Search This Blog

Stress-Management for Children with High-Functioning Autism

"I need some stress management techniques to use on my very anxious daughter with autism (high functioning). Thanks in advance."

Children with High-Functioning Autism (HFA) are prone to greater stress in their daily lives than their “typical” peers. Social interaction – especially with more than one peer in which the HFA child has to identify, translate, and respond to social and emotional cues and cope with unexpected noise levels – inevitably increases stress to a point where his or her coping mechanisms may collapse.

A “stress assessment” (based on the knowledge of HFA) will help parents and teachers determine what are the natural and distinctive stressors for the child. Subsequently, an effective stress-management program can be designed.



When there are concerns about an HFA youngster’s stress level, a stress assessment can be conducted in order to better understand why the stress is occurring and to determine the most effective interventions to address it.  

The assessment process involves:
  • observing the child’s behavior while he or she is experiencing stress
  • identifying the context in which the stress-related behavior occurs
  • documenting actions that precede and follow the behavior
  • triggers and payoffs for the behavior
  • parent response
  • child reactions to the parent response
  • frequency of the behavior

The goal here is to gain greater clarity about the child’s distinctive stressors and the function of the stress-related behavior so that effective interventions can be put in place to address his or her individual needs.


==> Parenting Methods for Reducing Stress in Your "Special Needs" Child [audio segment from lecture by Mark Hutten, M.A.] 
 

Components of a stress-management program may include the following:

1. At school, one option for the HFA youngster who becomes stressed on the playground during recess, for example, is to be able to withdraw to the school library, or for the child who is anxious about socializing during lunch break to be able to complete a crossword puzzle or go for a walk in the gym.

2. Help your HFA child understand his routine each day. He wants to know what is going to happen next. He needs to hear it every day – even if he did the same thing yesterday! You might hear your child ask the same questions over and over again. Try not to get frustrated with him if this happens. This is his way of trying to understand or asking you to give him more information. Also, talk to your child if he gets upset about a change. Ask him why he is upset. He needs help putting his feelings into words. Sometimes he just doesn’t like to stop what he is doing, or sometimes he might be worried about what will happen next.

3. “Cue-controlled relaxation” (i.e., a combination of deep breathing and repetition of the word "relax") is also a useful component of a stress-management plan. One technique is for the HFA child to have an object in his or her pocket that symbolizes – or has been conditioned to elicit feelings of – relaxation. For instance, one AS teen was an avid reader of fiction, his favorite book being The Secret Garden. He kept a key in his pocket to metaphorically open the door to the secret garden (an imaginary place where he felt peaceful and content). A few moments touching or looking at the key helped him to contemplate a scene described in the book and to relax and achieve a more positive state of mind. Parents can have a special picture in their wallet (e.g., a photograph of a beach scene) which reminds their child of the solitude and tranquility of such a place.

4. Let your child know if there is going to be a change in her routine. She feels worried inside when she doesn’t know what is going to happen or if she doesn’t know what she needs to do. It really helps when you tell your child about her day when she wakes up in the morning. Also, keep her updated as the day moves forward. Also, it really helps your child do what she needs to do when you can give her a five minute warning before a change happens. Even if she complains and doesn’t like what is going to happen, she can still get ready and do well with your help, if YOU stay calm.




5. Environmental modification can significantly reduce stress. This can include having a safe area for periods of solitude to relax, minimizing distractions and reducing noise levels.

6. If the parent or teacher recognizes that a particular event is a major cause of stress, then it would be wise to consider whether the source of stress could be avoided altogether (e.g., recommending the temporary suspension of homework).

7. Practice new things with your child before she has to do them with others. If she is going to do something new, it helps her get ready and feel good about trying if she can practice with you first. Even if the practice is not exactly the same as what is going to happen, just pretending about something new or simply reading a book about it can help. When the new thing happens, your child will remember about practicing with you and will know what to do.

8. Help your HFA child know what to do when he misses you. Being away from you is hard for him, even when he is doing something fun or is with someone he likes. Sometimes it helps if you tell your child what the two of you will do together when you come back.

9. Traditional relaxation techniques using activities to encourage muscle relaxation and breathing exercises can be taught to children with HFA as a “counter-conditioning procedure,” but parents and teachers must also consider the circumstances in which the child is particularly prone to stress. Counter-conditioning is the conditioning of an unwanted behavior or response to a stimulus (e.g., nervousness) into a wanted behavior or response (e.g., calmness) by the association of positive actions with the stimulus. For instance, when conditioning a child who has a “startle response” to loud noises, the parent would create a positive response by massaging or hugging the child when he or she reacts anxiously or nervously to a loud noise. Thus, this will associate the positive response with the loud noise.

10. Some stress is “good” stress, and some stress is “bad” stress. Not all stress is bad. Learning to do new things can be stressful for your child, but you can help her take a break if she needs to, or you can help her feel good about trying. 

Resources for parents of children and teens on the autism spectrum:
 
 
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

---------------------------------------------------------------

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.

Click here for the full article...

--------------------------------------------------------------

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.

Click here to read the full article…

------------------------------------------------------------

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."

Click here to read the full article…

------------------------------------------------------------

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.

Click here
to read the full article...

------------------------------------------------------------

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.

Click here for the full article...
 
------------------------------------------------------------
 
A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...

Part 4: Teaching Strategies for Students with Asperger’s and High-Functioning Autism – Problems with Generalizing



Many students with Asperger’s (AS) and High-Functioning Autism (HFA) are unable to generalize the skills that they learn. For instance, the teacher may inform the student how to respectfully address a teacher. Normally this skill would then be generalized to any adult in a position of authority. However, a student with AS or HFA is likely to only apply the skill to the individual initially used as the target of respect in the learning process. The student will probably not apply this behavior to a principal, dean, or police officer.

The inability to generalize can also pose a problem in classroom assignments. For example, giving the direction to open a math book to a certain page does not communicate to additionally begin solving the problems. Thus, teachers should verbally give all the steps necessary to complete an assignment rather than assuming the AS or HFA student will know what comes next.



There are additional techniques that have been used in assisting “special needs” students to learn to generalize. Modes of instruction such as "scope and sequence" can be useful in equipping these students with the skills that assist in social and academic learning as well as generalization. Scope and sequence training involves teaching the student about the basics prior to expecting the generalized rules to be learned. For example, it would be best to (1) teach the student that “the tone of a person's voice sends a message” BEFORE (2) teaching the student he should “use a tone that is respectful to others.” Due to the difficulty AS and HFA students have with generalization, failing to teach the basics will further enhance their inability to generalize.

The IDEA Act is clear in its declaration that students must be placed in the least restrictive environment possible in an effort to provide them with the best education possible. This can only be achieved by means of evaluation by teachers as to the effectiveness of their chosen teaching strategies and a willingness on the part of teachers to continue to learn new techniques of instruction. Every AS and HFA youngster needs to (a) be evaluated, (b) have a plan established addressing areas of weakness, and most importantly (c) have a teacher that believes in the student and expects her to reach appropriate grade level requirements.

It is important that the teacher understands what AS and HFA is – and how it hinders students. Without a clear understanding of this disorder, actions that are clearly a part of the syndrome can be confused with behavioral issues and dealt with inappropriately.

==> Teaching Students with Aspergers and HFA

Does Your "Obsessive" Child on the Autism Spectrum Have OCD?

"My child (with HFA) does obsess about certain things, but how can I tell if he has full-blown obsessive compulsive disorder?"

Obsessive compulsive disorder (OCD) is described as a condition characterized by recurring, obsessive thoughts and compulsive actions. Obsessive thoughts are ideas, pictures of thoughts or impulses that repeatedly enter the mind, while compulsive actions and rituals are behaviors that are repeated over and over again.

The obsessions seen in kids with Asperger’s (AS) and High-Functioning Autism (HFA) differ from the youngster with obsessive compulsive disorder. The youngster with AS or HFA does not have the ability to put things into perspective. Although terminology implies that certain behaviors in AS and HFA are similar to those seen in obsessive compulsive disorder, these behaviors fail to meet the definition of either obsessions or compulsions.

They are not invasive, undesired or annoying, which is a prerequisite for a diagnosis of obsessive compulsive disorder. The reason for this is that children with severe autism are unable to contemplate or talk about their own mental states. However, obsessive compulsive disorder does appear to coincide with AS and HFA.



Szatmari et al (1989) studied a group of 24 kids. He discovered that 8% of the kids with AS and 10% of the kids with HFA were diagnosed with obsessive compulsive disorder. This compared to 5% of the control group of kids without autism, but with social problems. Thomsen el at (1994) found that in the kids he studied, obsessive compulsive disorder continued into adulthood.

  • become preoccupied with whether something could be harmful, dangerous, wrong, or dirty
  • experience a need for symmetry, order and precision
  • experience intrusive sounds or thoughts
  • feel like they must perform the task or dwell on the thought
  • feel strong urges to do certain things repeatedly (i.e., rituals or compulsions) in order to banish the scary thoughts or ward off something dreaded
  • have a difficult time explaining a reason for their rituals
  • have a fear of contamination
  • have a fear of illness or harm coming to oneself or relatives
  • have a strong belief in lucky and unlucky numbers
  • have an "overactive alarm system" 
  • have upsetting or scary thoughts or images that pop into their minds that are hard to shake
  • may have preoccupation with body wastes
  • may have religious obsessions
  • may have sexual or aggressive thoughts
  • realize that they really don't have to repeat the behaviors, but the anxiety can be so great that they feel that repetition is "required" to neutralize uncomfortable emotions
  • try to relieve anxiety via the use of obsessions and compulsions
  • want to feel absolutely certain that something bad won't happen 
  • worry about losing things, sometimes feeling the need to collect these items, even though the items may seem useless to others
  • worry about things not being "in order" or "just right"

Compulsions that are most common include: 
  • cleaning rituals
  • counting rituals
  • grooming rituals
  • hoarding and collecting things of no apparent value
  • ordering or arranging objects
  • repeatedly checking homework
  • repeating rituals (e.g., going in and out of doorways, needing to move through spaces in a special way, rereading, erasing, rewriting, etc.)
  • rituals to prevent harming self or others
  • rituals to undo contact with a "contaminated" person or object
  • touching rituals

Moms and dads can look for the following possible signs of obsessive compulsive disorder in their AS or HFA child:
 
  • a continual fear that something terrible will happen to someone
  • a dramatic increase in laundry
  • a persistent fear of illness
  • a sudden drop in test grades
  • an exceptionally long amount of time spent getting ready for bed
  • constant checks of the health of family members
  •  high, unexplained utility bills
  • holes erased through test papers and homework
  • raw, chapped hands from constant washing
  • reluctance to leave the house
  • requests for family members to repeat strange phrases or keep answering the same question
  • unproductive hours spent doing homework
  • unusually high rate of soap or paper towel usage

 ==> "OCD: What To Look For" - Excerpt from Mark Hutten's Lectures


If your AS or HFA youngster shows signs of obsessive compulsive disorder, talk to your physician. In screening for obsessive compulsive disorder, the physician will ask your youngster about obsessions and compulsions in language that he or she will understand, for example:
  • Are there things you have to do before you go to bed?
  • Do things have to be "just so"?
  • Do you collect things that others might throw away (e.g., hair, fingernail clippings, dead batteries, etc.)?
  • Do you count to a certain number or do things a certain number of times?
  • Do you have to check things over and over again?
  • Do you have to wash your hands a lot?
  • Do you have worries, thoughts, images, feelings, or ideas that bother you?

