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Showing posts sorted by relevance for query adolescence. Sort by date Show all posts

How can you help transition an ASD child into adolescence?

Adolescence can be a very confusing and difficult time for kids with Aspergers and High Functioning Autism. The teenage years are complicated for all of us, especially for families who are unprepared for this time period. You are very wise to plan ahead for your family’s journey into adolescence. While planning ahead may not make the situation unfold painlessly, it will improve your chances for a smooth transition.

For kids with Aspergers, adolescence transition means much more than it does for typically developing kids. Areas of concern include:
  • Appropriate knowledge of dating and sexuality
  • Developing a healthy self-image
  • Education issues like special considerations and allowances due to specific weakness and strengths
  • Participation in all treatment options like classes, groups, therapy sessions, medications, etc.
  • Social skills like communication, personal space, basic personal hygiene, etc.

It is especially important that you plan for all the issues that affect your youngster with Aspergers during the teen years. There are several treatment options that you can investigate. However, the family environment can be extremely effective with or without additional outside therapies. Here are some treatments you may choose to examine:
  • Social-skills training for non-verbal communication, social cues and gestures, etc.
  • Cognitive-behavioral therapy for dealing with the feeling, emotion, and behavior connections
  • Individual psychological counseling for talking through issues and making plans
  • Career counseling to find the right career path for your youngster’s strengths and personality
  • Medication to help with depression, anxiety, and/or hyperactivity

As another option for your youngster with Aspergers, adolescence transition can be handled by caring parents in the home environment. Here are a few suggestions:
  • College and career planning: choosing a career, planning for college, trade school, technical school, etc.
  • Daily living skills: personal hygiene, home management, money skills, etc.
  • Organizational skills
  • Time management
  • Sex education: dating and sexuality knowledge
  • Social development: making and keeping friends, keeping a job, etc.

For kids with Aspergers, the teenage years do not have to be especially difficult. Using a published guide, you can cover all of these transition areas and more.


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

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

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

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

2. Can ASD occur with another disorder?

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

3. Can ASD occur with ADHD?

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

4. Can the person develop normal relationships?

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

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

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

6. Could ASD be a form of schizophrenia?

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

7. Could ASD be inherited?

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

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

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

9. Could we have caused the condition?

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

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

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

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

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

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

12. How do you share the news?

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

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

13. Is the person likely to become depressed?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

How To Parent An Aspergers Child: From Childhood To Adulthood

What works for your Aspergers (high functioning autistic) child at the age of 3 may not work for him/her at the age of 13. Here are some important tips for parenting children on the spectrum  across the lifespan:

Childhood—

After your youngster is diagnosed with Aspergers, you may feel unprepared or unable to provide him/her with the necessary care and education. Know that there are many treatment options, social services and programs, and other resources that can help.

Some tips that can help you and your Aspergers youngster are:

• Contact your local health department or autism advocacy groups to learn about the special programs available in your state and local community.

• Keep a record of conversations, meetings with health care providers and educators, and other sources of information. This will help you remember the different treatment options and decide which would help your youngster most.

• Keep a record of the doctors' reports and your youngster's evaluation. This information may help your youngster qualify for special programs.

• Talk with your youngster's doctor, school system, or autism support groups to find an autism expert in your area who can help you develop an intervention plan and find other local resources.


Adolescence—

The adolescent years can be a time of stress and confusion for any growing youngster, including adolescents with an autism spectrum disorder. During adolescence, teens become more aware of other people and their relationships with them. While most adolescents are concerned with acne, popularity, grades, and dates, adolescents with Aspergers may become painfully aware that they are different from their peers. For some, this awareness may encourage them to learn new behaviors and try to improve their social skills. For others, hurt feelings and problems connecting with others may lead to depression, anxiety, or other mental disorders.

One way that some Aspergers adolescents express the tension and confusion that can occur during adolescence is through increased aggressive behavior. Teens with Aspergers will also need support to help them understand the physical changes and sexual maturation they experience during adolescence.

If your adolescent seems to have trouble coping, talk with his or her doctor about possible co-occurring mental disorders and what you can do. Behavioral therapies and medications often help.

Transition to Adulthood—

The public schools' responsibility for providing services ends when a youngster with Aspergers reaches the age of 22. At that time, some families may struggle to find jobs to match their adult child’s needs. If your family cannot continue caring for an adult child at home, you may need to look for other living arrangements.

Long before your youngster finishes school, you should search for the best programs and facilities for young adults with Aspergers. If you know other moms and dads of Aspergers adults, ask them about the services available in your community. Local support and advocacy groups may be able to help you find programs and services that your youngster is eligible to receive as a grown-up.

Another important part of this transition is teaching young people with Aspergers to self-advocate (i.e., take on more responsibility for their education, employment, health care, living arrangements, etc.). Grown-ups with Aspergers must self-advocate for their rights under the Americans with Disabilities Act at work, in higher education, in the community, and elsewhere.

