD with ODD and a possible mood disorder.  For the least year he has been in behavioral therapy which became very inconsistent due to many cancellations.  He was put on Metadate CD by his psychologist who left the practice mysteriously.  When I saw the interim psychologist for another prescription, he suggested a low-dosage antidepressant to treat the mood disorder that now was more prevalent than my son's ADHD.  However, I believe that these two medication interacted in such a way that my son became completely defiant towards his teachers and classmates, disrespecting and hitting.  This lead to two suspensions within the last month.  During the last two weeks I have consulted my PCP who decided to take him off the Antidepressant gradually.  I have also begun the process in looking for new counseling services since I was not able to get any help from my therapist who cancelled again last week or the psychologist other than anew prescription.  He made it through the last weeks of school successfully and will enter fourth grade.  I want to use the summer teaching him social skills which he lacks as well as skills that help him control his impulsivity.  Can you give me any advice or help on how to help him? How can I help him to manage school without facing expulsion which the administrators have already mentioned?

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Mr. Hutten,
My son who has been diagnosed with Aspergers, is facing very serious federal charges as an accessory after the fact. He was directed by his "friend" to trade shoes with him after that "friend" had committed a crime. My son, who has an incredibly difficult time making friends, has always struggled to see the "big picture" and really struggles deciphering intentions or predicting outcomes when faced with situations. It seemed that he had found a "freind" who accepted him and he was unable to see this friend was exploiting him. As I have learned from combing your website and reading your ebook, this is most likely due to his condition. Do you know of any expert in Aperger's that would be willing to work with us in this case? We live in Manhattan, KS and are willing to pay a retainer fee and travel expenses. We are desperate Mr. Hutten. My son, who has the maturity of a 12 year old, is not a criminal. He just unfortunately got tangled up with some pretty bad people.

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Thank you Mark. Over the next few weeks we will be going over both pdf book but also online version with videos, etc. Our daughter is 3 and a half (will be 4 at the end of September) and we are bi-lingual and she does not speak well yet. She does not want to talk other than in her own language. At pre-k 3 she is exposed to English obviously and it really helped her and is picking up a lot of words however she does not form sentences in either English or Slovak. Other than very short sentences. But when she does speak other than her own language she only uses English. However since she has been attending pre-k her language skills picked up.

Hence our situation is so much more frustrating for her and for us in addition to dealing with Aspergers meltdowns. We know that at this age it is a lot more difficult dealing with a 3-4 year old than trying to help an older child. Plus not speaking well or not wanting to speak does not help either. Her speech delay seems nothing uncommon at her age it is just a mix of this + dealing with meltdowns. We are looking forward to going through the material.

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Hi,

I came across your information on an article about your book, Launching Adult Children, and I’m looking for information for adults with aspergers.  My significant other has been struggling with it and it has created a number of challenges both at home and in the work place.  We’re in NJ and unfortunately there’s only one support group that meets once a month and it’s not an ideal fit for her.

She is struggling with career challenges as well as establishing consistency with her goals.  She struggles with mood swings because she is also bi-polar.  Surprisingly she is a recovered alcoholic of 22 years so there are some things that she has maintained consistency with.

Her biggest challenge at the moment is her job and a boss who clearly doesn’t understand who he’s managing or how to manage her.  She’s a talented writer, but without the right support and encouragement she may never get far with it.  She had a short stint writing for the paper, has written online and can do professional quality work, but she can’t figure out how to get into that field, which is probably well suited for someone with aspergers.

Anyway, I’m looking for resources so thought you might be able to point me in a direction.