Treatment—

The most successful treatments for AS and HFA children with obsessive compulsive disorder are cognitive-behavioral therapy (CBT) and medication. CBT helps these “special needs” children learn to change thoughts and feelings by first changing behavior. The therapy involves gradually exposing children to their fears, with the agreement that they will not perform rituals in order to help them recognize that their anxiety will eventually decrease and that no disastrous outcome will occur.

Just talking about the rituals and fears have not been shown to help obsessive compulsive disorder, and may actually make it worse by reinforcing the fears and prompting extra rituals. Thus, for CBT to be successful, it must be combined with “response prevention,” in which the youngster's rituals or avoidance behaviors are blocked (e.g., a youngster who fears dirt must not only stay in contact with the dirty object, but also must not be allowed to wash repeatedly).

Many children can do well with CBT alone, while others will need therapy and medication. Selective serotonin reuptake inhibitors (SSRIs) often can reduce the impulse to perform rituals. Once a youngster is in treatment, it's important for moms and dads to participate, to learn more about obsessive compulsive disorder, and to modify expectations and be supportive.

AS and HFA kids with obsessive compulsive disorder get better at different rates, so parents should try to avoid any day-to-day comparisons and recognize and praise any small improvements. Also, try to keep family routines as normal as possible.



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

Part 3: Teaching Strategies for Students with Asperger’s and High-Functioning Autism – The “Hidden Curriculum”

Curriculum education is not the only education an Asperger’s (AS) or High-Functioning Autistic ((HFA) student encounters in the public school system. Social behaviors are not only necessary for successful playground interaction, they are necessary for successful acquisition of educational curriculum.

The “hidden curriculum” consists of important social skills that everyone knows, but no one is taught. This includes assumed rules, student expectations, idioms and metaphors. Understanding the hidden curriculum is difficult for all kids, but it is especially so for young people with AS and HFA who have deficits in social interactions.



The following example illustrates the difficulty children on the autism spectrum have understanding the hidden curriculum:

Michael was a popular ninth-grader, despite his social awkwardness. His classmates accepted him and were understanding of his disorder. One day Michael was hanging out with his peers in the hallway before class when his friend Jamie began swearing in disappointment about his D in math. Michael picked up on the swearing and associated it with disappointment. The bell rang and Michael went on to his next class. As he sat down, Michael realized that he left his history book in his locker. His teacher, Mr. Williams, would not let him go back to his locker, and immediately Michael got mad and began using cuss words. Mr. Williams sent Michael to the dean’s office, leaving Michael mystified about what he did wrong. He thought it was acceptable to cuss when he was disappointed at school. Michael did not understand the hidden curriculum – swearing may be acceptable around peers, but you should never curse when a teacher is present.

The hidden curriculum suggests an aspect of learning that is not obvious to students with AS and HFA. This aspect of learning includes the basic how-to's of daily functioning. These are things that other students seem to just know. The social know-how that tells “typical” students what is inappropriate subject matter may be foreign to an AS or HFA student. Thus, teachers should instruct students struggling in this realm through the use of acting lessons, direct instruction, scope and sequence, self-esteem building, and social stories. Social stories and acting lessons give examples of proper behaviors in various public settings.

More information on creating social stories can be found here: How To Write Social Stories

==> Teaching Students with Aspergers and HFA

Catatonia in Children and Teens on the Autism Spectrum

Catatonia is a complex disorder covering a range of abnormalities of movement, posture, speech and behavior associated with under-activity as well as over-activity. Research and clinical evidence reveals that some children with Autism Spectrum Disorders (ASD), including Asperger’s and High Functioning Autism, develop a complication characterized by catatonic and Parkinsonian features.

In children with ASD, catatonia is shown by the onset of any of the following traits:
  • increased slowness affecting movements and/or verbal responses
  • increased reliance on physical or verbal prompting by others
  • increased passivity and apparent lack of motivation
  • Parkinsonian features (e.g., freezing, excitement and agitation, a marked increase in repetitive and ritualistic behavior)
  • difficulty in initiating, completing, and inhibiting actions



Behavioral and functional deterioration in the teenage years is common among young people with ASD. When parents notice a deterioration or an onset of new behaviors, it is important to consider the possibility of catatonia as an underlying cause. Early recognition of problems and accurate diagnosis are important, because it is easiest to manage and reverse the condition in the early stages.

Catatonia is a serious condition that can become more severe. This risk increases the longer the condition is left untreated, and it becomes more difficult to reverse the more severe it becomes. Catatonia is distressing for the ASD child, which can cause additional behavioral disturbances.

Autism-related catatonia looks quite different from classic catatonia. It occurs across a spectrum from mild to severe. In mild and moderate cases, moms and dads often describe their ASD teenagers as “slowing down” or appearing depressed. Sometimes, these teens become stuck when trying to initiate a movement (e.g., he or she may walk up to a doorway and then freeze before stepping over the threshold). Severe cases of autism-related catatonia look a lot like classic catatonia, with the youngster almost completely shutting down.

Autism-related catatonia also produces changes in movement patterns, which can include a brief “freeze” during actions, bursts of hyperactivity, difficulty coming to a stop, incontinence, marked reduction in speech, odd gait, and stiff posture.

One of the reasons autism-related catatonia went unrecognized for so long is because many of its symptoms overlap with those of autism. Thus, the “red flag” for moms and dads is a “marked change in behavior.” What’s lost is the ability to turn intentions into action.

There is little information on the cause or effective treatment of catatonia. In one study of referrals who had ASD, it was found that 17% of all those aged 15 and over had catatonic and Parkinsonian characteristics of sufficient degree to severely limit their mobility, use of speech, and ability to carrying out daily activities. It was more common in those with mild or severe learning disabilities, but did occur in some who were high-functioning.

Autism-related catatonia appears to result from a depression in the GABA neurotransmitter system. GABA is a brain neurotransmitter (i.e., it enables nerves in the brain to send messages to one another). One medication used to treat autism-related catatonia is the GABA-stimulating medicine called lorazepam (trade name Ativan).

With true autism-related catatonia, positive response to such treatment are often seen within an hour or so. This lasts for up to several hours. Thus, a positive response (with the ASD child showing improved spontaneous movement) helps confirm the diagnosis. For many of these kids, this type of medicine is also an effective long-term treatment. For severe cases, treatment options include electroconvulsive therapy, which seems to act like a “brain reboot” that helps get the child moving and eating again.

Given the scarcity of information in the literature, as well as the potential adverse side effects of medical treatments, it is important to recognize and diagnose catatonia as early as possible so that environmental, cognitive and behavioral methods of the management of symptoms and underlying causes can be implemented. Detailed psychological assessment of ASD children, their lifestyle, environment, circumstances, pattern of deterioration and catatonia are needed to design an individual program of management.

When evaluating for catatonia, the doctor needs to understand what the child was like before concerns arose. How smooth were his movements? What were his interests and abilities? How did they change?

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

Understanding the Behavior of an Autistic Student: Michael's Story

Asperger's/High-functioning Autistic students can present a challenge for the most experienced teacher. These kids can also contribute a lot to the classroom, because they can be extremely creative and see things from a unique perspective. Teachers can learn a lot when they have a child like Michael in their class, but they may experience some very challenging days too. Here are some tips for teachers to consider: 



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





Part 2: Teaching Strategies for Students with Asperger’s and High-Functioning Autism – Creating the Right Environment

We continue our series on Teaching Strategies for Students with Asperger’s and High Functioning Autism:

Environmental Noise—

In creating the right environment, one problem to be considered is that of sounds. Think of the example of nails scratching on a chalk board. Just imagining it can send a chill down your spine. To a youngster with Asperger’s (AS) or High-Functioning Autism (HFA), every day sounds can have a similar affect. Thus, teachers should take an inventory to determine sounds difficult for the AS or HFA student to listen to. Also, teachers may want to consider allowing the student to listen to soft music with headsets during class times when there is excessive noise. Earplugs are another option as well.



Transitions—

Minimizing the stress AS and HFA students face is critical to education, and minimizing transitions and insuring the environment is predictable may be one of the best ways to reduce stress. Frequent changes in routines make it difficult for the student to focus on the curriculum due to preoccupation concerning what will come next in the day. When there are changes in the routine, the student should be prepped ahead of time in order to avoid excessive anxiety.

Transition Planning—

A public school is not a static environment. AS and HFA students, like all others, change teachers each year. In addition, there is the requirement of moving from elementary to middle to high school. Thus, a "transition-planning meeting" can be scheduled prior to such transitions. This meeting allows the previous teacher to educate the incoming teacher on successful techniques as well as provide general education on the traits of AS and HFA. The “special needs” student should be orientated as well. Allowing him or her extra time to become familiar with a new environment will prevent unnecessary stress during transition.

==> Teaching Students with Aspergers and HFA

Help for Anxious Children on the Autism Spectrum

"How can I help my daughter with autism (high functioning) to deal with her anxiety in ways other than simply hiding in her room all evening and on weekends?"

Anxiety is a common problem in children with Asperger’s (AS) and High-Functioning Autism (HFA). In fact, in some cases fear is their main emotion. One study revealed that 84.1% of kids on the autism spectrum met the full criteria of at least one anxiety disorder (i.e., phobia, panic disorder, separation anxiety disorder, avoidant disorder, overanxious disorder, and obsessive compulsive disorder).

This does not necessarily go away as the youngster grows up. Many teens and young adults with AS and HFA report intense feelings of anxiety that may reach a level where treatment is required. For some children, it is the treatment of their anxiety disorder that leads to a diagnosis of AS or HFA.



Children with AS and HFA are particularly prone to anxiety as a consequence of the social demands made on them. Any social contact can generate anxiety as to how to start, maintain and end a conversation or an activity. Also, changes to daily routine can exacerbate the anxiety, as can sensory sensitivities.

One way these children cope with their anxiety is to retreat into their special interest (e.g., video games, collecting baseball cards, tracking train schedules, etc.). Their level of preoccupation with the special interest can be used as a measure of their degree of anxiety. The more anxious the child, the more intense the interest. Anxiety can also increase their rigidity in thought processes and insistence on routines. In addition, the more anxious these children are, the more they experience other related symptoms. For example, anxiety often leads to depression and obsessive-compulsive behaviors.

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

One of the best ways to treat anxiety in AS and HFA children is through the use of behavioral techniques. This may involve parents (and teachers) looking out for recognized symptoms (e.g., meltdowns, shutdowns, rocking, hand-flapping, etc.) as an indication that the youngster is anxious. These kids can be taught to recognize these symptoms themselves (although some might need prompting).

Specific events may also trigger anxiety (e.g., recess and other unstructured school activities, itchy clothing, routine changes, a stranger entering the room, etc.). When certain events (internal or external) are recognized as a sign of imminent anxiety, action can be taken (e.g., relaxation, distraction, physical activity, etc.).

The choice of relaxation method depends very much on the unique needs of the child. Many of the relaxation products available commercially can be adapted for use for children with AS and HFA. Some kids may respond to watching their favorite video, while others may prefer to listen to calming music. Also, many benefit from having access to a quiet room.

Other techniques include:
  • aromatherapy
  • deep breathing
  • massage
  • physical activities (e.g., using a swing or trampoline, going for a long walk perhaps with the dog, doing physical chores around the house, etc.)
  • the use of photographs, postcards or pictures of a pleasant or familiar scene (these need to be small enough to be carried around and should be laminated in order to protect them)
  • using positive thoughts

It’s best to practice whatever method of relaxation is chosen at frequent and regular intervals in order for it to be of any practical use when anxieties occur.