There are many options for grown-ups living with Aspergers. Helping your adult child choose the right one will largely depend on what is available in your state and local community, as well as your youngster's skills and symptoms.

Below are some examples of living arrangements you may want to consider:

Independent living. Most grown-ups with Aspergers are able to live on their own. Others can live in their own home or apartment if they get help dealing with major issues (e.g., managing personal finances, obtaining necessary health care, interacting with government or social service agencies, etc.). Family members, professional agencies, or other types of providers can offer this assistance.

Living at home. Government funds are available for families who choose to have their adult child with Aspergers live at home. These programs include Supplemental Security Income, Social Security Disability Insurance, and Medicaid waivers. Information about these programs and others is available from the Social Security Administration (SSA). Make an appointment with your local SSA office to find out which programs would be right for your adult youngster.

Long-term care facilities. This alternative is available for those with Aspergers who need intensive, constant supervision.

Other home alternatives. Some families open their homes to provide long-term care to grown-ups with disabilities who are not related to them. If the home teaches self-care and housekeeping skills and arranges leisure activities, it is called a "skill-development" home.

Supervised group living. People with disabilities often live in group homes or apartments staffed by professionals who help with basic needs. These needs often include meal preparation, housekeeping, and personal care. People who are more independent may be able to live in a home or apartment where staff only visits a few times a week. Such residents generally prepare their own meals, go to work, and conduct other daily activities on their own.

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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

The Challenges of Puberty in Teenagers on the Autism Spectrum

"We seem to be having ever increasing difficulty with our 13-year-old daughter (high functioning autistic). We began to notice a change for the worse around the time she reached puberty. Her anger and anxiety have reached a new level. She also seems very very depressed much of the time. Is this normal for a teen with this disorder? What can we do to slow down what I see as a train wreck in the making?"

Puberty brings with it challenges for all children, however, children with ASD level 1 [High-Functioning Autism] face increased challenges through puberty. The behavior issues of impulsivity can increase in both frequency and intensity.

Kids with ASD who experienced bullying in elementary school - and now continue to experience bullying during their middle school years - may become increasingly aggressive. 

Adolescence can become a very difficult time for a child with ASD as peers may no longer be willing to tolerate someone who seems different. Moodiness, depression and anxiety can also develop in adolescence due to hormonal imbalances, resulting in increased separation of the "special needs" teen from his/her peers.
 

Adolescence is a time when social demands become more complex, and it becomes increasingly important to be able to understand social cues. Children with ASD can be more vulnerable to (a) manipulation by others and (b) peer pressure. They are likely to experience more rejection among their peers. With young people on the autism spectrum, interaction with peers usually creates more anxiety than interaction with younger or older people.


In order to create a few parenting changes that may help your daughter through this difficult time, answer the following:
  • Do any particular situations seem to trigger defiant behavior in your daughter?
  • Has your daughter been diagnosed with any other medical conditions?
  • Have your daughter's teachers reported similar symptoms?
  • How do you typically discipline your daughter?
  • How have you been handling your daughter's disruptive behavior?
  • How often has she refused to follow through with your rules or requests?
  • How often over the last six months has your daughter argued with you or her teachers?
  • How often over the last six months has your daughter been angry or lost her temper?
  • How often over the last six months has your daughter been vindictive, or blamed others for her own mistakes?
  • How often over the last six months has your daughter been touchy or easily annoyed?
  • How would you describe your daughter's home and family life?
  • What are your daughter's symptoms?
  • When did you first notice these symptoms?

Here are a few parenting strategies that can help:

1. If you're depressed or anxious, that could lead to disengagement from your daughter, which can trigger or worsen her behavior. Let go of things that you or your daughter did in the past. Start each day with a fresh outlook and a clean slate. Learn ways to calm yourself, and take time for yourself.

2. Set up a routine. Develop a consistent daily schedule for your daughter. Asking your daughter to help develop that routine can be helpful.

3. Remind yourself that your daughter’s behavior is most likely a temporary inconvenience rather than a permanent catastrophe.
 
==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

4. Recognize and praise your daughter's positive behaviors. Be as specific as possible (e.g., "I really liked the way you helped pick up your room tonight").

5. Pick your battles carefully. Avoid power struggles. Almost everything can turn into a power struggle — if you let it.

6. Model the behavior you want your daughter to exhibit.

7. Develop a united front. Work with your spouse to ensure consistent and appropriate discipline procedures.

8. Build in time together. Develop a consistent weekly schedule that involves you and daughter being together.

9. Assign your daughter a household chore that's essential and that won't get done unless she does it. Initially, it's important to set your daughter up for success with tasks that are relatively easy to achieve, then gradually blend in more important and challenging expectations.