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Hi Mark,

I have appreciated the information you offer to parents of children with asperger's as part of the group of people who receive your newsletters.  My 8 year old son was diagnosed with asperger's about a year and a half ago, and we have made a lot of progress through Occupational Therapy.  Social skills training has proven more difficult for him.  He has improved tolerance for social situations through OT by becoming more self-regulatory for being overwhelmed by too much input, but has no intrinsic motivation to socialize with his peers.  If I want him to have any measure of success in a social scenario with children, I have to reward him for doing well, and this becomes his motivation ahead of time to do well.  His OT says a reward is fine, but my concern is that his reward should eventually be his own success, not lunch at a favorite place, or a trip to a favorite store.  He prefers to have no interaction with peers, and so to motivate him to have successful experiences, I offer him these rewards.  What do you suggest is best?  I have spoken with other parents who also use rewards with their children on the spectrum.  Is there any harm in doing this?

Also - are you aware that there have been some recent studies done (one at Ohio State University) on levels of cholesterol in ASD children being too low?  I had my son's cholesterol tested, and it falls in the abnormal range according to the study, however, most doctors don't subscribe to this claim.  There is plenty of medication to lower cholesterol, but none to raise it.  I thought to share the study with you below if you are interested.  I believe there is something important to this.  The embedded video clip is particularly compelling:


Thank you!
Jennifer

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Dear Mr. Hutten:

My 26-year-old son was just diagnosed with (among others) subthreshold Asbergers Syndrome. The psychiatrist who tested him provided us the report. All the information I have found deals with young children or teenagers -- none with a just-diagnosed adult. I do not know how he managed to slip through the system of elementary school, junior and senior high school, numerous therapists and counselors, and two different colleges (neither of which he completed) without being diagnosed. He was under the care of a therapist and psychiatrist for two years. Both of them mis-diagnosed his condition as "bad parenting" and laziness. The psychiatrist merely prescribed higher doses of the same antidepressants rather than trying different meds until finding the ones that actually worked. My untrained friend researched his visible symptoms and suggested he needed testing for Autism. We went to his physician who referred us to a neuro-psych professional.

Because of my son's age he is uninsured. I lost my job seven months ago and am struggling to make ends meet. With the help of the professional who diagnosed him, I am going to locate a psychiatrist who can handle his medication, and a therapist who can work with his depression and anxiety issues. I have also put him on a gluten-free and milk-free diet and am applying for Social Security Disability benefits under his late father's social security number so that we can afford the treatment he so desperately needs.

I am not writing to ask for anything. I just need to vocalize the fact that it is possible for an extremely bright and artistically talented child can go through 26 years of struggling and suffering (and me, as his parent as well). I am now dealing with the guilt of not seeing the symptoms, and the overwhelming anger and frustration of the wasted, wasted years. Thank you for your time.

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My son is ten years old and wants to stay up all night long. When I talk to him about going to bed he argues that it is summer and it does not matter since there is no school. He is keeping his younger brother, who is 7, awake with him to play video games, drink soda, and watch TV to stay up all night. They call it “guys night”, which he got the idea from his favorite cartoon TV show he watches all the time. He is fixated on this and will not stop trying to stay up all night every night. I tried to explain that he can wait to the weekend or do this every once in a while, but not every night. I am not getting through to him. How can I help him understand my point of view about this situation?

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 My 11-year-old son who has Asperger’s still has difficulty with wiping after a bowel movement.  I believe it is due to sensory issues, he cannot tolerate the feeling of it even though he has lots of tissue.  He is able to get most of it, but usually not all even when using wet wipes.  He just  becomes completely grossed out by the idea of it and becomes upset.  He wants to be able to do it for himself, but is not there yet.  Do others have this problem and what can we do to help him overcome it?

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We live in the UK and our 8 year old has just been diagnosed with Aspergers. He is extremelly bright, an amazing mathematician, very able to write, but struggles with reading facial expressions, lacks empathy, is unable to catch a ball, can't keep eye contact, can't 2 things at the time (talking and getting dressed), he can't talk and no listen  to others for a long time etc...

He loves riding a bike, but he does not want to swim. He has swimming as part of PE next year in school and I don't want him to feel different, but he really does not like the water in or near his eyes, ear, nose etc.... What shall I do?

I have tried to teach him and he doesn't let me...  Would a private teacher be a good idea? or shall I wait till he wants to learn?