Drug treatment may be effective for anxiety. Many AS and HFA children have responded well to:
  • benzodiazepines
  • buspirone
  • clonazepam
  • propranolol
  • selective serotonin reuptake inhibitors (SSRI) antidepressants 
  • St. Johns Wort

One mother of a child on the autism spectrum states, "My recently diagnosed 13 y.o. daughter with HFA experiences anxiety about some very necessary things, like drinking water (she saw her brother guzzle water and vomit and now associates water intake with vomiting), eating (if she starts to become anxious while eating a particular food, that food becomes a trigger in itself) and sleeping -- haven't quite figured out what frightens her about sleep, but it often results in her staying up until she just can't keep her eyes open any longer. Then of course, she's tired and can't focus and that contributes to her other anxieties in school and such. She's on an SSRI, and has been working with a CBT therapist for several years. I wish it were as simple as avoiding or modifying things that caused her anxiety but eating, drinking and sleeping are everyday necessities."

As with all drug treatments, it will take time to find the correct drug and dosage for any particular child – and must only be conducted through a qualified medical practitioner.

Whatever method is chosen to reduce anxiety, it is vital to identify the cause of the anxiety. This should be done by careful monitoring of the antecedents to an increase in anxiety and the source of the anxiety tackled. For example, many children with AS and HFA have difficulty with noisy, crowded environments. Thus, the newly arrived middle school student who becomes agitated or aggressive in the hallway during passing periods may need an accommodation of leaving class a minute or two early to avoid the congestion and over-stimulation that provokes anxiety and subsequent dysfunctional coping mechanisms.

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

Key issues to address when discussing this strategy are:
  • Will the antecedent strategy need to be permanent, or is it a temporary "fix" which allows the child to increase skills needed to manage the anxiety in the future?
  • What can be done to modify the anxiety-producing situation if it can’t be eliminated entirely?
  • What can be done to eliminate the problem (i.e., the antecedent condition)?

The importance of using antecedent strategies should not be underestimated. Kids with AS and HFA often have to manage a great amount of personal stress. Striking a balance of short and long term accommodations through manipulating antecedents to anxiety and problem behavior is often crucial in setting the stage for later skill development.




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 & QUESTIONS [for Nov., 2015]

 Do you need some assistance in parenting your Aspergers or HFA child? Click here to use Mark Hutten, M.A. as your personal parent coach.

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

Dr. Hutten, I just wanted to let you know there are very few places here in WV that help with children that have Aspergers, and every time I see a parent that are having the same struggles that we have with our daughter, I tell them to look you up on Facebook and You Tube, you have been so helpful to my family.  Now, it seems that our biggest challenge is the education system.  Teachers here seem to have the , “don’t tell me what to do, I am the teacher”.  It makes everything so stressful.  We had to hire and advocate and had to fight for two years to finally obtain her IEP.  Emily is not in the 4th grade and we are fear of what middle school will be like for her. 

Again, thanks for all the uplifting words and I am thankful I found your site.  God bless you and keep up the amazing work!!!!
Joy

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

I am overwhelmed with emotion as I began reading your ebook as the light has come on and for the first time in years of depression and resentment I feel hopeful. There is a reason for all of this and that is Aspergers. It all makes sense now. All of it fits together. I could use pointers on how to approach my Aspergers husband in suggesting he consider that he has this. He is very defensive and understandably now that I am seeing how I have not helped the situation.

I cannot thank you enough for this information as I seek to find what My role is.

Wendy


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

Question:

Mark,

I just recently discovered your blog and email list.  I wish I'd have done so years ago.  Thank you!

My 10 year old Aspergers daughter is extremely high functioning in all academics, and we've made some great progress in social interaction, focus and self-control with medication and 1:1 counseling.  We've not been able to make any progress whatsoever with the breadth of foods she's willing to eat.  I believe it's contributed to her extremely underdeveloped physical size and overall health.  She understands food and nutrition.  However, other than grains, it is impossible to get her to eat anything but a handful of fruits, vegetables or proteins.  We've tried a few strategies to bridge to new but similar foods without success. She can't tolerate any kind of spice.  Is there anything you can advise us to try?

Thank you,
Matt


Answer:

Unless it causes a serious risk to health, I suggest putting this issue in the "pick-your-battles-carefully" category.

Some parents get upset when I say what I'm about to say to you: You have bigger fish to fry than worrying about whether or not your child eats enough fruit.

You want my advice? Don't fight this battle. You haven't won so far... so stop beating your head against a brick wall.

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

Mark,
I found your website about parenting teens with aspergers.
I have a teen who possibly has Aspergers, but he is not my biggest problem.

I have recently realized that my husband may have Aspergers, and a much more severe case than my son. I don't see my husband considering the possibility, at least for a while, that he has it. He doesn't notice anything wrong with his rages etc.

 Since I realized that, I have just stopped having any expectations of him, and decided to find my happiness elsewhere. And he has calmed down somewhat.

But I feel very sad about this. Is there any hope that we can have a "normal" "friendly" "kind" relationship? Do you have any resources to deal with it? In particular, he has locked away all our money in his accounts. I am left begging from him for food money every week, and cannot usually buy my children what they need. Do you have any advice?

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

My beautiful partner of 2 years was recently diagnosed with Asperger’s, high functioning but very substantially Aspie. She and I are also Blind. I love her so much it hurts my soul to see her suffer when she goes under, when she is so obviously suffering so deeply. my ex-wife and I raised a beautiful son with Asperger’s who is now 19 and facing the world very successfully thus far. Even with the knowledge from that experience, I’ve come to understand that it is a different experience living with a woman with Asperger’s, living with an adult who has lived her whole life without realizing she is an Aspie, it seems so much harder.
The diagnosis has certainly helped us both understand better what happens to her. when she is not in crisis, she seems to be learning to see that she isn’t bad, that what she has believed about herself and her own worth to herself and those she loves has not been accurate through the course of her life. I believe we are both encouraged by this knowledge, but the meltdowns still raise their ugly heads too often and she simply withdraws from everything into a closed room and cannot talk to me at all, sometimes for days and days at a time. during her withdrawals, I try to communicate via text but her responses are so angry and hurtful, it rips at my heart to see it. during the withdrawals, the silent meltdowns, are terribly traumatic for me and I know it hurts her even more. The burden she takes on herself, the  guilt she later feels for her own behavior during the meltdowns, behavior she seemingly cannot stop from doing, eats her alive and she becomes depressed and feels the only thing she can do to protect me and others she loves is to go away and live in isolation. I try to tell her I am here, that I’m not going away, and that she doesn’t have to face this alone.
I so want to be the support she needs, the lover she deserves in her life, the one she can find refuge in and who she can rely upon no matter what comes. I love her with my whole heart and soul and want to help her. I just don’t know what to do other than stay quiet and leave her to herself during these times. It is hard and lonely for us both, I know that, but I struggle to keep my spirit calm and at peace when she is suffering and quietly raging at me and the world. She has a life full of rough experiences behind her, a horrifying physical burn trauma as a little girl, victim of emotional abuse as a child, , a trail of rough relationships through her adult life, and now facing blindness (diagnosed with RP at age of 35), and now finding out that so much of what she is can be explained squarely by her Asperger’s. She is truly a beautiful human being when she is “with me” and she has brought me joy I never realized possible before she came into my life.

I want so much to keep her in my life and to be here for her in hers. I need answers, more answers.

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

Hi, Mark.  I have found you online.  Our son Joseph has been diagnosed with Aspberger's Syndrome, is 8 going on 9 and his symptoms are on (what feels like) fast forward.  It has all been "under control" until about three months ago when it began to go so fast.  His anger is startling.  His tantrums, his social/emotional struggles, etc.  We are completely and totally lost.  We've just been denied by a hospital in Orlando where we wished to seek psychological help in the form of counseling, etc for him.  Apparently, they do not accept our insurance.

Mark, we are so lost and need direction.  Where do we begin?  Do we explain Aspberger's to him? How?

Forgive me for inundating you....do you provide online counseling services?

Any advice, direction and/or guidance would be GREATLY appreciated Mark.

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

Hi Mark,
I understand , yes email is good as well.
I would like to know if your program will help me deal with my 18 year old son who was diagnosed with ADHD  he was also diagnosed with Aspergers in elementary school by the school psychology team
My son is immature for his age and has a high IQ
The problem I have is that he is using marihuana on a daily basis, and had tried other drugs
He was kicked out of school because of bad behavior and now is going to school to take the GED which the school said he is ready to take the test because of his high scores. He has the mentality that he doesn't need to work or study all he wants to do is go out and smoke pot
How your program works and what kind of tools it will provide me to re direct my son to a path of independence and social skills and stop the entitlement mentality that I have to support him forever
P/s His doctor prescribed him adderall to be able to concentrate at school and it seems to be working fine
Thank you for your time and guidance
Alba

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

Hi Mark,

I purchased your ebook on living with a partner that has Aspergers.  It was excellent!  Unfortunately, my husband also has addiction issues.  It looks like we are headed for divorce because he is so stubborn, is "always right," and doesn't think his obsessive video-game playing and drinking nightly are a problem.  He thinks I am the problem and I just need to "loosen up."  Anyhow, it is tremendously difficult to find a therapist who truly understands what I am going though living with an Aspie partner. I was wondering if you do Skype phone therapy sessions?  Please let me know either way.  Thanks.

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

I recently took my child to the marcus institute in Atlanta and was extreamly disappointed but before i go there here the back ground. If you dont have time i completely understand. I thought of you because i watch your youtube,anywho. 
I have a 5 year old born at 35 weeks for the most part heathy nicu for a week for low sugar and feeding problems jaundice.  With in the days bringing him home he had horible dig issues changing milks adding cearl and priolsac.  But he did not like to be swaddled have his diaper changed or the lights to be on and riding in the car well lets just say my other kids whom were teenagers would have rather walked he cried and wailed. Riding is still intense sometimes but he has found a song (im a gummy bear) in which is the first thing he ask for and is usually on repeat from a to b. He took himself off the bottle at 8 months in which time he had learned to suck through a straw and would drink no other way but did use a passy untill 2 in which he also got rid of by himself. He has never cared to be held and will give hugs if he wonts but absolutely no kisses he will but till raw. At 2 he knew many shapes and was writing numbers he still loves shapes and drawing. While playing when he was young consisted of lining up cars spining wheels and such. He didnt wont to leave the house and some days are still a challange.
He would ask for toys like ninja turtles for them only to be put in a row but never played with. He does not play with toys at home they are untouched unless my grandson comes over. We finally got him to pee in the toilet at 4 and he still shows no desire for pooping it does not bother him that it should be the normal nor does it bother him if he wears it.
We put him in an early intervention program at 4 where he was suppose to go 3' a week but became so combative most days he would miss when he did go he stayed by him self and spoke few words if any. I should mention if stressed or some place new he will go completely mute and sometimes he will shut down completely and go to sleep.
We have put him back in the program he goes 5x a week and he is on 1/2 tes of prozac daily. He does much better does communicate with teacher and does "play" with a few freinds. He is extreamly rule bound at school and will not even play with kids whom do not. That being said teacher as well as ot because motor skills were behind and he is still behind on visual motor. States that he plays parallel to the other children and play on the play ground consists of running jumping or talking about video games or YouTube his obession. After picking him up from school he is off the walls most days jumping from furniture constant pacing coughing which was determined by ped to be a tic . The list is longer but u get the idea. He is a BIG time sensory seeker as in jumping hanging upside down he has no fear of getting hurt. Must watch him closely in parking lots as if something catches his eye he will dart and not look for cars especially if there is a puddle to jump in.
Untill this year he would not eat infront of others but does now teachers say well but when observing he is watching others and moving his feet. He is constantly tapping at home an opening and closing doors turning lights on and off.he eats things like pet food from fish to dogs (im told repeatedly this attion seeking even th he does it in secret) he licks salt shakers froozen food and if i dont watch him closly raw meat packages.  He also licks and sniffs people . Hecwill steal airfreshners deoderant and such to sniff. I am told the problem is at home as they dont see as many issues as i do altho they do observe his tics like coughing adjusting his shirt and constantly toughing his nose.
Sometimes he seems deaf but i know he is not sometimes he does not answer to his name and i will have to remind him that someone has told him goodbye or to say hello.
He does well with small groups but can quickly be overwhelmed in large groups.
He doesnt show imagination for instance at christmas last year he got a shaving kit he told the giver he didnot wont that it was not real and remains untouched he is also very literal. The teachers were talking about dressing up for pic it took me 2 days to make him undetstand the diff between dress clothes and costumes. When he waz younger playing i got ur nose was a nono as he would go into fits thinking you had it. He uses alot of big words and profound statements such as he was with my 18. Year old and ask if mom was home the 18 year old playing stated i was his mother to his responce was well has the mother of this household arrived.  And when ask why he doesnt play dress up he stated that he didnot care for fashion. He also didnt understand what on purpose ment but when reworded and used intentionally he understood. He speaks very loud and high pitched.
Marcus stated that alltho they see many asd traits but he had good eye Contact. When i ask about sensory seeking they said everybody does and i ask about licking and food i was told thats just weriod. Should i seek a second opinion and does the fact that he is so calm at school and so disruptive at home mean that im really a bad parent thanks so much