10. At first, your daughter is not likely to be cooperative or appreciate your changed response to her behavior. Setbacks and relapses are normal, so be prepared with a plan to manage those occasions. Behavior often temporarily worsens when new limits and expectations are set. But, with persistence and consistency, the initial hard work will pay off with improved behavior. Also, as she passes though the storms of adolescence, things are likely to improve by default.

 

COMMENTS:

•    Anonymous said... Alpha-Stim AID for anxiety. And, it gets better once adult.
•    Anonymous said... Encouraging articles.
•    Anonymous said... I'm having the same problem with my son. He is on a low dose antidepressant and it made such a difference. My happy boy is back.
•    Anonymous said... I've been going through that with my 13 y/o Aspie, too. Wicked anxiety and depression. It really started at about 10 or 11 and peaked for us this year. Luckily, between therapy and regular talks, we're in a better place now. I try not to rush her or stress her out. Her daily routines help calm her so we do our best not to interfere with them.
•    Anonymous said... Jed Baker gave the best explanation of one of the reasons why this happens, they become aware of all the drs, meds, therapies, spec schools etc, that they feel they are broken and unfixable. This happened to my son too. Meds and therapy helped, but Jed Baker also adds that we must increase our praise to help them during these years. I can honestly say doing this has helped our son. Good Luck!
•    Anonymous said... Medication. Risperdal and depakote work great but cause weight gain.
•    Anonymous said... My daughter too is in a major depression, she is on depokote and it is not working, neither did Prozac and another anxiety medicine. Feeling hopeless/helpless over here
•    Anonymous said... my son is 16 and is a nightmare with moods, temper, despite what we do as parents its not enough. he wont chat.!
•    Anonymous said... Totally! Normal! My guys meltdowns increased & aggression. I stuck to my guns with him and haven't used Meds. I've used humour, timeouts & rewards. It's hard but he's trying very hard!
•    Anonymous said... We are in the SAME boat over here!!!
•    Anonymous said... Yes yes yes!!! Totally normal...unfortunately! We got my daughter back into counseling and had a medication change also. Good luck .
•    Anonymous said… She's probably having trouble making/keeping friends and is likely being bullied. This is the age where they become acutely aware that they are different from others. Does she have any hobbies? I would strongly suggest getting her involved with a group of kids with similar interests, social skills groups, etc.
•    Anonymous said… my son has autism and i know is similar to aspergers. He is 17 now and I wish all the parents out there with teenage children with aspergers all the luck in the world through this difficult stage in both yours and their lives xxxx
•    Anonymous said… My daughter is only 10, going through puberty and anxiety is at an all time high!
•    Anonymous said… My daughter is 6 (almost 7) and is showing physical signs of puberty (breast development and armpit hair - along with the odor). She has become increasingly non-compliant in school and becoming more aggressive towards her teachers... At home she's almost a perfect little angel. Of course we have a very strict schedule/routine at home and any change in it has to be explained thoroughly before we get compliance.
•    Anonymous said… I'm 26 and autistic and still can't deal with puberty. It's extremely hard to explain. I just can't accept the physical change in myself or friends I knew before/during it. It's just too different seeing them with facial hair etc. I find it very crippling that my mind makes these natural things so hard to deal with even when they've happened a long time ago.

Please post your comment below...

Parenting Teens on the Autism Spectrum: Changes in Adolescence

"My high functioning autistic son will become an official teenager next week (13th birthday). Any advice on what parents should do differently with an HFA teen vs. a child?"

First of all, there's no need to worry. Children with ASD or High-Functioning Autism eventually go through adolescence on their way toward becoming strong, focused adults -- regardless of the misinformation you may have been fed.

While adolescence is a difficult time for all teens, it can easily be much worse for those dealing with HFA. With the right education and support, most of these young people go on to graduate from high school.

Because they tend to be loners and have odd mannerisms, HFA teens can be shunned from popular groups of kids -- and can be the focus of teasing. Even so, these teens develop feelings for others they become attracted to, though they can’t always express their feelings correctly.

This can lead to frustration and anger in the HFA teen who develops his/her first tentative relationships. They are more likely to face rejection from their peers and be left with a low self-esteem as a result.

Often, a teen on the autism spectrum fares best with one or two close friends with whom they can practice adolescent social skills and "growing up" behaviors. Even one relatively close relationship can make the difference between a depressed, awkward teen -- and one who is beginning to learn valuable social skills with a select few others.

Parents and family may need to help facilitate relationships between their "special needs" teenager and other teens his own age. Offering to have other teens overnight or taking their teen to an activity with one or two other acquaintances can help facilitate closer connections between their child and others his own age.

Having a teen "love experience" is often much more difficult for teens on the spectrum. Their tendency to want to be alone comes into conflict with their desire to be close to another person. Psychotherapy and family support can go a long way toward helping a teen with HFA get through the difficult adolescent time.