And .... so far I have told him that he has trouble making friends and interacting with others because his brain works in a different way since he is brilliant at Maths , science and has an amazing memory.  

2 years ago we discovered he was able to say the day of the week of any given date up to 2 years earlier.  We thought that it was strange and we kept him away from any calendar. 

When is it the right time to tell him that he has Aspergers or what it is called now high funcioning Autism?

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Dear Mark Hutten
Hope this email isn't too late as I've only just received your email after being away.  I will try to keep it short.
The last question on your email was very interesting as the 14 year old sounded like my grandson only he is 18 this month and has Aspergers.  My son being the strict one of the two.
He was granted a place at a college for teenagers (only allowed home for the weekend every two weeks) who have Aspergers last year but hated the discipline and behaved very badly.  He has hardly been there this year as they have suspended him twice.  Although they are willing to take him back again he now wants to do an apprenticeship and not return there.
His behaviour is still very bad and is obviously affecting not only his parents but his younger brother who is only nine.  He smashed up his bedroom door a week ago and my son has to pay out for a new one.  My son and daughter-in-law are at their wits end - although my daughter-in-law doesn't like anyone to know how bad he is.  I think my son would just like him to leave home although I worry what would become of him if he does.
I would be very grateful for any advice you could give.

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I have a 16-year-old daughter who has been getting into trouble for two years and I've really had to crack down and check up on her; trying to get her to earn trust back.   A month ago she got caught lying, stealing and called me a nasty name.  When I went to ground her for two weeks, she went to "live with her dad." (We are divorced and I am remarried)  He does not have custody of her, but she wants to continue to live there because he doesn't follow through with checking up on her the way I do.  This is killing me as a mom. I can try to force her to come back home through the courts, but I don't know if that is the best thing to do.  Has anyone been in this situation?  I am so worried she is going to end up doing thing that will affect her for years to come. 

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My son is six with undiagnosed mild Aspergers (suspectd for a year now), first picked up by his teaher in his first primary year.  It is now being suggested i have him officially diagnosed although i am told his needs educationally and emotionally are being met.  i am suspicious of this sudden change in opinion by the school.  What could he gain by a diagnosis when he does not need one to one help and his needs are currently being met.  I have expressed no concerns he has his little quirks but i have read lots and we are coping well and helping our son where we can.  I really worry that the label of Aspergers could do more harm than good for a mild sufferer who needs and would get little or no extra support.
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Dear Mr. Hutten,

My name is Priya and my younger brother ("K") is a 21-year-old with high-functioning autism and Asperger's syndrome. We live in Los Angeles, California. I'm sorry to contact you out of the blue but I'm really not sure what else to do at this point.  The situation with my brother has gotten out of control, and I am now convinced that unless serious action is taken, the future of our family is at risk.  We need help, and I'm not sure who else to ask.  I read your book on Launching Adult Children with Asperger's - many of the steps you mention are ones we are already taking with my brother, but we need a different type of help with him that I'm hoping you might be able to provide.
To give you a little bit of background, K has attended the University of Southern California for the past year (he transferred from a community college last year, and is going to be a junior this fall).  During the past school year, he lived in a dormitory on-campus during the spring term, and stayed there a few days a week and, since we live relatively close by, stayed at home for the other days.  Since the beginning of that term (not sure if there's a connection between the two), his condition has taken a severe turn for the worse.  He has always had trouble controlling his obsessive tendencies, rigid need for predictability and 'sameness' in his schedule, etc, but lately things have taken a very bad turn.