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

Hi, i have a diagnosed teen with Aspergers and have had ABA training provided to me to help minimize meltdows and to help with compliance etc.. so it's going....well it's never perfect it's work but it's been better than before.
My question coincidentally goes along with your latest video. Is it worth getting a diagnose for an adult? We beleive my husband might be HFA. The dr. That diagnosed my son said he could do the evaluation. Im hesitant to do it because i know a big part of the evaluation is childhood development and my husband  was raised by grandma and she is now very old to recall much of anything . On the other hand Mom is available but not much help since she didn't  raise him or live with him and have a strange relationship, more like siblings. Like sometimes they hate each other and sometimes they need to talk to each other.
I know there were many struggles and difficulties and things that happened in his childhood...behavior wise, some kind of giftedness while contrasting  with poor skills on other aspects, etc...
And I also have known him for 20 years now. Do you recommend going through with the evaluation? Being honest i am terrified of not getting a carrect diagnosis for the lack of childhood info and loosing all hope when dealing and coping in everyday life with him.
(Sometimes it's just very hard).

My other question is that i felt horrible after doing the evaluation for my son because i felt i had betrayed him by exposing all the problematic behaviors or difficulties. But this is my husband...i am afraid he will loose trust and will resent me.

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

Hello there,

My boyfriend and I have been searching for help online via webinars, books, etc
His 21 year old son has Asperger's syndrome. He is very high functioning but we are struggling to make him find a job. From May until now, he's had 4 jobs that he's not been able to maintain. When his dad pressures him to do a job search, he throws a fit and makes up these wild stories of how he's from another dimension. Oddly enough, when dad backs off, he's fine and acts quite normal.

He does tend to sleep all day, stay up most of the night and binge eat on anything with sugar, especially chocolate.

We are both feeling like we've reached a dead end with him because he has no desire to work and has made it clear to dad. Any suggestions?

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

Hi Mark,

My name is Bobbie and I've been married to an aspie for 15 years now. I'm at the end of my rope and want to leave, but my husband said he will do anything it takes at this point to make things work, even go get a diagnosis and some help with asperger's, which he has refused to acknowledge up until this point. My question is, do you know of anybody in the Southern California area who is an expert? We live in the Riverside area, which is kind of out in the sticks, but if you know of anybody out this way, that would be even better. We really need somebody who is very familiar with ASD in adults as my husband is very mild and his masks are really good. It's not until he gets home that he lets it all out. Nobody on the outside guesses that he's got these issues, he's that good at covering it. If he sees somebody who tells him that he's not an aspie, that'll pretty much be it for us. He'll cling to that and I'll be left thinking "Well then, he's just an asshole, I guess" ...but I know that's not it.

Anyways, I would so very appreciate any leads.

Thank you for your time. And yes, I bought your book! Thank you for taking this issue seriously! And when is your next NT/AS marriage seminar? I want to attend!

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

Hello sir - I came across your biography and noticed you have some on-line support for parents.
I have a 18 year old daughter with Aspergers.  She is very negative about life, and pretty much everything.

I try to talk to her to look at things more positive, and of course, she will have none of that.  I have also suggested a counselor, which she thinks is "stupid and a waste of time".
We cannot even watch TV together without her finding something negative about the cast, or what they are doing.   It's very frustrating to say the least.  She is in a community college and has no friends at all, except the ones she has made on-line in gaming.  She hasn't been able to find a part-time job and I do worry about when she does how long she will be able to hold onto it because of her negativity.

Do you have any suggestions, or can you help me locate the link to your support group etc. Thank you in advance.

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

My son is 32 years old and I have just accepted the fact that he has aspergers syndrome and ODD syndrome. I have always been aware of a difference.

Is there anyway I can help my son now? He is struggling with life and the way I have been working with him does not help.

He says he feels like he is about 25 yrs old. He has always been delayed in development.

I would like a book or a resource so I can help my son, and if you have a local to my area person to help, I would appreciate it. He has been through lots of trauma, at times I think we have seen progress, then I think not.

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

Hi Mr.Hutten,

I have not seen my particular problem on the website nor have I found it in any research Ive done.

I have a beautiful 14 yr. old daughter that is diagnosed as having Aspergers and is a very HFA child.

When my daughter was in elementary school she was a straight A, Honor Roll student. Then Junior High happened. Which also coincided with AZ law changing as far as Custody. Since my daughter was 5 yrs old I had Sole Custody, and in 2012 the state changed the law as to the Presumed best Interests of the Child was Joint custody.

That is when my daughter's symptoms worsened, she became an F student, had anxiety and depression melt downs were of epic proportions. With the law change came extra visitation with the mother. My daughter would have meltdowns either before or after (sometimes both) a visitation with her mother. There was also extra summer vacation time ordered, and life became Hell here. I understood what was going on,but both the mother and the Court felt I was just trying to control my daughter's life and alienate her from the mother.

I'll fast forward to this year the mother has always held that my daughter was just being a teenager and there was nothing wrong with her. Now the diagnosis is confirmed and both she and the Court have to accept it.

Last July after an evaluation by a Psychiatrist,the mother was going to pick up my daughter for another week of summer vacation. This time my daughter refused to go. She said she was tired of being ignored, and just doing things that her mother wanted to do,which I agree with my daughter those things hold no appeal for most any child.My daughter was often left alone while her mother worked or passed off to the mother's partner or another family member.When her mother came home from work my daughter was still ignored and left to entertain herself, video games, a laptop, you tube etc. No quality time with her mother,her mother would spend time with her partner as opposed to being with my daughter.The mother and partner would eat in the living room and make my daughter eat by herself in the dining room there was very little interaction. The partner assumed a parental role, which upset my daughter a great deal, especially when her mother didnt assume that role.

When my daughter refused to go to her mother's her mother threatened her with calling the police, then turned to me and threatened to call the police on me as well if I didnt make her go.

The mother showed up at pick up time and my daughter refused, and she was then threatened with the police again. The mother called me and was told that I wasnt going to force my daughter to go. The police were called and they couldnt do anything. The mother left in a huff.

Since July my daughter has seen her mother twice for an hour each time and has taken very few phone calls from her mother.

Her grades are up she is almost a straight A student again, she is bright and cheerful, meltdowns are very rare. She is a joy to be around. Her personal hygiene is back up there, she is taking care of herself like she did before.

I feel that being away from her mother has been a blessing, as my daughter is afraid of the mother and partner and hates the partner as well. Last June over a video game being played when my daughter couldnt sleep,( she suffers from insomnia off and on, and does take Melantonin for it) her mother attacked her because she felt my daughter should be sleeping, she hit my daughter and called her a freak.This contributed to my daughter not wanting to be forced to see her mother in July.

The Psychiatrist feels that my daughter should not be forced to see anyone that she doesnt want to, I cant get him to commit to that on paper however. The school psychologist agrees.

I believe the mother to have  NPD. I read on  your website that they target Aspies. Anyway Id like some advice as to what to do about this problem. I understand parental rights, I understand the law although I dont agree with it. The Court is trying a readjustment period between the two of them. It isnt going well for my daughter so far, she is basically doing it so I dont get in trouble with the court. I tell her to follow her heart. The mother blames me for my daughter's problems.

Please dont think Im using my diagnosis of the mother as having NPD as a crutch,Id much rather say a few expletives along with her being manipulative,conniving and a blameless liar, but she is hurting my little girl. Ive always felt that the mother does not want my daughter,but she doesnt want me to have her. My daughter is my world. I want to help her as best I can.

It is quite evident that by not being around the mother that my daughter is having a vast improvement and she is doing it on her own she has a will to be successful now.

For a while I had a significant other, she made a profound difference in my daughter's life,but sadly we had some issues and we broke up, Id like to get her back into our lives. My daughter has often said that "my girlfriend had done more for her in a few days than her mother has done her entire life for her. Sadly that is true.

I dont know what to do, Id gladly continue on with her not seeing her mother, but I could be at risk for jail time for being in contempt of court and if that happens she will have to live with her mother, which she doesnt want in the least. I also worry that my daughter would go overboard with her mother as far as self defense. Since an early age Ive taught her to defend herself and that she isnt anyone's punching bag. All the years of pent up anger and emotions could come out at that point. I dont want my daughter jailed or in any fashion of trouble, she is very law abiding and observes the golden rule. She is a good person. Another attack by the mother could be the straw that broke the camel's back. My daughter doesnt deserve that.

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

I cried a bit reading your e-book as one of the most reassuring things is just seeing one's experience mirrored in someone else's story. It helps to take all the sting out of it. It's not me. It's not even him. it's just Aspie.

I am wavering between seeing him as a partly alien helpless being, not responsible for his meltdowns and tantrums, his incapableness at earning money, his rigid timetabling anyway, and his financial controlingness, to thinking he is capable of more.
I'm so unsure. Can he change himself significantly, it he'd want to, Or is it all up to me to prevent the conditions that lead to meltdowns, to cope within his limitations etc, to guide him step by step through every detail?

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

Mark, can you please talk to the issue of educators who are clueless about Aspergers (but, infuriatingly, claim to be knowledgeable) and so again and again mischaracterize classic Asperger traits -- especially high anxiety -- as opposition and defiance.  Worse, they then disqualify children for the categorization of ASD on an IEP. Or as the ESE head said in a recent meeting as she held the list of my son's diagnoses submitted by his doctor(s), "Doctors can give many diagnosis, but WE are the education experts." I said I didn't believe you could be an expert when you ignored the science of a child.  An IEP should follow a diagnosis!  How you approach a child with neurological high anxiety is, or should be, different than a child who is behaviorally/emotionally defiant.  Please speak to this...I have just had to pull my son from school because this mischaracterization was having such a devastating impact on him.

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

Hello,  I am writing from the UK on behalf of my daughter & son-in-law.  They have an 11yr old son with Aspergers & are currently having great difficulty & sadness.