In summary:
  • With the right education and support, most HFA teens go on to graduate from high school. 
  • Teens on the spectrum fare best with one or two close friends with whom they can practice adolescent social skills.
  • Parents may need to help facilitate relationships between their teenager and other teens his own age.
  • Psychotherapy and family support can go a long way toward helping a teen with special needs to get through the difficult adolescent time.

Promoting Independence in Adolescence: Help for Teenagers on the Autism Spectrum

"Now that my son with high functioning autism has become a teenager, are there things that I should be doing now to prepare him for adulthood?"

The teen years can be difficult whether or not your child has High-Functioning Autism (HFA) or Asperger's (AS). In situations where he does, however, there are special challenges that differ depending on the child.

Some parents find themselves dealing with a teenager who is a loner, who has few friends, and focuses on one or more hobbies or preoccupations. This type of child is independent in some ways, but lacks the maturity to truly be independent in life. A teen like this needs to be pushed in the direction of finding friends and developing relationships.


He or she may also need to learn some of the specific things necessary for “life independence,” like how to deal with money, cleaning up after oneself, doing the laundry and other life skills that will be needed once the teen is ready to leave home. Interpersonal skills, including how to talk to service people, shop assistants, and other people he may meet along the way, should be taught and practiced as concretely as possible.

Other parents are dealing with the ongoing presence of rituals and obsessions that might interfere with the teen’s eventual independence. Psychotherapy might work in this kind of situation, but there are also medications designed to control ritual behavior. Getting this under control as a teenager will go a long way in enhancing the teen’s adult experience as she grows older.


Other things that you can teach your son to prepare him for adulthood include the following:
  • Accepting responsibility and consequences for actions (e.g., missing a deadline) and learning how to plan for emergencies
  • Balancing educational and recreational computer use
  • Completing homework, essays, and projects without reminders or involvement from mom or dad, professors, or tutors
  • Developing realistic expectations and plans about academic workload at college or technical school
  • Doing chores (e.g., laundry, cooking, and cleaning)
  • Good sleep habits
  • Handling increased social freedom and pressures (e.g., drugs and alcohol, dating and sex)
  • Healthy nutrition and exercise
  • Knowing schedules for classes
  • Money management (e.g., using ATM’s, credit and debit cards, checkbook, online banking)
  • Navigating public transportation and knowing how to get around new areas
  • Organizational skills needed to balance work and social life
  • Organizing study materials
  • Time-management skills
  • Running errands (e.g., grocery, gasoline)
  • Scheduling, canceling, and keeping doctor’s appointments

Adolescence is a time when depression can develop in teens, especially in those who know they don’t fit in and suffer from resultant poor self-esteem. Be aware of the signs of depression, and be proactive through the use of psychotherapy or medications to control some of these symptoms. This means, as a parent, you need to be aware of excessive isolation, “dark” language, outbursts of anger, or self-mutilation.

Help is available and can assist the teen resolve some of the conflicts unique to adolescence and having HFA or AS.

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

Moodiness and Depression in Teens with Asperger's and HFA

“How should I handle my teenage son’s emotional instability? Specifically, how can I tell the difference between 'normal' moodiness that occurs in adolescence and depression? My son seems to have significantly more ‘downs’ than ‘ups’. He’s usually very grouchy and pretty much stays to himself. Is this typical for teens with level 1 autism? Should I be concerned? What can I do to help?”

Moodiness and depression are common among teens in general. And young people with Asperger’s (AS) and High-Functioning Autism (HFA) are at even greater risk for these comorbid conditions. Teens on the autism spectrum have a “developmental disorder,” which means that their emotional age is significantly younger than their chronological age.

For example, the teenager may be 16-years-old, but still have the social skills of a 9-year-old. This dilemma causes problems for the teen due to the fact that he or she experiences great difficulty in relating to same-age peers, which in turn may result in rejection from the peer group – and this contributes largely to the AS or HFA teen’s lack of self-esteem and depression.



In addition, cognitive control systems lag behind emotional development making it hard for AS and HFA teens to cope with their emotions. Furthermore, beyond the biological factors, a lot of other changes are occurring during adolescence (e.g., experiencing first loves and breakups, butting heads with parents, start of high school, etc.). No wonder some teens on the spectrum struggle through this time in their life.

==> Discipline for Defiant Aspergers and High-Functioning Autistic Teens

Unfortunately, other complicating factors are at play during the teenage years:

Difficulty with transitions— Largely due to the uneasy transition toward adulthood, most teens on the spectrum experience an increase in anxiety. It is during this time that they are dangling between the dependency of childhood and the responsibilities of adulthood. It can feel intimidating to prepare to leave high school, head off to college, or into the job market. All these factors induce more mood swings and anxiety in AS and HFA teens.