In what continues to be a pattern of progressively worse episodes, K has been going into violent rages and making frightening and graphic threats towards my parents and especially toward me in the past six months.  For instance, a few months ago, Krishna physically attacked our father because of a mishap concerning one of Krishna's projects for school.  For this project, Krishna had interviewed a museum curator during the day using a voice recorder, and he asked our dad to help him transfer the recording to the computer.  In what was a truly unfortunate but obviously accidental error, my dad erased 15 of the 30 minutes recorded on the voice recorder while trying to transfer the recording, and Krishna went absolutely berserk.  He grabbed my dad and slammed his head against the wooden closet door, slapped him, and punched him repeatedly in the chest, arms and knee caps.  Our parents tried to figure out what had happened and desperately tried to retrieve the lost information while trying to get Krishna to stop attacking them, but Krishna was absolutely wild.  

I tried my best to calm him down, speaking in a level voice and explaining again and again that it was a mistake and that he had every right to be angry and devastated but that this was not the way to handle it.  At the very least, I wanted to prevent him from seriously injuring our dad, but he shoved me, grabbed a heavy three hole punch and threw it at my legs - it missed, fortunately, but damaged the hardwood floor.  He then grabbed a vase and flung it as well.  He then ran into the family room next door and grabbed anything he could get his hands on - phones, remotes, etc and threw them at me as I tried to tell him as calmly as I could that I understood why he was so angry, but he needed to stop that behavior before someone got seriously injured. Amid all the broken items on the floor, Krishna repeatedly screamed that he wanted our dad to 'pass away' and if he didn't, Krishna would kill him. My parents also came into the room and tried to explain that there was still lots of material left on the tape that he could use, and that my dad would personally go and try to get him another meeting with the curator, but he would not listen to any of it.  He continued to physically lash out and hurled several unmentionable words as epithets at us countless times, threatened to kill us all, to leave and never come back, and all sorts of other things  I eventually got him to go to his room until he could calm down, but not without getting punched, clawed and scratched over my torso and arms.  I should note that he had brief moments of clarity in the midst of all this - he would briefly acknowledge my remarks that everyone makes mistakes, that our dad also devotes his life to Krishna and that this one error should not trump all of that, etc - but these moments were inevitably overshadowed by the crazed anger that had taken over his mind.  

Few episodes have been quite as violent as that one, but in the course of his many 'rages' (which vary from 2-3 times per week, sometimes more or less often), he has thrown items at each of us, threatened to rape and/or kill my mother or me, fervently and loudly wished that I would die in a plane/car crash, and the like.  He has never attempted to truly physically harm any of us, and is always deeply repentant afterwards - he recognizes that his behavior is completely out of line, dangerous, and irrational in light of the seemingly meaningless triggers that incite his anger (which vary from not getting the particular lunch that he wants, to hearing me discuss how lawyers in a particular branch of government that I may one day apply to get paid $170k per year, etc).  He recognizes that he needs to change, and tries desperately to show that he does love all three of us, cares for us deeply, and appreciates his need for us in his life.  Yet these rages continue, and as my parents are in their 50s, they are less and less able to cope with these 'tantrums', and as I am getting married and moving away this summer, I honestly fear for their safety as long as my brother continues to lash out in these unpredictable ways.

I have believed for a long time now, that much of his anger stems from frustration, which is owing in large part to the fact that the academic standards of USC, and standards for most jobs, are not ones he can handle without quite a bit of difficulty.  That frustration, of being constantly found 'lacking', combined with the fact that he has no friends and no one who willingly spends time with him besides my parents and me, is manifesting as violent rages and I'm truly frightened or where that may lead.  Much as it angers me that, despite his efforts to reach out to them, none of his peers see fit to befriend my brother - who is, at heart, a truly good, sincere, and sweet young man - it is not something that is easily fixed.  The best we can do is try to help him handle these things that upset and frustrate him in a more productive way. 

To that end, I think he truly needs some combination of medication (he currently takes about .5 mg of risperidone every night) and intense cognitive behavioral therapy, and whatever else will help him effectively deal with the many things that (rightly) frustrate and upset him. Can you please provide me with some information about the most effective anger management rehab centers in the Los Angeles area that you know of, or suggest another means by which we might be able to help him, and by extension, help ourselves, deal with his condition more effectively?  I strongly feel that some action has to be taken because the status quo cannot be endured any longer.