Josh went from main stream education to special needs 3 years ago.  His new schooling suited him & all went smoothly for some time.  However his behaviour deteriorated about 1 year ago.  He started secondary school this September, as is customary here, & sadly his behaviour is still cause for concern.  One problem seems to be in the making & keeping of friends, & the disappointment when relationships go wrong.  His response is to lash out & be disruptive in class.

His parents have devised two rewards systems.  One is directly related to his school day, & good behaviour is rewarded with a merit card which entitles him to play electronic games etc in the evening.  This seems to work well.  The other system is more about his behaviour at home though feedback from school is also taken into consideration.  They have a traffic light system, whereby he has to get 4 green lights per week for a reward at the weekend.  The reward might be a trip to the cinema, a new DVD, fishing, bowling etc.  He does seem to be motivated by this, yet the bad behaviour continues & this has become a serious issue with the school.

My query is this ......is it advisable to incorporate the school day into the traffic light system?   Sometimes, after a bad day at school, he will calm down & apologise, with the family enjoying a pleasant evening.   Is it fair then for him to be punished for whatever happened at school, bearing in mind that his parents may not get a totally accurate account?  Conversely, his bad behaviour does often continue into the evening.  He has frequent meltdowns over which I presume he has no control.

Our dilemma is that we do not want to give him the wrong message.  If he knows that the consequence of undesirable behaviour at school will only result in a loss of computer playing time, & not affect his weekly reward, he may be less motivated & take advantage.  There are fewer pressures at home than school, & we want to do all we can to encourage him in a safe & happy environment.

On the other hand, his parents are understandably reluctant to give him a green light, when a school day has been particularly bad, even if he has tried to redeem himself at home.  And if he thinks all is already lost, we don't want him to lose the motivation to try & turn things round after a bad day at school.   We are also concerned about damaging his self esteem if he is so frequently in the bad books of his parents & teachers & is repeatedly suffering the consequences (eg cancelled outings)

Should the slate be wiped clean at the end of a bad school day, with an opportunity for a fresh start, regardless of how awful the behaviour might have been?   How do we send the right message?

In between the meltdowns my grandson is a charming young man who is great company.  We so desperately want to help him in the best way possible & look forward to your reply.

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

Hello Mark,
My husband and I need your advice on how to talk to our 14 yr old son.
He already knows that he is different from his peers, but we don't want to necessarily put a label on him.
Is it better to explain that everyone has challenges and aspects of their personality to work on?  He is well adjusted, likes sports, music, gets good grades, etc.  He is very shy, awkward and we're not sure how this news will be taken.
We appreciate your opinion on this.  Thank you so much!

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

Thank you Mark,

These concepts are working already - in me. It really resonated with me on the topic of why I have any authority in my 32 year old sons life now. Because he is not acting like an adult. Last week it was freeing to me to actually accept the fact (that I had known a long time) that my son has Aspergers Syndrome and ODD syndrome.

I feel intense freedom this week knowing that I can make a difference in my son now. Who knows what the outcome will be. It will be hard for me to be consistent. But I feel that I have the support and the resources to follow up on now. It's like I feel like I have permission to follow through with what I know is right and not to be controlled by the situation.

I had heard these concepts, I believe from you, years ago. But I just got confused and didn't follow through. I remember a time at a Christian Fair in Spokane and going by a booth with information like yours. Maybe it was you, I don't remember. But whoever it was had picked up that we had major problems in our family with another son who is not autistic. I was feeling helpless but It made a real impact that someone would care enough to offer to help. It was refused as we just walked by, but I felt a heart tug that I wanted to do something to help my kids. They were teens at the time, going through really tough times.

I am praying that I can be consistent and not fall away. It's just my autistic, high functioning son and me now.

All this to say thanks for helping me start again. I am having a rough beginning but I am seeing instant hope and relief in my son's response. I am emphasizing the child versus adult reactions and actions, and that he has the whole responsibility of that choice. I am staying calm and not letting him pull me a different direction. But it's only been one day! LOL!  :)

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

Hello,
I am looking for feedback but didn't want to post publicly on Facebook.

My 8 year old daughter was diagnosed at age 5 with high functioning Autism/ Aspergers.
She is also now seeing a rheumatologist for Hypermobility syndrome. In researching the Hypermobility Syndrome, it can be a result of a connective tissue disorder, which may also effect the gut creating GI issues, which we have also sought help for at age 2.

Given the association of Autism with " leaky gut" issues... I am wondering about the correlation in Autism Spectrum disorders and Connective Tissue Disorders.

I strongly suspect my spouse (daughters father) to have Aspergers as well. He also suffers and has long family history of Autoimmune conditions, which now, after years of harmful medication, has resulted in Multiple Myeloma an incurable cancer.

I strongly feel as though the Aspergers may truly be correlated to the " leaky gut" ( connective tissue disorder) as so many on the spectrum have rheumatologic conditions as well. I'm hoping you could poll the group for Autoimmune disorders , GI disorders, etc...
Hoping to make headway in treatment so that 40+ years from now, my daughter isn't diagnosed with life threatening illness as well. Another contributing factor in play could be a lifelong struggle with anxiety & stress hormones also shown to play a factor in cancers and heart disease.

Just imagine, if we can find the source of the issues, how many lives could potentially benefit!!

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

hi Mark

thank you for the email. I've been reading the pdf on the commute and have gained many valuable insights into how to communicate with my wife Amy who has Aspergers. One thing I am struggling with however is her outbreaks of jealousy, to the extent that after opening the side gate for our new (female) neighbour on Sunday and then talking to her (mostly about car parking spaces) for about 1-2 minutes, once back in our flat she shouted at me never to speak to her again. She got more upset when I advised she speak to her counsellor about her jealousy and has yet to apologise or accept that her actions were inappropriate. This is a repeating pattern and I have been feeling angry, frustrated and depressed over this the last couple of days, which have caused a further deterioration in our relationship. Is this a typical Asperger female trait and how best to handle this?

I appreciate you must deal with a large body of correspondence daily but any advice would be greatly appreciated

Best Regards
~~~~~~~~~~~~~~~~~~~~~~~~~~

But I have spend time and money on other “proven” books and cds not to mention multiple therapists, workbooks, blah blah.  Starting when my son was 4.  And my son is now 12.  And despite having above average intelligence, a creative problem solving mind, and a well hidden tender heart, a desire for social success - his oppositional behavior has landed in him single room special education setting because it the only way they can manage him at our public school.  My other children are wary of his unpredictable behavior.  I get calls and emails from school weekly – even in that accommodating and enclosed environment, he cannot stay out of trouble.  He is horridly rude to my babysitter – and repeats the same silly offenses over and over, despite consistently applied consequences – because he wants to do what he wants to do – he is 12 and  stills throws tantrums! He is a type 1 diabetic and not always mature about managing that..

BUT….. he can be the best helper, most responsible oldest child, and even secretly a kind and sweet son to me…..he is a great athlete and team member, and loves loves his friends…When he is feeling kind, he is the best brother and  friends and neighbors LOVE him, telling us he is the most helpful, polite and respectful kid they have ever met – i.e. HE CAN BEHAVE!!! He can be a good fellow human - He simply chooses not to most of the time – and I do not know what to do. 

I am tempted to just pull the trigger and order your book – what’s another $29 after the thousands already spent… but I just don’t know if I have it in my to believe – and to spend even more money on someone who maybe isn’t (?) capable of changing…. Can you give me a little confidence booster to help this worn out mom of 5 who’s oldest son is wonderfully horribly terribly amazingly exhausting… 

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

Hi Mark,

Is it true Asperger's don't lie? I bought your online book "Living with an Asperger's Partner". What I can't cope with is the disappearing act. Currently we are not living together and my boyfriend disappears for days at a time with no text response. Once I stopped by his place and he was enraged and offended I stopped by. I've never caught him in a lie or cheating, but I'm wondering if I'm being naive or taken advantage of. We have been together a year and a half.

He suggested he would commit to see me once during the weekend and once every weekend. This was his solution since I threatened to leave him a few weeks ago. I have not heard from him since Wednesday....so he broke this promise and is AWOL.

Any suggestions? Comments?
~~~~~~~~~~~~~~~~~~~~~~~~~~ 


Hi there,

Hope you’re well and having a good week.

My name is Helen and I just wanted to reach out to say how helpful your site www.myaspergerschild.com has been. Earlier I was just looking around for some educational resources for my daughter who is home-schooled and getting ready for her exams soon and then I came across your site and it really helped me and my daughter out!

I have already recommended your site to a few others as well.

Whilst having a look around I have also come across a fantastic guide to home-schooling and I thought you could add it to your great list of resources on this page: http://www.myaspergerschild.com/2010/12/top-100-aspergers-blogs-for-2010.html


Since my daughter took up home-schooling because of her disability, she has progressed incredibly quickly and I just feel home-schooling needs to be promoted more as an option.

I would love to know your thoughts

Also if this is not the correct email address to send this to, can you please let me know or forward this message on to the correct person.

Looking forward to your response and thank you once again.

Kind regards,

Helen



~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 
Howdy,

Hope your day is going well.  My husband and I spent two weeks on week one and now we are moving through.  My son had wellbutrin added to his mixture of meds about
3.5 weeks ago and it really seems to be helping him.  

Your program has been very helpful in structuring us and our response…and to some extent keep things from escalating as much as usual….the new drug and the new program came at a perfect time.

Question….He has been on a 24 hour restriction.  His escalations after imposition of the restriction (5pm yesterday) have been—
Threatening…”you’ll be sorry”
Silent treatment
Refused to do yesterday’s chore
Refused evening meds (trazadone) for sleep
Refused to go to bed
Wandered house all night
Refused dinner
Refused to help with feeding and letting dogs out
Turned radio off in car while I was driving
Put feet on dashboard

You would have been proud of my poker face…my husband is out of town so it was just me.  Sigh.


So..my question is…that sure seems like a lot to pile on with the Next time you are placed on restriction if any of these things happen it will be extended talk.

What do you suggest?

I’ve told him he is off restriction after he looks at a program I want to use with him for phonics & a short conversation requesting his consideration to accept help and direction.  His refusal to do those two things is what got him on 24 hour restriction.  He asked not to go to tutoring but once a week, and the tutor okayed it if I would work with him at home.  He outright refused to even consider the program I wanted to use without looking at it.  He also refused a conversation about how he is limiting his options significantly if he refuses help and insists he knows everything.  I just want to get the words out…no more than 2-3 minutes.

No death threats this time:)  Yay!!

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

Hi Mark,

I wrote her Primary Care Doctor a letter. I requested genetic testing. I asked via the nurse and office and she said she doesnt know how to read or order the tests! Yes she has not been a doctor for a year. But she is the only one who has seen my daughter act ODD. And believes me.
Any one that sees my child thinks (at first) there is nothing wrong.

I applied for the Autism Waiver.
I applied for ABA.
I am getting help.

If the doctor will not order genetic testing (which I feel is my only hope of proving she has something very off).... I will have to get a new doctor.

Whatever it is she has. It looks like Intelligence and OCD, anxiety. Quirks and all. The hitting me and not caring is my biggest concern. The self harming, when she is angry is also scary for me to watch.

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

Do you happen to know any life coaches in Dallas, TX?  I have a 20 year old son with Aspergers, He has completed 3 semesters in college, and we have had to withdraw him from 2 semesters.  He is ready to get out of Texas yesterday, but has no money or a job, and his adrenals are shot from stress.  Valium keeps getting prescribed - he is always tired, and not sleeping.  Not sure how to help him at this point.