Peer-rejection— Many teens on the spectrum are deliberately excluded from social relationships among their age group. As a result, they often choose to isolate themselves, which makes a bad problem worse. A teenager who feels rejected often spends too much time playing video games and on social networking sites, thus losing touch with peers even more. Teens who are ostracized by their peers also tend to underachieve academically.

Poor social skills— Most young people with AS and HFA experience social skills deficits. As a result, interactions with peers become very unpleasant. The more they “fail” in connecting with peers, the more they isolate. They want to “fit-in” and be accepted, but simply haven’t figured out the social politics needed to find and keep friends.

Low self-esteem— Peer-group rejection results in a decline in their self-image, a state of despair, behavioral difficulties, loneliness and seclusion.

So as a parent, how do you know when to wait out the moods – and when to worry? The truth is that it's difficult to know, because every teenager is different. Rapid physiological changes are occurring during adolescence. Therefore, a degree of vacillation between "ups" and "downs" can be expected. However, there is big difference between teenage mood swings and genuine depression. The major symptoms of depression may include:
  • changes in appetite
  • episodes of moping and crying
  • fatigue
  • loss of enthusiasm or interest in favorite activities
  • headaches
  • insomnia
  • irritability
  • mood swings that seem out of proportion to the circumstances
  • negative self-concept
  • outbursts of anger 
  • painful thoughts that manifest themselves in relentless introspection
  • persistent anxiety
  • persistent sadness
  • poor school performance
  • sense of hopelessness
  • withdrawal and isolation

If an AS or HFA teenager is suffering from depression, parents can expect to see the following symptoms unfold in three successive stages:
  1. Inability to concentrate, withdrawal from friends, impulsive acts, and declining academic performance
  2. Acts of aggression, rapid mood swings, loss of friends, mild rebellion, and sudden changes in personality
  3. Overt rebellion, extreme fatigue, giving away prized possessions, expressions of hopelessness, and suicidal threats or gestures

Other common symptoms of depression in adolescents include: eating or sleeping too much, feeling extremely sensitive, feeling misunderstood, feeling negative and worthless, poor attendance at school, self-harm, and using recreational drugs or alcohol.

==> Discipline for Defiant Aspergers and High-Functioning Autistic Teens

Symptoms caused by depression can vary from child to child. To discover the type of depression your AS or HFA teenager has, your physician may add one or more “specifiers.” A specifier simply means that your teen has depression with specific features, for example:
  • Seasonal pattern: depression related to changes in seasons and reduced exposure to sunlight
  • Mixed features: simultaneous depression and mania, which includes elevated self-esteem, talking too much, and increased energy
  • Melancholic features: severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, major changes in appetite, feelings of guilt, agitation or sluggishness, and worsened mood in the morning 
  • Catatonia: depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture
  • Atypical features: depression that includes the ability to temporarily be cheered by happy events, increased appetite, sensitivity to rejection, a heavy feeling in the arms or legs, and excessive need for sleep
  • Anxious distress: depression with unusual restlessness or worry about possible events or loss of control


Treatment—

1. Psychotherapy: Different types of psychotherapy can be effective for depression in AS and HFA teens (e.g., cognitive behavioral therapy). Psychotherapy can help your teen:
  • regain a sense of satisfaction and control in his or her life
  • ease depression symptoms (e.g., hopelessness and anger)
  • learn to set realistic goals for his or her life
  • identify negative beliefs and behaviors and replace them with healthy, positive ones
  • identify issues that contribute to his or her depression
  • change behaviors that make depression worse
  • find better ways to cope and solve problems
  • explore relationships and experiences
  • develop positive interactions with peers
  • develop the ability to tolerate and accept distress using healthier behaviors
  • adjust to a crisis or other current difficulty

2. Alternative Therapies: Therapies other than face-to-face office sessions are available and can be highly effective for teens on the autism spectrum (e.g., as a computer program, by online sessions, or using videos or workbooks). These can be guided by a therapist or be totally independent.

3. Social Skills Training: Teens on the autism spectrum experience depression largely due to their awkwardness in interpersonal relationships. Thus, social skills training is perhaps the best method for combating depression in these young people. A major goal of social skills training is teaching AS and HFA teens:
  • how to understand verbal and nonverbal behaviors involved in social interactions
  • how to make "small talk" in social settings
  • the importance of good eye contact during a conversation
  • how to "read" the many subtle cues contained in social interactions
  • how to tell when someone wants to change the topic of conversation or shift to another activity
  • how to interpret social signals so that they can determine how to act appropriately in the company of others in a variety of different situations

Social skills training assumes that when “special needs” teens improve their social skills and change selected behaviors, they will raise their self-esteem and increase the likelihood that others will respond favorably to them. The AS or HFA teen learns to change his or her social behavior patterns by practicing selected behaviors in individual or group therapy sessions.