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Mark,

I downloaded the eBook this morning and have already read half of it.  It is very straight forward and a lot of common sense when you sit and think about it.

Sometime we can’t see the forest from the trees, we need someone to point them out for us.

Thanks for the book.

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 I came across your information upon my research of Teens with Asperger's. My 15 year old nephew has never been diagnosed, but I strongly suspect that he may have Asperger's, as the traits I have seen listed, are synonymous with his. 

I am deeply concerned because as a teenager, I know that he probably feels "different" from his peers but can not understand why. 

He attends regular school, but his social skills are not up to par for his age. He prefers to spend most of his time alone and I know that although he can't express it, he is dealing with some pain inside. 

Because it has not been addressed and everyone ignores the elephant in the room, I don't know where to begin to initiate conversation with my sister (his mom) and I don't think she would know how to speak with him without causing him to feel insecure as a result of him possibly believing it is something to feel ashamed of. 

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 My son, who is 18, is leaving for college this coming year.  His biggest obstacle is not following through when faced with a challenge he can't reason the answer for.  If he can plan out the end result, all in his head, he succeeds, but he thinks asking for assistance is cheating in some way.  He just stops the process.  I wonder if he maybe put the project aside to let go of frustration; this is a common reaction in people.  However, he doesn't pick up the task again to find the solution and follow through.  With him going to college, this style of problem solving is worrisome.

Also he doesn't take a shower after he has worked up a sweat.  He only seems inclined to shower and brush his teeth at scheduled times.  We have tried explaining that he may not be bothered by his smell or the crud on his teeth, but others really notice both and not keeping your gums clean causes problems down the road.

Do you have any experience with these two tasks?  We live in a remote area so there isn't a lot of assistance, but when he goes to college I'm going to look for an Occupational Therapist, so that he'll have support if/as needed.

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 When I try and explain how I feel towards something he has said, he will usually always deny that is what happened.  Eg for example, he was telling me about his mom who is refusing food because she had a stroke and wants to die, and describing how she will only eat a little bit of a strawberry.  So I join in the conversation and chirp in and say hey how about bacon and puree it; to which his response is no, bacon is no good; I would eat fruit as I like fruit.  Now I felt offended by this as per usual I feel any comments I suggest are dismissed without any thought (he would not do this to any one other than me ie to outsiders he is polite and well mannered and would agree with them and say yes that is a great idea).  I explain to him why I’m offended and it causes an argument cos he proceeds to deny that’s what he meant; to which I respond that I’m not saying that I felt he meant to offend me and that I was trying to explain to him why I was offended and would appreciate if he could perhaps in future listen and consider my feelings; so it doesn’t happen again; otherwise I’ll just end up shutting down from him cos I feel dismissed.  It caused a huge argument which went into the 5 D’s as I call them, ie dodging, ducking, diving, deflection and defensiveness.  

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 Whenever I try to break down and share how I feel, my husband’s response, instead of listening, will be to automatically say the opposite of what I’m saying, and I end up not feeling heard.  Most of the times it’s over the most trivial thing that isn’t important; but what hurts is my husband’s lack of emotional response and denial that hurts ie invalidation.  I’ve spent years trying to explain to him how I feel invalidated and he always responds with a no, in the monotone voice, devoid of any emotion apart from a high pitched tone which drives me nuts as I can only hear the irritation in his voice.

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 This afternoon before he goes to work, I’d asked him to set up a folded rebounder which was in our bedroom by taking it to the living room.  In our bedroom we have a massage chair and my husband clumsily banged into the very expensive massage chair, damaging it (again as he damaged it last night as well with the rebounder).  I got cross and told him so and he responded in his monotone voice and with a whingey complaining moaning tone that the room was too cluttered.  I then try to explain to him that an NT would just say woops, darn, sorry about that and that’s it, over and done with; but no he has to go and whinge about the room being too cluttered instead of taking responsibility and saying sorry.  It’s the lack of emotion that upset me more than the banging into the massage chair and denting it.  It caused a huge row as he would not acknowledge how I felt or attempt to understand and kept whinging and complaining, saying that sorry wouldn’t change things.  If I was a work colleague or anyone else, I’ve seen my husband in action and he is on his best behaviour with others and would not react the way he did with me.  I’ve been told he’s like this cos he’s comfortable with me; but hell it’s ruining our marriage.