Any guidance would be appreciated.

~~~~~~~~~~~~~~~~~~~~~~ 

Your program sounds really promising, but what is out there for a single mother with 2 daughters that has had the oldest one (now 15 yrs old) run our lives into misery and cant afford to pay for help? STUCK! The O.D.D. she has makes or causes or whatever her not to take medicine so I cant even get professional help because without her taking the meds they wont even 'waste their time', 'nothing they can do'. So I stay alone again Totally no friends, family, professional help or funds to pay for help. Any suggestions were there is free help? Thank you for your time, k.c.

~~~~~~~~~~~~~~~~~~~~~~~~ 

Good Afternoon,

I am a research assistant for LaVae Hoffman, an associate professor of speech language pathology at the University of Virginia. Dr. Hoffman is seeking input from parents of students who have language impairments. I would like to invite parents who read your site to share their thoughts through Dr. Hoffman's online survey. This survey is being conducted by the approval of the University of Virginia's Institutional Review Board.

Dr.Hoffman hopes to use parent's thoughts and opinions to guide the development of materials and services to support the academic success of students with language impairments.

May you post an invitation to parents on your FB page and website?

Thank you for considering my request,
Aubree Surrency
LaVae Hoffman, Ph.D.CCC-SLP

PS. In case you would like to look at the survey before making a decision, this is the link :https://www.surveymonkey.com/r/8JXFJHB


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Dear sir,

Thank you for your post on the blog and youtube.  They are very encouraging and helpful.  Our son was diagnosed with high functioning Autism some three years ago.  Things did not turn out as good.  This was supposed to be a start of a new chapter since we knew what we were dealing with but it was like a ticket to hell as far as his schooling was concerned.  The first thing that happened when we informed the school of the diagnosis was to cancel his place for the following academic year.  The school even tried to contact his doctor to change his IQ mark so that he could fit in special school stream.  Unfortunately registering a child with autism here is such a big challenge because they believe that these children belong to special school.  We of course had to register him in a school without first informing them that he has aspergers but informed them when he started school.  We had no choice because he has high IQ and every school we tried to register him the minute we mentioned autism we were dismissed immediately and informed that they have no space the classes are full.  One thing I can tell you is as soon as they learnt he has autism the game changed and they immediately informed us that he cannot continue in that school.  It has been a real battle to have him in that school and now he has one more year before he goes to secondary school.  Now the new thing we are told is - he will never make it in because he has autism.  The teachers do not want to give him a chance and they say he is not the only child in class.  He works very well in class but he is not as fast because he believes in working neatly.  He panics exams time and of course brain goes blank.  He gets full load work like all other children and gets no class help but the fact that there is that diagnoses he is not very welcome in that school.  We have nothing against the special schools here but the special schools admit children with low IQ.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

I have 5 children 14, nearly 13, 11, 8 and nearly 6.

I’m happily married with a devoted husband and father. 

My older boy turned 14 in June this year and has created havoc for the past 2 years experimenting and challenging the boundaries.  Financially, we have suffered as we have been trying to reign him in.  He has is on the police radar – not yet charged as too young but heading down a very dangerous path.

His enrolment was terminated at private college and I have arranged the reconnect support group to help him but he is still quite rude, arrogant and belligerent to me.  Sadly, he has a very high IQ and heaps of potential.  He didn’t do sports for 5 years as did not want to but now he is interesting in boxing.  I’m trying to encourage a team sport – soccer/basketball. Etc..

He will not arrive at school on time so I am forced to drive and pick him up every day as he is under conditional enrolment.

Now my other children are acting out and showing all sorts of issue.  We are currently in family therapy with the older ones because of the younger ones and then they will be brought into the sessions later.

Where to from here? It is a very slow process with the teenager and I realise that reconnect have to build a rapport but it is difficult.

Any advice, suggestions would be great.

I am looking at options of boarding school.  Sadly, my husband is looking at moving from the suburb and moving more remote as that is where his work is more situated.  Also looking at other schools around the remote area.  It’s about 45 min away from where we are now.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Hi Mark,

My name is Cynthia and I’m a school social worker at Eastridge High School (grades 9-12) in upstate New York.  In June 2016 at least five of my senior students, some with Autism,  will graduate and either move into post-high school transition programs, college or remain in our building as 12+ seniors.  As we prepare our students in school about transitioning from Eastridge, I would like to know if you provide webinars aimed towards parents, school staff, service coordinators and students?   Thanks in advance for your attention to this email. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Hi Mark,

In my situation things were great in the beginning of our relationship and now instead of it increasing for better, it seems it went reverse and now like I am with an amature teenager. He was ontop of his game so well in the beginning in our courtship and now being married he went to he doesn't know what do to in the bedroom, I am confused as to what happened to him? where did that steamy hot man go. Not sure what to do, I bring it up to him and he says me "complaining" puts him off.

And what equates to them loosing interest? is it because they grow bored of their partner. I asked him directly if he is bored of me and he says NO, he says if he was he would tell me. He has said that he loves me for other things and just not that. I read the book love languages and my love language is "physical touch" he knows that, I express to him how important intimacy is to me. His libido is really down and has been taking ciales. He says he has anxiety that he feels he is not in control of his erection and that is why he is having a hard time maintaining one during. He was a lot  more aroused when we first dated  but has been taking pills since we got married and won't even bother trying slowly without the pills.

His special interests are movies (mine too), watching different TV series shows (which are mine too), computers, reading about fitness-weight training, nutrition, and of course working out at the gym-which this works great for me since I am also a person who loves to work out a lot too, I join him at the gym on the weekends even when we don't workout together, few times we do. I share this interest with him a lot because it's important to the both of us but his interest is a lot more deeper. I can skip the gym if I need to but he must "get it in". But he exhausts himself working out that he is constantly tired especially towards the end of the day and sex that day especially if it's "leg day" is off the table. He is always tired and i think because too he exhausts his mind with every thing he reads and "focuses" so our "time alone" suffers.

He used to watch porn at the beginning of the relationship and all of a sudden stopped. He said he wasn't interested looking at that stuff anymore...  I do remember early on in our relationship he was kinda quinkey but nothing way out there for me, he was aggressive but in a good way and in control and that would turn me on like crazy and he would let me be in control too. It lasted for about 1-2 years, then when we decided to get married he wanted to wait until we got married, I think because he was already experiencing libido problems so since we got married last November i thought we were going to just pick up from where we left off but no, it has been a challenge..... About a 3some for some reason I think it would be something he would NOT be open at all even if it was a female, I jokingly suggested that since I was just frustrated one time and he said I was crazy and in no way would he want that that it would create problems and he views that as cheating. I even suggested for us to have an open relationship and I don't have to bother him with sex and of course he felt offended by it and got very angry.

I am not sure if its his anxiety of his libido problems that causes him to push aside our sex life, but he does bring up to me to get the ciales pills from my doctor because he says he needs them, so is that a good sign? That he is willing to at least take pills for us to maintain a sex life? I am very much afraid that it will get worse. We are down to 4-5 times a month, I think this is abnormal since I think 3-4 times a week is more like average for me for our age and being recently married. I keep up with my personal appearance and so does he, we are relatively healthy so I don't see why not and he thinks I am obsessed with sex, but as you know its not about the sex, its about the intimacy in it where I want to feel very connected and close with him.

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

my 11 year old daughter, diagnosed with Asperger's when aged 4, is proving really difficult to get up in the mornings in order to leave for school on time. She is in a very deep sleep when I wake her 6.15am (she is getting enough sleep as most nights is asleep at 9pm) and then it is a battle to get her do each step towards getting ready for school from dressing, to breakfast, hair brushing and teeth cleaning in time to leave for the bus with her younger sister. She is very angry with me for making her get ready for school and is convinced she will not miss the bus if she does everything in her own time but if left unattended she would just go back to bed so I have to nag her at every stage and I just feel awful - like the enemy! This morning she kicked me hard in the shin when I was telling her to hurry up - she has absolutely no sense of urgency and cannot do anything quickly which is why I give her a whole hour to get ready. She has to leave for the bus at 7.15. Most days she gets there in the end but it is just exhausting and very upsetting for the whole family. I then have to get her youngest two siblings off to school and myself to work. I have a good relationship with the school and the SENCO and dont think anything is going particularly badly at school for her -  she just doesnt want to go and is very fatigued. What do you suggest we do to help her and to make the mornings less traumatic and to improve the situation for the whole family.

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

Dear Mr. Hutten,
  I am writing you today looking for some help in dealing with my son , Michael , who is 25 years old and was diagnosed with Aspergers in the Spring of 2012.  Michael has had many issues throughout his life, but not any that we didn't feel we could deal with.  He was always a great student, but always socially awkward.  He didn't really care to have friends or even meet people.  He is very athletically talented but never fit in with the team concept.( he played both baseball and hockey)  He recently finished his Masters Degree.  You might wonder, what is the problem?  Well, the issue is, just about a year ago when he was 24 he was arrested for disseminating indecent material to a minor( 15 year old).  He is charged with a felony and the possibility of having to register as a sex offender.  We live in New York State.  We are now on our second lawyer, as our first felt that the Aspergers diagnosis had no bearing whatsoever on his behavior.  We are currently seeing a counselor who really has no idea either on how to reach Michael.  My question to you , do you think you can help us in terms of coaching Michael for his future endeavors and more immediate concern is, do you believe his Aspergers is a mitigating factor in his actions?  I would appreciate any guidance you may afford me in this matter.  Thank you very much,
Dianne

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

Hi,

My daughter has not been diagnosed with Aspergers, however I have been told on several occasions that she could be borderline. I have never been to a medical doctor to get a diagnosis. She is now 9yo and while we used to get major meltdowns on a nearly daily basis, these days they are much less frequent and last a much shorter amount of time. I have tried many, many things doing that time and they finally seem to be working.

What I am asking is, that now we seem to be past the regular meltdowns, do you think the OPS and book would still be helpful? We of course have ongoing issues around behaviour, as I think most parents do but the daily hell we lived in has past. If it was only a year or two ago, I would have immediately signed up, now though, I am wondering if it is still relevant.

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

Good afternoon,

I just read your post, Lying or Wishful Thinking: Which One Is Your Aspie Doing?, and this is my 9 year old son to a T.  My question is How can we teach him to stop or know the consequences that come from his lying?  Recently my son has been making up horrible stories and telling his teacher at school, who has to report them and now DCF is involved and I am very concerned about the repercussions his lying is having.  He had told his teacher that on one day that he was at his brother and sister-in-law's house that they had left him to care for his 4 year old nephew all by himself (said they were in their room sleeping), that he had to take care of him and feed him and change his diaper all day long.  First off I had been texting with my daughter-in-law literally all day so I know she wasn't asleep.  His attendant care worker had picked him up from the house at 930am and didn't return him until close to 1pm.  Then I was there at 4 to pick him up.  He doesn't cook anything by himself, plus my grandson hasn't worn diapers in 5 months.  He has since admitted that he knows those things weren't true but he doesn't understand what could have happened to my other son, daughter-in-law and grandson if the state had really believed him.

A note about my 9 year old son - along with being diagnosed with Aspergers, he is also diagnosed with Bipolar and ADHD.  So he has a whole lot going on inside his head that I know he doesn't completely understand.  I am trying to get him help in every aspect.  I got the school system to place him in a special (PBS - Positive Behavior System) class setting, he gets a lot of help from the Mental Health Association (attendant care worker, case manager, peer group).  But here in Wichita they don't have a whole lot of any type of help for me.

Is there anything you could possibly advise?

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hi Mark,

I would so value the opportunity to chat with you about so many things and I’d love you to be a guest on a free interview series I’m hosting this coming spring called The student triumph summit: how to get your best grades and be a top student.
I am a British academic and passionate about supporting students to improve their performance, especially in essay writing.  Also I have a very strong desire to bring this information to disadvantaged youngsters who would really benefit from it.  I am a great believer in student directed learning and Einstein’s observation that all children are born geniuses.

I think you’d be an amazing fit for this, since you’re a shining example of how you can be authentically yourself, share a message you’re passionate about, and make a difference in the world.  I think your story would be so inspiring to our listeners and, as a beacon in the industry, I would be honoured to have you join us!

Would you be interested in participating?  Please say you will.

Warmly,

Dionne Johnson
  

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Hi Mark,

I've tried to give you as much information about my son as concisely as possible. I've also attached a timeline to this email to make it even easier for you. I hope it helps.

·        My son, Andrew, will turn 17 in about 2 months, on February 1, 2016.
·         He was diagnosed with CAPD in grade 2
·        retested in grade 7 and determined he was only boderline CAPD.
·        Since he was still struggling in school (esp. Math) I had him tested for ADHD and they said he had it.
·        He started taking 18 mg of Concerta daily in grade 8 and the results were amazing.
·        Around grade 9 he became increasingly contentious, started missing youth group because he didn’t like anyone there, getting in fights and chose friends who used marijuana.
·         I reacted to that by making youth group mandatory, explaining to him youth group activities were better than running around the mall or hanging out in the park smoking weed.
·        Immediately, Andrew called his father and my ex-husband encouraged him to move in with him and his wife to escape from my unreasonable demands.
·        Stops taking ADHD meds
·        Father starts smoking weed with him on a regular basis and encourages his friendship with troubled teens.
·        Skipping school becomes a regular practice
·        Caught in the act of breaking and entering with an older teen and sentenced to community service and 5 sessions with a counselor.
·        Withdraws from almost all friends and changes from being an extrovert to introvert.
·        Switched schools in grade 11 hoping to make new friends to no avail
·        He decides he just doesn’t like people anymore
·        Father and step-mother’s arguments are frequent and sometimes end up with police coming to the house.
·        Last summer Andrew and his dad couch-surfed at relatives but returned back to step-mother’s home when school started.
·        I helped him to apply for welfare so he could get out of that toxic environment (he still refused to live with me despite my willingness to lift the youth group rule).
·        He was placed in a residence for young men until an apartment became available in a government funded program to help youth in crisis.
·        After one month he was asked to leave because he was skipping school, not doing allotted chores daily, not participating in life skills program.
·        Now he’s moved back in with me for about 2 months, until they give him an apartment.
·        He seems to be trying to provoke arguments with me.
·        Denies having any feelings whatsoever.
·        Contradicts himself about whether or not he needs to go to school
·        Complains of headaches, stomach upset and sore throats often which leads to missing more school.
·        Refuses to participate in problem-solving discussions and won't ask directly for anything, instead he insinuates what he wants in text messages and expects me to understand him.
  • blames me for everything.
·        He refuses counseling and I’m not sure if medication is the answer

I think he may be depressed but not suicidal as well as ODD. I would appreciate any advice you can offer me.

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

Hi Mark,
Things are deteriorating fast and we have hit a brick wall with our son...
* His OCD psychologist who is 600 km away has said that there is nothing she can now do because he doesn’t want treatment
* He no longer takes any medication and has become quite hyper focus and just screams at us all the time
The psychiatrist is at a loss at what to put him on as he gets sick on a lot of meds - there is one but he is refusing because he doesn’t like the way it makes him feel.
*We have stopped doing most things and now he is buying canned food to eat as he won’t prepare any food due to contamination 
*We have only been able to access 2 hours of assistance from a worker who has to take him out to get him out of the house
*We are still washing his clothes and cook him dinner… that is about it
We did say we would stop washing his clothes and he aid that he would go naked! - Remembering that his OCD surrounds soap
*we have had a meeting with the disability support people who say his case is terrible but there is no money so therefore no assistance at present
*We have a work assessment in a few days with the government - he does get $800 in disability payment - it is paid to us - he can sign that over to himself and then we are in trouble!
Have called the police when he is abusive and they are not interested unless there is a gun at our head!
He won’t leave and have no friends or contact with anyone else apart from his internet games “ friends"

Have no idea what to do - he is just deteriorating daily… He says he is never leaving home!!!!

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

I have a young man that he is working with, but he is not familiar with organizational skills. I have been reading online about some techniques, usually from SLPs. I always end up as the "tutor",
and frankly my son wants me to just be Mom. Alabama has cut back their tutoring supports for students with disabilities in college, as the state is bankrupt. I always end up providing the supports,
but I am tired! I am very encouraged by your website.

Thank you for your support online. I actually had a previous counsellor refuse working with my son again, as she said he was "done" with her! She did not feel he could benefit from CBT. Sigh.
He does have a counsellor from his high school days but she does not write down her directions, so they are lost due to  poor working memory. My son does not accept that he has Aspergers,
since in Alabama "Aspergers" means "retarded". Autism means "very retarded". He accepts OCD and anxiety as his diagnoses.

I currently work as a special needs Sunday school teacher. I have a boy with autism, ODD, ADHD, and OCD. He is 10 and is waiting to get on with a psychiatrist. He is not on meds. I told her 
about your website. Huntsville, AL is overflowing with ASD, due to the concentration of "science types". You should market here! There is such a need.

Thank you!

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

Our son has been doing really well since adding Wellbutrin to the mix about 5 weeks ago or so. 

He had a sleep over with friends at our house Friday night and the good trend was continuing…he cleaned the house Thursday evening to get ready for his friends.

Saturday, I asked him to do his daily 15 minutes of phonics work with me (after his friends had gone) before he watched tv. I got a lot of lip..encouraged him to take
a walk to cool off which he refused.  Since he choose not to do phonics with me he choose the consequence of loosing screen time for the rest of the day.  That night
he refused to take his medication and that was something that we had discussed before coming out of the deal with it later file…that if during a consequence he refused to take his medication that the  consequence would be increased to include loss of his phone and being grounded.  He did decide several hours later to take his meds. (should that have removed the additional consequence that was added hours before when he refused??).

At any rate…Sunday morning he refused to get up and go to church with us. He called while we were on our way home from church and asked to
work to have his 24 hour phone consequence removed. I said no.  When we came home he was gone.  He returned home at 3:30 and protested that he had not been grounded, but the phone was his only consequence. I asked him to mow the lawn ( his weekend chore that he put off until Sunday).  His response was “hell no” followed by lots of F words.  We said that he had now earned a 48 hour grounding and removal of privileges which would start when the lawn was mowed.  What followed was
ugly.  We were fairly good at the poker face until he kicked a hole in the kitchen cabinets and threatened to kill us. Sadly, he did get some intensity then…but we tried to rein it in.  We went upstairs and blasted rap music as loud as possible…then came after me taking my phone from me.  When he went for the knife drawer in the kitchen my husband wrestled him to the ground and sat on him and we called the police. He has had homicidal threats before…I don’t think he really means it…but they usually have ended with the police coming and going for a psych eval.  He turns 18 in one month.  This time the police had crisis intervention trained officers with them too.  They choose to arrest
him for domestic violence..threats.  He was hauled off in handcuffs and we picked  him up later in the evening…released until trial in custody of parents.  Trial Jan 4.

He was contrite last night…physically ill from the stress…said he was a failure to which my husband encouraged him that he was not…what counts is how he responds
to this event going forward.  He was hoping to go on a mission trip to Haiti with church…this arrest will probably prevent that.  His friends are the most important thing in
the world to him…and if their parents find out I would not be surprised if they forbid their kids from seeing him.  Too bad, because I think they have been a good
influence on him.  They are all two years younger than he is which is closer to his emotional maturity level.

Specifically…where do we go from here?  Do we hold to the consequence we set up before he was hauled off by the police?  He can’t mow the lawn today because he  had
a basketball game at 6 PM and won’t be home until after dark…same for tomorrow, too with practice.

PS..this is our adopted kiddo from Ukraine.  We got him at age 13…in March he will have been home with us for 5 years.  He has never integrated into the family..
always retaliating with any consequence.  I’m sure we made it worse by not holding firm early on…but his scorched earth policies were something we were not prepared to deal with as our two bio kids were at home.  This year our last bio kid is off at college and we were once again trying to regain some control of our home.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Dear Mark,
My husband has AS. I learned about it last year, still in Dallas, TX from a great psychologist Lorene Vanzant.
Im happy to know about it ( after 20 years of marriage) but now i dont have hope that things can change.
Since a few months we live in Switzerland( he wirks for a swiss- international pharma company - novartis). Here is a different world. Find a help might be a problem...

Im thinking about a divorce. He is in denial of having any problems. Im alone with everything. We have 2 kids, who need a father too. But he is not available-completely isolated from us. I have no more energy.

Maybe You have any idea what to do? How to survive? Without his help i cannot change anything in our  sad life. He is a very inteligent guy but only in the office.

Thanks for any idea:)
Ludmila

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

Good Day Mark,

My name is Jazmine Clark and my partner is Matt Peplinski, and our situation is fairly, extensive, to say the least. He and I are both autistic adults in real need of effective counseling/therapy. 

I am originally from Michigan near the Flint area, and I was diagnosed at 12 or so after several diagnostic (and often times very biased) tests. I actually used to be non-verbal, and my prognosis even at age 3 was not very optimistic. I grew up in a very dysfunctional and psychologically abusive environment, including but not limited to regular bouts of intense verbal abuse from my mother for 5-8 hours consecutively. In highschool and community college I could out-run that abuse and turmoil for a while through several art competitions, 3.88/4.0 gpa, even losing 100 pounds, earning even scholarships to go to University of Michigan in Ann Arbor. My 1st semester at UofM was bright, but the PTSD and the toll from the psychological pain caught up to me, and my progressed declined rapidly. I reached out everywhere I could for help, from a wide variety of state/college/therapeutic/departmental sources. Plus I was a poor student in a very expensive town, which only socially isolated me even more. Despite my best efforts, I crashed hard at UofM and that was devastating, there was no help no matter where I turned, no matter whom I turned to, there was only disgust and shame. I was deeply depressed and suicidal those 3 years at UofM but did manage to graduate with Cum Laude BA from the school of art and design. 

I couldn't get employed, I got fat again, I got sicker among my more antagonistic/aggressive relatives/mother, I became an alcoholic because of the pain, I was thrown on piles of meds that made things far worse for me, I got sicker and things spiraled for 2 years after I managed to graduate. To give an idea of what these people are like, I was date raped from trying to drink my hurt away and one relative in particular gossiped about it like it was a well written joke, even laughing in my face about it. My friends distanced themselves as did extended family, everyone vanished never to return. 

In 2013 things hit quite a low, I was isolated at my mom's house and she got ever more aggressive even when I was sober from alcohol and trying to build my life/heal myself. I then met my now partner online, he was as isolated and hurt as I, if not more so. He was in Poland. 

Matt didn't have the chance for a diagnosis because of the level of neglect he experienced. There were times when he was whisked away via ambulance weekly from panic attacks he was fully expected to "cure himself" of, on top of being verbally abused by a fully enabled drunk father and his sister. He taught himself english to have any chance at making any life for himself, he even has a certificate from Cambridge with the highest grade possible for english fluency. He's only been bullied by therapists and his entire community but I could easily tell he was gifted but deeply hurt like me. 

After 2 months of meeting him, I went into homelessness to get away from my relatives and mother to have a chance at making it to him. Seven months later I made it to him, and I've been in Poland with him for the last year now. 