4. Medication: Many types of antidepressants are available, including:
  • Atypical antidepressants (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL, Remeron, Trintellix)
  • Monoamine oxidase inhibitors (Parnate, Nardil, Marplan, Emsam)
  • Selective serotonin reuptake inhibitors (Celexa, Prozac, Paxil, Pexeva, Zoloft, Viibryd)
  • Serotonin-norepinephrine reuptake inhibitors (Cymbalta, Effexor XR, Pristiq, Khedezla, Fetzima)
  • Tricyclic antidepressants (Tofranil, Pamelor, Surmontil, Norpramin, Vivactil)

Other medications can be added to an antidepressant to enhance antidepressant effects. Your physician may recommend combining two antidepressants or adding medications (e.g., mood stabilizers or antipsychotics). Anti-anxiety and stimulant medications can also be added for short-term use.

Other things that parents can do to combat moodiness and depression in their AS or HFA teenager include: encouraging physical activity; praising the youngster's skills; promoting participation in organized activities; reminding your youngster that you care by listening, showing interest in his or her problems, and respecting his or her feelings; and setting aside time each day to talk to your youngster (this step is crucial in preventing further isolation, withdrawal, and progressive depression).

==> Discipline for Defiant Aspergers and High-Functioning Autistic Teens

Helping Aspergers and HFA Teens Cope With Life

The teenage years are the most difficult time for young people with Aspergers (AS) and High-Functioning Autism (HFA). Most experts do a great job of presenting the problems these teens face, but they offer few solutions.

Below are 50 tips for parents who want to help their "special needs" teenager survive and thrive during the tough adolescent years:

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

2. A regular bed time for the adolescent gives you time you can count on each evening for yourself and/or your spouse. If you can build in regular respite—such as a night your adolescent spends with a grandparent once a month—go for it, and plan ahead for some relaxation, fun, or culture. (Divorced moms and dads may be able to count on a little time alone or with friends as long as they set up and adhere faithfully to a regular visitation schedule.)

3. Adolescence is a time of tumultuous change for most kids, but for adolescents dealing with Aspergers or HFA, it can be one of tremendous difficulty. In order to combat this frustration, social training is critical. A small class with an instructor who is capable of creating strong bonds and trust within her students is paramount. Once this bond is created, systematic teaching of how to interpret indirect communication, manners, and body language can take place, and may help remarkably in allowing this type of adolescent to navigate the often confusing world of adolescence.

4. An activity the adolescent can walk to is great—for my grandson it was Tae Kwon Do lessons; he could decide how many lessons to attend each week, and get himself there and back. Learning to use public transportation is also great. Consider buying a T pass, or rolls of quarters.

5. Appropriate school placement and staff training, exercise (martial arts, yoga), and/or appropriate therapy with a carefully chosen professional, may help control the level of anxiety. Meds may need to be introduced or adjusted.

6. Forgive yourself for being an imperfect parent, and for not loving your youngster “enough.” Forgive yourself for sometimes losing your temper, yelling, or handling a tense situation awkwardly. Forgive yourself for getting your adolescent diagnosed “late”—there are still plenty of years in which to help your youngster. Forgive yourself for not arranging play dates, or sports, or tutoring, the way other moms and dads may be doing. We each offer our youngster our own unique talents, interests, and qualities, as people and as moms and dads. We each do the best we can to gather the information, insights, resources, and services that will help our children live and grow through adolescence. And—willingly or of necessity—we each end up making significant sacrifices for our children. In the hardest years my mantra was: “The best I can do has got to be good enough—because it’s the best I can do!” It is a hard job; we are all heroic moms and dads.

7. The “job description” of an adolescent is to pull away from moms and dads toward more independence; for our children, the process can be extra messy—not least because they may be even less ready for independence than other adolescents. Although some adolescents on the autism spectrum are more docile and child-like, be prepared to tolerate/ignore considerable distancing, surliness, or acting out, knowing that it won’t last forever. At the same time, set some firm limits, and keep a close eye on the youngster/adolescent’s welfare.

8. Be patient. Remember that kids and adolescents with Aspergers and HFA are relatively immature, socially and emotionally, compared to non-autistic kids of the same chronological age. Imagine sending a 10 year old off to high school (even if she has a chronological age of 14), or putting a 14 year old boy behind the wheel of car (even if he has a chronological age of 18)—or sending that 14 year old off to college or the army. We need to adjust our expectations for adolescents with AS—and make sure they still have appropriate supports. Don’t pull the “ramp” out from under the “wheelchair”!

9. Males may need to spend increased amounts of time with their fathers, and/or other male role models, as they undertake to become men. If dad has taken a back seat, let him know his son really needs his attention now. If you are a single mother, look especially hard for male mentors at your son’s school or in the wider community.

10. Build and use any support networks you can: extended family, close friends, church/synagogue groups, and an understanding school staff. If you don’t have a good network, consider individual or family therapy for a little support during a stormy, demanding life passage. When you have a demanding adolescent, it’s good to be reminded once a week that your needs and feelings are valid and important, too!