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  I still do not understand the key to communication with an Aspie.  I run on emotions; my husband runs on whinging and what I find is a lack of emotions with a monotone complaining voice which comes across as negative.  I walk on egg shells around him; and am at the end of my rope with him.  I’ve been trying for almost five years to fix and heal our marriage and communication problems.  You mention that counselling wouldn’t not work much over social education or something along those lines?  My husband always responds that he feels normal and that I’m the abnormal one who is overly sensitive.  It takes all my strength inside to find a way to talk to him so that he understands me; and it usually works by example ie if I talk him through an example.  Eg he complains that I tend to say my life was better when I was single before him; so he feels he should leave when the marriage gets tough; so I explain that hey, I complain that the house was tidier before our 4 cats lived there with their cat towers, beds, cat fur, throwing up, food bowls everywhere and the house was much quieter before the 7 budgies we have with the aviary and feathers and poo and the horrendous noisy chatter when they are happy to see us; and I complain when I’m frustrated but it doesn’t mean that I want the budgies to leave or the cats and I try and find solutions to make our lives work together ie noise absorbers, ear plugs, more tidying up etc.  Only then did he understand.  

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 What do I do when he always says the oppositve of what I say, doesn’t listen or hear me, claims he’s normal and I’m overly sensitive and doesn’t hear what I say and constantly denies everything when I’m trying to explain my feelings?  We saw an Aspergers therapist yesterday who said to write it down; we’ve tried this and it used to work and there’s not much time these days as we have much going on in our lives; and we had agreed when he moved in that if we don’t nip it in the bud when it happens, he will forget the sequence of events.  Then he’ll deny everything saying no, that didn’t happen and will have forgotten.  Am I supposed to just put up with behaviour and comments that hurt just cos he’s got Aspergers, I’ll just switch off from him and shut down instead emotionally and the love will shrivel up.

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 Hi Mark,

I just recently found your site and have found a lot of beneficial and reinforcing info on it. Thank you. It is the best site I have found so far on information on raising a child on the spectrum. My son is 9 and I have suspected HFA since age two. His pediatrician of the last year is now leaning towards that too. He has not been tested for it yet, has many indicators, and is on Paxil and Adderrall currently. I am considering heavy metal or chemical toxicity from early childhood (he was adopted from Russian orphanage). Do you have any info on this or know of any sites on toxicity I can research also?

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I love you Mark Hutten....joking. But really, on days that are difficult and I'm left wondering, how do I help, your emails pops up and gives me tips, guidance, and understanding. Thank God I found you! Jill 

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Dear Mark I am really struggling with my 15 year old son. He has not been tested yet but I am almost positive he has aspergers. When he was younger I contacted the children's mental health association in our area and was told if he was doing okay in school to leave him alone which he was at the time.This is his first year of high-school and it has been very trying. He is really struggling with Math and is going to fail. When I try and tell him to get a high-school diploma you must have 3 maths he just says he doesn't care . I have even hired him a tutor but he says he just tunes out because it is so boring. I have asked the school about having tested for aspergers but they advised me to go through our family physician. Is Math a particularly difficult subject for aspergers.

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My grandson is a 17 Y/O with undiagnosed Aspergers. I am sure of this because I have worked for most of my career with Special populations,before that in mental health and before that in medical. Amazingly I am having Difficulty getting help for him. he has now reached such a state of anger that he refuses any help. He has frighten away an in home case mgr and walked out on a therapist. What I want is a diagnosis. but he refuses. Can you offer any suggestions? I know this should have been addressed long ago. Soon he will be 18 may of 2014 and I am afraid he will wind up in prison. 