He and I deeply, deeply struggle with PTSD issues from our relatives, and his mom does financially help us as we get some money from freelance. We've tried getting therapy in Poland but every time we tried this we kept getting no real help because Polish therapists are not at all equipped to help with our issues, neither are Michigan ones. He and I are able to round up projects and aim to better develop income with online work, but our deep issues really get in the way of he and I launching our lives. We hurt every day trying to manage this pain and we need help.

This was a long letter and I'm not entirely sure that you'll take the time to read it, but it at the very least provided some level of healing to write this down to you. 

 ~~~~~~~~~~~~~~~~~~~~~~~~~

I just found you on you tube. I have a very high functioning Aspergers child (12 year old) with ADHD. His father and I are divorced and although we try to co parent his father doesn't seem to grasp the fact his son has Aspergers. I am a nurse who has worked in child/adult psychiatric hospitals. I still when it comes to my child don't know how to help him feel less overwhelmed and reach him in times of "fits". He has flipped me in a chair and pulled a knife on me but it was like it wasn't him. He was VERY REMORSEFUL AFTER.  He does have a 9 year old very intelligent brother who at times likes to "push his buttons". I will order your handbook. My child is in therapy but my ex seems to think he choses to behave or misbehave the way he does. He has always fought me on medication. I want my son to understand his Aspergergers and know he and help from us can stop the destructive behavior. We are all clueless. He has been under so much stress as his older sisters have drug addicition issues. (Runs in the family). McCall (Asperger's child) is a sweet giving child and when these moments happens the son I know disappears. I just want to help the right way. Not say "Boy you know what you are doing stop". (my ex) In the middle of the "fit" he looks in control but I see in his eyes (HELP ME).....I ask for any help you suggest. I understand and work with addicts this is a whold new ballgame.

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

Dear Mark -

We receive your newsletter and very appreciative of its advise.

Our teen is high functional aspergers, has had P.A.N.D.A.S., has sugar processing issues and has ODD/OCD.  She is very bright, but her mother and I have a very tough time helping her.  She has seen a number of physicians and is working with a psychologist in the Toledo (OH) area.  We were seeing a psychiatrist, but we have a lot of issues with sensitivity to medications (i.e. their side affects).

The question is do you offer counseling in the Toledo area, joint counseling with another therapist or have names of people that you may offer that can help us with our teenage daughter?  

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

Dear Mark,

Happy Thanksgiving! I am blissfully at home with my family and do not have to deal with extended family today. My question is, my sons' psychiatrist is now forced to go with ASD instead of Aspergers.
Will you address this in your literature? I do not agree with this, and as a result my son in college will not use ASD or Aspergers as his diagnosis. He says he has OCD and anxiety. I use semantic/pragmatic language disorder when I speak of him due to the stigma. Autism is so "loaded" so I wonder if parents will shy away from diagnosis.

Thank you again!

Mrs. Terry

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


I'm unclear where to turn and like most everyone you deal with kids.  There is no clear test to establish if you are Autistic.  There is no clear test to establish if you have FAS.  I have very, very distinctive features of FAS and my mother drank heavily.  My father swears not while she was pregnant and she did have one older child and two younger ones (4 of us total).  I'm unclear if you are aware of this but radical changes occurred in 1986- high functioning Autism was discovered; I was 16.  FAS was similarly discovered around that same time period; 1986.  

I was nonverbal until 5, all milestones were missed, I have serious coordination issues, I struggle with articulation, I struggle with communication and more.  We believe I am autistic.  IF you compare a youtube video to my meltdowns they look almost identical.  Sadly I am obviously now an adult and have a child whose thankfully also an adult; 22.  The issue is coming in in that we also believe I am seriously suffering from regression.  I am struggling more with multiple aspects but to include especially blind rage.  In school in the 70s they would tie me up, we've seriously thought about this given the level of the meltdowns.  I have requested medication, showed up in an ER and stated I'm Autistic and that I either need (and listed two meds).  We don't know where to go, who to turn to or how to solve this problem. Pediatricians refuse to see me.  Almost all sources available IF I were still a child have simply slammed the door in our faces since I am not a child.  Given we've watched several videos you've put out we figured we could try to see if you have any ideas.  To add to the list of problems, my daughter suffers from TBI since she had open heart surgery when she was 4 months old.  We've thought of taking a video of my meltdowns and trying inpatient hospital however, my daughter can't manage very long on her own and in an ideal situation it wouldn't be the single mother whose regressing with Autism so we have to tread lightly in attempting to get help.    

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

My son's behavior is rather defiant. Also despite every attempt made by his father and myself, he still is able to a hold of pornography. He has a bad problem with masturbation. We are scared that his issue will spill over and affect his two smaller sisters. We are going to try outpatient and inpatient therapy first. Sending him away for help is our last option.

~~~~~~~~~~~~~~~~~~ 

Hi Mark,

Ive been receiving your emails for some years now and in the early days of diagnosis they were an invaluable source of support.

I've had an extremely distressing incident with my daughter this weekend. Sh has appeared to have come so far and be so in control at home and school that I have been literally bursting with pride. She is more able and talented and academically is in the top 1% in the UK for her age. She has recently undertaken a stunning performance of shakespeare at the county theatre and all her teachers, and family are amazed at how well she is doing.

Then this weekend we had contact with the Scratch computer coding site. Seren has been seriously cyber bullying other children for no reason other than jealousy that they were receiving praise for their work but this cyber bully is near inarticulate, incredibly foul mouthed, threatening and vile it's as though she has been possessed.

We are a middle class, hard working family. I don't drink or smoke or watch inappropriate programmes but the way she was talking to these poor children sounds like she's some sort of New York Gangster rather than a middle class Welsh girl. She's ridiculing them for being four eyed geeky ooh readers (exactly what she is) and for having useless soft toys when she herself has a collection of meerkats!

I feel as though there are two separate children in one body and I'm feeling at a complete loss.

Have you ever come across this sort of thing before, can you help me in any way please.
~~~~~~~~~~~~~~~~~~

Good morning Mr. Hutten,
my husband saw this article & I thought of you & those in your practice.
If more colleges found out about this what a blessing it could be to so many of these young people & their parents!
Thank you so much for all of the insightful articles & resources I've been able to avail myself of & to share.
Sincerely a mom blessed with a son "sharing the spectrum of life",
Leora 

http://www.foxnews.com/health/2015/11/29/new-jersey-colleges-program-gets-autistic-adults-ready-for-work.html
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Mark,
I have been watching your videos, and reading your articles. My 8 year old grandson lives with his Mom and Dad and 12 year old sister, a few miles from our home He functions at a very high level, gets straight A's and no longer qualifies for special services at school. Sometime they do take him out of the classroom for a break when needed. They enjoy a high income and our grandson gets just about everything he wants, when he wants it. He was diagnosed at 18 months, but has made amazing progress. The problem we have is really not him so much, it is our daughter and her husband. We are convinced that this boy has temper tantrums to get his way, and he always does. He will never accept the word no or not now. If anyone says no, he pitches a fit, yells and screams and pushes the issues till he gets his way. He will scream at you, call you names and on and on. Our son-in law yells at him,  and our daughter coddles him so he will be quiet and not upset his dad, and gives in to him all the time. When he visits, and we ask him to do something or not do something, our daughter will step in and pick up the toys for him, so he doesn't have to. If we ask him to stop chasing to dog he will not. We ask again and again and he ignores us....so about the 3-4th request, our daughter would get up and let the dog outside. These are just examples of course, to help you understand our dilemma They never follow through with threats, always give in. Even when they are not here, and we have our grandson, and he does agree with our request, he then texts his Mom. Of course, his mom then calls us and lets me know that the boy can have what we said no to. I don't think I have ever seen a meltdown as you described in your video, just temper tantrums. We love our daughter, and our grandson very much but we don't know what to do. Our daughter is very sensitive, and any deep discussion about their parenting choices could hurt our relationship. We have not walked in their shoes, and are trying to understand how to deal with our grandson. Our concern is that he is getting more and more aggressive. Can you offer us any help or suggestions? Thanks.................
~~~~~~~~~~~~~~~~~~~~

My 4 yr. old  has been Dx't with Autisum almost a year ago, I live in Florida and have been in Columbus, Ohio visiting for about a month now and seeing what my Daughter has been going thru just breaks my heart.  Freedom has a sister in kindergarden, a brother that just turned 2 and a baby sister 6 months old ( YES She has her hands Full ) I had hoped my daughter would be able to talk to you about things to do to help Freedom , He attend school 2 1/2 hours a day, and is learning to talk better, but still has meltdowns where it is getting harder for Tonya to control him (he is strong for a 2 year old)

Thank-You for any help you can give us, Elaine

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

At 18 months my grandson was diagnosed with Autism. He flapped his arms, would not make eye contact no speech and slow motor skills. His folks immediately got help and now at 8 years, by looking at him and sitting with him....you would never know. he is so very smart it is scary, but about certain things like weather, trains etc. He no longer qualifies for IEP (special help at school) and gets straight A's. If he behaved at school the way he does with his parents and with us, they would expel him. When we say No to anything that he really wants he "pitches a fit" screams at you, and does the activity anyway.....till you have to take him by the arm and place him in a quiet room to time out. He just will not obey..., and his folks overlook most all this behavior.

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

Dear Mr. Hutten,
     I just found your site and I'm impressed by all of the information on it.
     I just found out last month that my 10 year old son has High Functioning Autism, Level 1.  He has been attending a small Catholic School here in San Diego since Kindergarten.  He is currently in 5th grade and has had social issues with his peers for a long time. 
     I'm considering pulling him out of his school at the end of this school year and sending him elsewhere.  Do you have a recommendation for any schools in the San Diego area for kids with his diagnosis?
     Thank you so much,
     Cathleen 

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

Have you written articles geared towards high functioning kids (aspergers) and school support options- middle school? We are dealing with many issues surrounding our sons " lack of" responsibility/organization/
motivation. He has never needed any special services to this point. His response to us is " mom I'm learning why do I have to show it all the time? Grades are just a number".
Just a little stressed around here!!!!
~~~~~~~~~~~~~~~~~

Hi Mark,  I am really learning a lot from your articles, we are in the process of getting our 11 year old son diagnosed as having aspbergers.  He has always been considered gifted academically, but the pressures of 5th grade have made him take a sharp left turn this year, he insists that he can't go to school and if he has to go he would rather die.  He has missed weeks at a time.  We have him in counseling and is going to school half days but is starting to rail against even that.  My husband and I are trying to learn all we can to learn how to parent him, to give him what he needs but it feels like most of the time we are just reacting and he is in the driver's seat.  We are working with the school system to get him evaluated but it is a slow process, and it is hard to be upbeat a lot of the time.  I look forward to reading more of your articles and continue to learn anything I can to help our son...

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

Hello,
I'm writing to you in order to find out more information on your programme.
Namely, as you can see from the subject I have two sons with ODD problems. Ivan is 9 and Alan is 4 and I am divorced. We are from Croatia,  Europe.
I just wanted to check whether your programme works for these ages.
Ivan is very disobidient and difficult to manage.  I am very tired and frustrated.  It is very difficult to get any kind of professional help in Croatia so I would very much appreciate if I could get help from you. Although I cannot claim that Alan suffers from the same diagnosis,  it seems that many symptoms are present (not sure whether he just copies the older brother) but it is harder for me to manage it with every further day.
Thank you for your help in advance.
Best regards,
Marinela

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

2024 Statistics of Autism in Chinese Children

Autism Spectrum Disorder (ASD) has emerged as a significant public health concern worldwide, and China is no exception. As of 2024, new rese...