11. Consider delaying graduation in order to ensure that transition services are actually provided under DOE. It may be hard to convince an academically gifted, college bound student to accept this route. However, it may be very helpful for students who will need a lot of help with independent living skills and employment issues. Services need not be delivered within high school walls. Community college courses, adaptive driving lessons, and employment internships are just a few alternatives to consider.

12. Discipline & responsibility: A simple, low key, consistent approach is more important than ever, as adolescents become taller and stronger—not that physical restraint was ever very useful with our children. Pick your battles. Set and enforce only your bottom line rules and expectations—matters of safety and respect. Write them down. Make sure both moms and dads/all involved adults agree on the rules. Give choices when possible, but not too many. Engage your adolescent in problem-solving; what does s/he think would work?

13. Encourage your adolescent to carry a wallet disclosure card to show if stopped by a police officer or other first-responder. A lot of adolescents on the spectrum like to walk at night to unwind, and police may view their behavior as suspicious. You may want to introduce your adolescent to your local police community relations officer, and explain a little about the disorder.

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

15. Even for a previously well-adjusted youngster, multiple stressors during the adolescent years may bring on anxiety and even depression. Stressors seem to include increased academic/abstract thinking and social demands at school, peer pressure, increased social awareness, and fears of the future. Highly anxious adolescents who do not get help may be at risk for hospitalizations, school failure, acting out (including alcohol and substance abuse), or even suicide attempts.

16. Go with the flow of your youngster’s nature. Simplify schedules and routines, streamline possessions and furnishings. If your adolescent only likes plain T shirts without collars or buttons, buy plain T shirts. If your kid likes familiar foods, or has a favorite restaurant, indulge her.

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

18. If both parents can largely agree about an adolescent’s diagnosis, treatment, and rules, it will save a lot of family wear and tear. To get your spouse on the same page, attend conferences or classes together. When you hear the same information, you can discuss it and decide what will work best for your adolescent and in your family. As you learn more about the disorder, you may also come to better appreciate each other’s contributions to your youngster’s welfare. Attend team meetings at the school together, or alternate which parent attends. Seeing your youngster’s therapist together (possibly without the youngster), or seeing a couples or family therapist, may help you weather a tough time together.

19. If you can afford it, you may prefer to pay private school tuition rather than paying a lawyer to negotiate with a financially strapped or resistant school system. However, a private school may not be the best choice. Some families move to a community with a better high school. If you have not talked to your adolescent about the disorder, you or someone else should do so—to the extent that the adolescent is ready to hear it. It’s tricky for adolescents—they so much want to be “normal” and strong and successful. A diagnosis can seem threatening or even totally unacceptable. In truth, however, the adults with Aspergers and HFA who do best are those who know themselves well—both their own strengths, which point them toward finding their niche in the world, and their own blind spots: where they need to learn new skills or seek out specific kinds of help.

20. If you have not yet made a will and set up a special needs trust, do it now. Ask the lawyer about powers of attorney or other documents you may need once your adolescent is no longer a minor. Few moms and dads assume guardianship of a young adult 18 or older, but it may be necessary and appropriate in some situations.

21. If your adolescent seems like a good candidate for college, take him or her to visit colleges during the spring vacation weeks of the junior year of high school, or during the summers before junior and senior year. Visits reveal a lot about what environment the adolescent will prefer. Purchase a large college guide to browse.

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

23. In adolescence, communication becomes complicated, as adolescents invent words, signs, and body language to discreetly talk with a friend. For a youngster on the autism spectrum who has been struggling just to understand common social cues, this change can be frustrating and incredibly difficult to understand. The best scenario is when language is "concrete and definite." Teenage conversations that use shortened terms or lingo are going to be very difficult for a youngster with Aspergers or HFA.

24. In so far as you can, keep your cool—they can’t handle our upset feelings. Walk away if you need to.

25. Instill the essential habit of a daily shower and clean clothes: peers, teachers, and future potential employers are very put off by poor hygiene. If possible, put your adolescent’s clothes on a well-organized shelf in the bathroom, near the clothes hamper.

26. Children still need structure, down time, soothing activities, and preparation for transitions.

27. Children with an autism spectrum disorder can be difficult to parent and to love even when they are young. Often, our children neither accept nor express love or other positive feelings in ways a non-autistic parent expects or finds most comfortable. Children’ behavior can be trying or embarrassing for us. Adding adolescence to the mix can make this dilemma even more painful.

28. Look for opportunities for a sheltered, successful overnight stay away from home with no parent. Examples: long weekend visits to relatives, a week or two of a carefully chosen sleep-away camp, taking a course on a college campus.

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

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

31. Not all adolescents are ready for a residential college experience right after high school. To decide, use the evidence of how the adolescent did at sleep-away camp or similar samplings of independence, and look carefully at executive function skills (organizational skills). As an alternative, community colleges offer a lot of flexibility: easy admission, low cost, remedial courses if necessary, the option of a light course load, and the security of living at home. Some college disability offices are more successful than others at providing effective, individualized support. However, if the adolescent is living at home, you may be able more easily to sense trouble, step in with help, or secure supports your young adult needs to succeed.

32. Reading body language and understanding sweeping generalizations can also be quite frustrating. Therefore, adolescents on the spectrum benefit from systematic social training, where they are given the change to role play, study body cues and language, and practice interpreting new signals that may not have been evident in early childhood. I recommend speaking clearly, using a small amount of abstract terms, and directly communicating as much as possible.

33. Residential schools may be worth considering for some. The right fit can build tremendous confidence for the adolescent, give the moms and dads a break, and prepare everyone for the independence of the post high school years.

34. Schedule regular monthly educational team meetings to monitor your adolescent’s progress, to ensure that the IEP is being faithfully carried out, and to modify it if necessary. Because adolescents can be so volatile or fragile, and because so many important things must be accomplished in four short years of high school, these meetings are critical. If an adolescent is doing very well, the team can agree to skip a month—but be sure to reconvene to plan the transition to the following year.

35. Seek out activity-based, practical social skills groups designed especially for adolescents. Participating in such a group, being accepted by group leaders and peers, is probably the most powerful way to allay an adolescent’s potential despair at not fitting in socially and not having any friends. The positive social experiences and new skills they learn will be assets for the rest of their lives.

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

37. Make sure the IEP provides for social skill learning/social pragmatic language. A good overarching goal is: “Robert will learn the social skills appropriate to a 9th grader …10th grader … to the workplace …etc.”

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

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

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

41. Adolescents begin to see themselves as independent entities and often use this time in their life to forge new friendships and intimate relationships. For an adolescent with Aspergers or HFA, friendships can be a struggle. This youngster may not understand social cues, and may not know how to be someone's friend. They may feel the typical feelings of a first crush, but be uncertain on how to act on it. I recommend social therapy to help combat the frustration. Social training can help adolescents who are dealing with their disorder understand social cues, slang, and meet other kids who feel similarly about how to deal with new friends. In these social trainings, adolescents should be taught how to listen, and how listening and reacting appropriately can lead to stronger bonds. The parent should try to explicitly explain what the act of flirting is, by pointing it out on a TV show or movie.

42. Adolescents need to learn when to ask for help, from whom, and how. It’s very helpful to have someone such as a trusted guidance counselor whose door is always open, and who can coach the adolescent in problem solving.

43. Adolescents with Aspergers and HFA are less prepared than non-autistic adolescents for the new challenges of sexuality and romance. Some are oblivious; others want a girl or boy friend, but are clueless about how to form and maintain a relationship. Males especially may be at risk for accusations of harassment, and girls especially at risk for becoming victims. Teach appropriate rules, or see that another adult does. Look for supervised activities in which boys and girls can socialize safely together, supervised by a staff person who knows about autism spectrum disorders - and can coach appropriate social skills.

44. Tell your adolescent just what he needs to know, one message at a time, concisely.

45. The transition plan (part of the IEP) should address the skills that an adolescent needs to acquire while in high school, in order to be prepared for the kind of independent life he wants to lead after graduation. Many high schools are unfamiliar with transition planning, however—especially for college bound students. The more you know as a parent, the more you may be able to ensure that a solid transition plan is written and carried out.

46. What kind of living situation, employment, and transportation fit your adolescent’s picture of his/her future at age 18 or 25? Once the goals are set, where can the adolescent learn the necessary skills? Consider academic courses, electives, extracurricular activities, and additional services within and outside the high school (e.g. community college, adaptive driving school).

47. With or without autism, most adolescents become less willing to take a parent’s word or advice; so we need to hook them up with other trustworthy adults. If you want your adolescent to learn or try or do something, arrange for the suggestion or information to come from a trusted adult other than a parent (e.g., handpick your adolescent’s guidance counselor). Look for other good mentors: Uncle? Scout or youth group leader? Psychologist, social worker, peer mentor, “Big Brother,” social skills group leader? Weight room coach or martial arts teacher?

48. Yes, Aspergers and HFA adolescents do continue to grow and develop. You may get some nice surprises along the way, as you see the adolescent take an unexpected giant step toward maturity. I think of it as their neurons maturing on the vine! Maybe it’s just that they figure some things out, and get used to the feel of their new body chemistry.

49. You want input and ownership from the adolescent as far as is possible, but moms and dads can and should have input. You may need to have team meetings when the adolescent is absent, so you can speak frankly about your concerns, without fear that the adolescent may feel you lack respect for or faith in her/him.

50. Have plenty of patience – and take care of your mental health along the journey!

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

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