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 I live in WV and my 7 year old daughter has just completed 1st grade.  We had a terrible experience, she has an IEP and her teacher did not tell the truth with things going on in the classroom.  She has spent the year being punished for normal Aspie reactions: standing, singing not standing on the line in the hall and etc.  This is behind us, we have had a tudor for over two weeks and she goes to Speech and regular counseling.  The Speech person is not helping at all she is focused on attentive answers and full statements.  The normal counselor says she is adjusting just fine and wants to wien her off from the visits.  It took us a year to get into this place, and we have to drive 45 minutes for each appointment, sorry I go on and on.  The point is she is not reading!  She states “she does not need to learn to read”  She also states “there is no benefit to me to learn to read”  we have deep talks on the benefits.  She can not blend sounds.  She is high functioning and she of course the other part ADHA and OCD.  My concern is she is going into second grade and we have made no progress on reading from Kindergarten.  She was writing before 2 and she could recognize her name, my name, her dad’s name in any type of print.  She is very bright.  In Kindergarten she tested 115 on the bell curve whatever that means.  Her school went from treating her as a problem hard headed child to what she is.  In first, it stopped and she lost all zeal for school or learning.  I have exhausted every avenue I can think of.  Because she is not abusive, she is not allowed in any type of programs.  My daughter is falling through the cracks and I can not catch her.  I work 45 plus hour and most of the time she is with me.  She is now developing the separation issue we had when she started Pre-K.  My heart is breaking and I don’t have any place to turn.  Please any suggestions would be really welcomed.  It is not fair that it seems every program has failed her.  I keep telling her there is a special world just waiting for her if she would start to read, she of course questions how that is possible.  I AM LOSING HOPE FOR MY CHILD PLEASE HELP.

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My 18 year old is on academic probation from 2 college universities,  just has been arrest for possession of marijuana and drug paraphenalia.  He is currently attending an Intensive outpatient program (IOP).  He does have a full time job in a maintenance dept.   He wants to go back to college for a technical degree in auto mechanics.  My husband and I agree that we would pay his tuition as long as he is drug free (which would mean he would have to submit to drug testing by his parents (IOP ) would be be completed by then.  He wants to move out,  he would pay for his own apartment. My son has clearly said to us he wants to continue smoking pot.  Remember he is currently in treatment.    Are we being fair to him if he pays his own rent,  we pay for college,  but he would still have to do drug testing?.   He wants to be free to make his own choices since he is paying his own rent.   What do you think?

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QUESTION:

Hi Mark
I found your website and book on-line and purchased and downloaded your Booklet "Launching Adult Children with Aspergers".  I found it very informative and helpful.

I have a 19 year old son who was diagnosed with NLD. He fits some of the Asperger criteria/behaviour but not all. He really does fit NLD more.  I have done extensive reading on Aspergers and less so on NLD as there does not seem to be as much published.
Do you have any material on the similarities and  differences between these two?

Also, do you have any material on Asperger's or NLD and Gender Identity Disorder?  I understand there can be a co-morbidity and some believe that the Gender Identity Disorder can fit with the OCD piece of this.  Is the Gender Identity Disorder permanent (likely) or have there been cases of it resolving without transition?


ANSWER:

RE: ... found your website and book on-line and purchased and downloaded your Booklet "Launching Adult Children with Aspergers".  I found it very informative and helpful.

Thanks... be sure to listen to all the audio files on your download page.

RE: Do you have any material on the similarities and  differences between these two?

Here: http://www.myaspergerschild.com/2010/12/aspergers-versus-nonverbal-learning.html

RE: Also, do you have any material on Asperger's or NLD and Gender Identity Disorder?  

There have been several recent studies linking Aspergers in adults with gender identity disorder (i.e., a disorder where an individual feels like they are actually a member of the opposite gender they appear to be). Much more research is currently underway to look for the causes of Aspergers and possible solutions to managing the condition.

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