My ASD Child: Help for Depressed, Lonely Children on the Autism Spectrum

“Is it common for children on the autism spectrum to be depressed? Lately, my teenage daughter has been quite sad much of the time for no apparent reason that any of us can identify. She does tend to be a 'loner' - but she says she prefers it that way.”

Research suggests that almost 70 percent of young people with ASD level 1, or High-Functioning Autism (HFA), suffer from depression at some point in their life. Mood disorders and anxiety disorders are very common. Also, around 30 percent of these children have ADHD. Depression and anxiety can be more difficult to detect, because their facial expressions and body language are often not as easy to read - and they may have difficulties in describing emotions.

Kids on the spectrum have difficulty verbalizing their feelings and thoughts. This can be misinterpreted by adults and can lead to the assumption that because these thoughts and feelings aren’t verbalized, that they don’t exist. Often, the opposite is true. Many have an overwhelming number of thoughts and feelings that go unexpressed. This inability to express feelings can lead to depression.

Young people with HFA often find school a challenging environment. Difficulty with social interaction can lead to a youngster feeling isolated and friendless, especially during adolescence. Those feelings of isolation and confusion can lead to depression. This can be compounded by an inability to express the feelings of depression to parents.

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Learning to cope with depression is an important part of learning to cope with the disorder. Since depression in these "special needs" individuals is often linked to feelings of isolation and frustration with not being able to express themselves, it’s important for you to understand that while your HFA daughter doesn't necessarily express her feelings, this doesn’t mean that she doesn’t have them.

The three best things you can do to help your daughter avoid - or beat - depression are (1) help her to identify emotions, (2) teach social skills, and (3) watch for the early warning signs of depression.

Identifying Emotions

Talk with your daughter about how she might be feeling about her social relationships with peers. Try to give her the words to use (e.g., mad, glad, sad, frustrated, etc.). By giving her these “feeling words” and trying to help her differentiate the words and identify those feelings, you can help her develop her voice while expressing her emotions. You may not be able to make her social relationships smoother for her, but you can try to get her to understand that her feelings surrounding those relationships are valid.

Talking to your daughter about emotions can be a frustrating experience for you, but the benefits will hopefully outweigh the frustrations you are dealing with.

Teaching Social Skills

Each youngster on the spectrum has his or her own temperament. Some enjoy higher levels of social activity, while others prefer less. While this may be a preference, young people with the disorder don't have the same degree of what experts call “social competence” (i.e., the ability to get along with others) as compared to non-autistic children. Social competence must be taught. This means that it needs to be practiced and improved upon - and the youngster's mother or father must be a patient coach.

Teens on the spectrum don't need to be the most popular people in their class, but they do need good social skills. Being sociable helps them with resilience (i.e., the ability to withstand hard times). Those who are constantly rejected by peers are lonely and have lower self-esteem. When they are older, they are more likely to drop out of school and use drugs and alcohol. Moms and dads can help their teenagers learn social skills so that they are not constantly rejected or begin to bully and reject others.

In an ideal world, social skills include the child’s emotions, intellect, ethics, and behaviors. Emotionally she learns to manage strong feelings (e.g., anger) and show empathy for others. Her intellect is used to solve relationship conflicts and make decisions. Ethically, she develops the ability to sincerely care for others and engage in socially-responsible actions. Behaviorally, she learns specific communication skills (e.g., turn-taking, how to start a conversation, etc.). But we don’t live in an ideal world. Your daughter will need your guidance to achieve these skills.

Moms and dads can act as coaches for their youngster to develop these social skills. The child learns a lot from how his parents treat him and when he observes how they interact with others. Parents, like other coaches, will need to be creative and specific in teaching social skills. Beyond saying "You need to be better at X," good coaches teach concrete skills and then support the use of these skills across a variety of situations. The goal should be not just to teach kids to "be nice," but also to help them to advocate for themselves as well as care for others.

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Many kids experience occasional rejection, and some are often socially clumsy, insensitive, or even unkind. Signs that a youngster may need some social coaching include:

Acts bossy or insists on own way a lot
Can't seem to start or maintain a conversation
Doesn't show empathy when others are hurt or rejected
Has trouble losing or winning gracefully
Lacks at least one or two close mutual friends
Seems constantly ignored or victimized by other kids or constantly teases or annoys other kids
Uses a louder voice than most kids

Moms and dads can use opportunities to point out when others are using desired social skills. It might be a specific behavior of the parent, another adult, a youngster, or even a character in a book or on TV. The idea is to give kids examples and role models of people engaging in the appropriate social skill.

A parent can help the youngster substitute a specific appropriate response for a specific inappropriate one. This might mean brainstorming with the youngster about different alternative responses and then practicing one or more with the youngster. Practicing can involve mapping out actual words to say or behaviors to use, role-playing, and using the newly learned skills in real situations.

Often, kids on the autism spectrum are not eager to work on new skills, so moms and dads must reward them with praise when the new skills are practiced as a way of helping the skills become habits. This might be a specific verbal statement (e.g., "You did an awesome job of X instead of Y when you got angry at the store"), a nonverbal sign (e.g., a thumbs up), or even a treat (e.g., 10 minutes extra computer time before bed).

Without nagging, moms and dads can gently remind their youngster to use a new skill when the opportunity arises. This might be verbal (e.g., "Now might be a good time to count to ten in your head") or nonverbal (e.g., zipping the lips when a youngster is about to interrupt).

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Any good coach knows that patience is important, because learning new skills takes time and practice. And everyone differs in how long it takes to learn something new. Coaches often have to be creative in their teaching strategies, because HFA kids have different ways of learning.

The important thing to remember is that the ability to have good social relationships is not simply about personality or in-born traits. Children and teens that get along with others have learned skills to do so, and they practice these regularly. Just like a good coach can make the difference for a budding football player, moms and dads can help their HFA kids become socially skilled.

Watching for Warning Signs

It’s also helpful for you to understand the warning signs of depression. Watch for behavioral changes that might indicate depression in your daughter. For example: