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Meltdowns vs. Shutdowns and How Parents Should Respond

"Are shutdowns actually avoidance behavior, in other words, the child is simply trying to get out of doing something uncomfortable? And how is it different than a meltdown? I'm not sure exactly where to draw the line between intentional and involuntary acts with my 10 y.o. (high-functioning) son."

When it comes to dealing with a child who has High-Functioning Autism (HFA) or Asperger's (AS), there aren't too many differences between meltdowns and shutdowns. Both are extreme reactions to everyday stimuli. Both tend to be the result of long-term unresolved issues rather than the more obvious triggers, and both are almost completely out-of-the-control of the youngster rather than being used as a means to an end (which would be either a tantrum or emotional blackmail).

Some kids on the autism spectrum are more prone to meltdowns while others lean more towards the shutdown reaction. It's possible to do both, but this depends greatly on the root cause of the problem. There's a personality component to the reaction with HFA kids who are more sure of themselves or more fiercely independent leaning towards meltdowns rather than shutdowns, but again there's a wide variance depending upon the feelings brought on by the trigger. Some events can make even the most confident youngster on the spectrum doubt himself or herself.

What exactly is a shutdown?

While a meltdown could be described as rage against a situation, a shutdown tends to be more of a retreat. Behaviors which manifest during a shutdown include:
  • rolling oneself into a ball or fetal position
  • crawling under objects
  • lying face down or completely under the covers on a bed
  • gaze avoidance tends to increase significantly
  • conversation may be non-existent

As with meltdowns, in a shutdown situation, the youngster may act irrationally or dangerously. Unlike a meltdown however, the harmful activities are almost always directed at oneself. The youngster may attempt self-harm - and may even be suicidal in some cases. He or she may be more likely to take reckless risks (e.g., attempting to jump out of a bedroom window).
 

What causes a shutdown?

As with meltdowns, the cause of a shutdown tends to be cumulative, and the trigger may bear little resemblance to the actual problem. The real problems associated with shutdowns tend to lean towards depression, loneliness, poor self-image and poor self-worth.

In younger children, a shutdown may be triggered because of a simple breakfast issue (e.g.,  they were given something they don't like). In this case, the cause may actually have nothing to do with breakfast at all, but rather it may be symptomatic of the youngster's frustration at not being able to make himself understood.

What does a shutdown look like in adults on the autism spectrum?

In grown-ups, shutdowns can result from extreme events (e.g., losing a job, marriage break-up, etc.), but they can also have very small triggers, which simply remind the person of a larger pain (e.g., a small incident at work can provoke some long-term insecurities and cause a retreat).

A shutdown will move some form of emotional pain to the center of the adult's focus, and he or she may start contemplating "what if" and "if only" scenarios. These thoughts are always counter-productive, because you can't change the past, and they usually only make the person feel entrapped by events. During a shutdown, the adult may collapse into a heap and will generally not have any contact with anyone.




What can be done?

Think of the fight-or-flight response. When a child shuts down, he is in flight mode. In other words, the child is trying to protect himself/herself from real or imagined harm. So, your objective as a parent is to think in terms of assuring the child that he or she is not in harm's way. Here are a few tips to achieve this objective:

1. Children on the autism spectrum often shut down as a result of being teased, rejected or bullied by others (e.g., siblings, peers, etc.). Thus, it's very important to counter any negative messages your son is receiving from others. If those negative messages are coming from teachers or other family members, then you may need to get involved yourself.
 

2. Unlike meltdowns (where it's best to leave the youngster alone - but in a safe place), it's generally helpful to talk in a soothing voice during a shutdown. Just make sure that you're careful what you say - and keep things positive. The only thing to remember when soothing your son during a shutdown is that you're still dealing with a child on the autism spectrum. Don't try to force eye contact, and don't touch him without either being invited to do so - or being cautious to see the reaction first.

3.  Send him a text message (assuming he has a cell phone) voicing your concern. In this way, you are less likely to elicit an immediate and defensive reaction. The advantage of a text message is that it allows stepping away from the situation and invites reflection and thought.  

4. When your son is in shutdown mode, don’t talk directly to him. When possible, let him overhear you expressing your concern (in a non-critical and non-judgmental way) to someone else (e.g., a spouse). In this way, you are giving your son a chance to understand your concern with no immediate response called for on his part. Your son is more likely to hear your words as concern rather than an attempt to control. You are giving him an opening to talk when he is ready.

5. When your son shuts down, sometimes the best thing you can do is whisper, because it is so different from what he normally hears. If you get down at his level and whisper, then he has to pay closer attention to what you're saying in order to hear you. He will be very curious as to what you're saying (e.g., "I see you're upset. I want you to know that I'm here to listen to you when you're ready to talk. In the meantime, you are safe and nobody is going to hurt you.").


More resources for parents of children and teens on the autism spectrum:
 


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Parents’ Comments:

•    Anonymous said... my son has shutdowns more than meltdowns i never knew there was more than one kind... thanks for the post makes sence now weve been told to grab and hold him when hes trying to hurt himself since it can get serious. he still managed to bang his head good last one we had. does anyone else see a kid that doesnt remember what happened in a shutdown? ours claims he cant remember its what led us to the therapist saying something is wrong... they said aspergers. he was missdiagnosed for years
•    Anonymous said... My daughter is also more prone to shutdown more than meltdown as she has such a beautiful and caring nature. She has now learnt that rather than going through the frustration of trying to explain herself verbally, it's much easier for her to draw a picture or act it out (the arts, both visual and performing, are a life long obsession) and she asks for visual cues when she can't understand whats being explained to her, or she simply says "I don't understand, can you please show me another way?" So she is basically overcoming her difficulties her own way to avoid frustration.
•    Anonymous said... My 4-year-old is just like this. I hadn't read anything about shutdowns before, but this is exactly what he does when he is distressed (hides under the bed, curls up on the floor, etc.).
•    Anonymous said... My 8 yr old has meltdowns at home, but he will shutdown at school, so that's when I get a phone call to come and get him.
•    Anonymous said... I don't know what's worse. My 5 year old has the mother of all meltdowns. It's so hard. However I'm sure that it feels helpless when your child goes into shutdown mode.
•    Anonymous said... Thank you so much for sharing this!
•    Anonymous said... I had not read about shutdowns before either - this is so so helpful!
•    Anonymous said... I must admit I hadn't realised shutdown was a thing, my son has meltdowns, but they are few and far between just now, he seems to have switched to shut downs instead. His self harming behaviour is not present during shutdowns, just meltdowns. I would rather deal with a shut down, but after reading this I realise I still have a lot to do :) Thank you x
•    Unknown said... Thank you so much for this information. Both my husband and son were diagnosed with HFA. I am learning much about the issue surrounding the disorder, and through mistakes and life experience. I hope this article helps others as well.
•    Upside Down Cake said... I can tell you shut downs are pretty horrible. When I have one I can't even talk. People around me will think I'm being rude but I'm not, I literally have no control. For me I normally get them with too much stimulation but they can be the result of a build up of stress. I also have partial shut downs which can last for days and leave me needing my bed the whole time. I find these partial shut downs are caused but stress and I can face going out or having contact in any form with the outside world. It is nice tho if there is a calm caring person around to make tea and give sympathy. During these partial shut downs I am totally drain and I suffer with a lot of pains, my arms go numb too xx
•    Multiple Me's said... My aspie had a total shutdown for 6 months in school and his teacher never communicated that to me. He was then placed in a gifted class and struggled to catch up. Meltdowns and shutdowns were his entire life until he was diagnosed with a new mood disorder and treated. Once I put him in online school, he became a different boy and started articulating what had happened in his mind for 2 years. The poor child was in such pain, yet at 12 yrs was able to finally start talking and so intuitively it was shocking. That was when we finally got the ASD (aspie) diagnosis. His schooling caught up, straight A's for two years, advanced classes, and even high school math credit in 8th grade. We're able to work through meltdowns and shutdowns quickly now because we both look for triggers and work them out. I wish I had this article when he was a toddler and either started his violent meltdowns or seemed secretive and stoic and wouldn't cry or talk. He still doesn't cry, even when hurt, so I know he continues to escape.

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Why "Traditional Discipline" Doesn't Work for Many Kids on the Autism Spectrum

“Why is there a general consensus that children on the autism spectrum (specifically on the high end) should not receive ‘traditional’ discipline that works with most other children? What am I missing here?”

Traditional discipline may fail to produce the desired results for kids with High-Functioning Autism (HFA) and Asperger’s, primarily because they are unable to appreciate the consequences of their actions. Consequently, punitive measures are apt to exacerbate the type of behavior the punishment is intended to reduce, while at the same time increasing the anxiety-level of the child.

This paradox is due to some of the traits of the disorder, specifically the following:
  1. Executive dysfunction: An impairment in the higher-order processes that enable us to plan, sequence, initiate, and sustain our behavior towards some goal, incorporating feedback and making adjustments along the way.
  2. Theory of mind deficits: This is an inability to recognize that other people have thoughts, feelings and intentions that are different to one's own, and an inability to intuitively guess what these may be.
  3. Weak central coherence: The inability to bring together various details from perception to make a meaningful whole.

Let’s take a closer look at each of these deficits:

1. Executive function can be defined as the way in which people monitor and control their thoughts and actions. It is actually a broad category that includes such processes as working memory, planning, cognitive flexibility, and inhibitory control. “Inhibitory control” is one aspect of executive function, and is the ability to restrain (or inhibit) potentially interfering responses and to self-regulate in certain situations.

2. Theory of mind is the ability that we all have in order to make sense of the world we live in. Every person's thoughts, knowledge, beliefs and desires make up his or her own unique theory of mind. From the age of around 4 years, “typical” kids understand that other people have thoughts, knowledge, beliefs and desires that will influence their behavior. However, children with HFA and Asperger’s appear to have some difficulties conceptualizing and appreciating the thoughts and feelings of others (i.e., lack of empathy).

It is this “mind-blindness” that may impair these special needs kids to be able to relate to - and understand the behaviors of - others. Mind-blindness also means the child has difficulty in distinguishing whether someone's actions are intentional or accidental. By failing to account for other’s perspectives, children on the spectrum tend to misinterpret their messages. Many of the social-skills deficits observed in children with HFA and Asperger’s may have their genesis in the lack of ability to decipher subtle meaning from the environment.

3. Central coherence is the ability to focus on both details as well as wholes. However, children on the autism spectrum appear to have a heightened focus on details rather than wholes (a cognitive style termed “weak central coherence”). This is the reason why some kids with HFA and Asperger’s have hypersensitive sensory perceptions. The inability to hold information in mind in order to use it later in other tasks is what causes the child to lack central coherence. A lack of cognitive central coherence can easily cause the child to miss the importance of the subtle cues that create meaning in a social context.

How parents can help:

Consider maintaining a diary of your youngster's behavior in order to uncover patterns or triggers. Recurring “bad” behavior may be indicative of a youngster taking some satisfaction in receiving a “desired” response from parents, siblings, peers - and even teachers.

For example, a student on the autism spectrum may come to understand that hurting another student in class will result in his being removed from class (aside from the associated consequence to his peer). The solution may not be most effectively rooted in punishing the youngster for the behavior, or even attempting to explain the situation from the perspective of his injured peer, but by treating the root cause behind the motivation for the misbehavior. In this example, can the youngster be made more comfortable in class so that he will not want to leave it?

One of the means to achieve this may be to focus on the positive. Praise for good behavior, and reinforcement by way of something such as a Reward Book, can help. Positive verbal cues delivered in a calm tone are likely to elicit more beneficial responses than harsher verbal warnings (which may be effective on kids without an autism spectrum disorder).

When giving directions to stop a type of misbehavior, they should be couched as positives rather than negatives. For example, rather than telling the youngster to stop hitting his brother with the ruler, he should be directed to put the ruler down, and then receive verbal praise for following the parent’s request (e.g., “Thank you for doing as I asked. That’s you being respectful of others”).

 
Resources for parents of children and teens on the autism spectrum:
 
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Tantrums & Meltdowns: Prevention, Intervention & Post-Meltdown Management

Question

I'm so frustrated! My 4 year old son was diagnosed with high-functioning autism last year, and for the year prior to that I was dealing with his overwhelming emotions. Now it seems like even if he's happy, he's too much for me. When he's not happy, he throws things, slams doors, screams, climbs furniture etc. So basically I have the same behaviors no matter how he's feeling. I fear the thought of going out anywhere with him. I have 4 other children, and he has drained everything I have inside me. I just don't know how to cope with him anymore. He is aggressive to the baby… I have to fight with him to change his clothes. I just feel like I've done all I can and now I'm back at square one again without the ability to do it again. Any advice on how to get through to him and calm him some?

Answer

For children with High-Functioning Autism (HFA) and Asperger's, tantrums and meltdowns look similar in the behavioral sense, but have different causes (click here for more information on tantrums versus meltdowns). In any event, it's much easier to prevent both of these than it is to manage them once they have erupted.

Here are some tips for preventing these behaviors and some things you can say:

Prevention Methods—

• Avoid boredom. Say, “You have been working for a long time. Let’s take a break and do something fun.”

• Change environments, thus removing the youngster from the source of the meltdown. Say, “Let’s go for a walk.”

• Choose your battles. Teach kids how to make a request without a meltdown and then honor the request. Say, “Try asking for that toy nicely and I’ll get it for you.”
 

• Create a safe environment that kids can explore without getting into trouble. Childproof your home or classroom so kids can explore safely.

• Distract kids by redirection to another activity when they meltdown over something they should not do or cannot have. Say, “Let’s read a book together.”

• Do not ask kids to do something when they must do what you ask. Do not ask, “Would you like to eat now?” Say, “It’s suppertime now.”

• Establish routines and traditions that add structure. For teachers, start class with a sharing time and opportunity for interaction.

• Give kids control over little things whenever possible by giving choices. A little bit of power given to the youngster can stave off the big power struggles later. “Which do you want to do first, brush your teeth or put on your pajamas?”

• Increase your tolerance level. Are you available to meet the youngster’s reasonable needs? Evaluate how many times you say, “No.” Avoid fighting over minor things.

• Keep a sense of humor to divert the youngster’s attention and surprise the youngster out of the meltdown.

• Keep off-limit objects out of sight and therefore out of mind. In an art activity keep the scissors out of reach if kids are not ready to use them safely.

• Make sure that kids are well rested and fed in situations in which a meltdown is a likely possibility. Say, “Supper is almost ready, here’s a cracker for now.”

• Provide pre-academic, behavioral, and social challenges that are at the youngster’s developmental level so that the youngster does not become frustrated.

• Reward kids for positive attention rather than negative attention. During situations when they are prone to meltdowns, catch them when they are being good and say such things as, “Nice job sharing with your friend.”
 

• Signal kids before you reach the end of an activity so that they can get prepared for the transition. Say, “When the timer goes off 5 minutes from now it will be time to turn off the TV and go to bed.”

• When visiting new places or unfamiliar people explain to the youngster beforehand what to expect. Say, “Stay with your assigned buddy in the museum.”





Intervention Methods—

There are a number of ways to handle a meltdown. Strategies include the following:

• Hold the youngster who is out of control and is going to hurt himself or herself or someone else. Let the youngster know that you will let him or her go as soon as he or she calms down. Reassure the youngster that everything will be all right, and help the youngster calm down. Moms and dads may need to hug their youngster who is crying, and say they will always love him or her no matter what, but that the behavior has to change. This reassurance can be comforting for a youngster who may be afraid because he or she lost control.

• If the youngster has escalated the meltdown to the point where you are not able to intervene in the ways described above, then you may need to direct the youngster to time-out. If you are in a public place, carry your youngster outside or to the car. Tell the youngster that you will go home unless he or she calms down. In school, warn the youngster up to three times that it is necessary to calm down and give a reminder of the rule. If the youngster refuses to comply, then place him or her in time-out for no more than 1 minute for each year of age.
 

• Remain calm and do not argue with the youngster. Before you manage the youngster, you must manage your own behavior. Spanking or yelling at the youngster will make the meltdown worse.

• Talk with the youngster after the youngster has calmed down. When the youngster stops crying, talk about the frustration the youngster has experienced. Try to help solve the problem if possible. For the future, teach the youngster new skills to help avoid meltdowns such as how to ask appropriately for help and how to signal a parent or teacher that the he or she knows they need to go to “time away” to “stop, think, and make a plan.” Teach the youngster how to try a more successful way of interacting with a peer or sibling, how to express his or her feelings with words and recognize the feelings of others without hitting and screaming.

• Think before you act. Count to 10 and then think about the source of the youngster’s frustration, this youngster’s characteristic temperamental response to stress (hyperactivity, distractibility, moodiness), and the predictable steps in the escalation of the meltdown.

• Try to intervene before the youngster is out of control. Get down at the youngster’s eye level and say, “You are starting to get revved up, slow down.” Now you have several choices of intervention.

• You can ignore the meltdown if it is being thrown to get your attention. Once the youngster calms down, give the attention that is desired.

• You can place the youngster in time away. Time away is a quiet place where the youngster goes to calm down, think about what he or she needs to do, and, with your help, make a plan to change the behavior.

• You can positively distract the youngster by getting the youngster focused on something else that is an acceptable activity. For example, you might remove the unsafe item and replace with an age-appropriate toy.
 

Post-Meltdown Management—

• Do not reward the youngster after a meltdown for calming down. Some kids will learn that a meltdown is a good way to get a treat later.

• Explain to the youngster that there are better ways to get what he or she wants.

• Never let the meltdown interfere with your otherwise positive relationship with the youngster.

• Never, under any circumstances, give in to a meltdown. That response will only increase the number and frequency of the meltdowns.

• Teach the youngster that anger is a feeling that we all have and then teach her ways to express anger constructively.


More resources for parents of children and teens on the autism spectrum:
 

 
 
PARENTS' COMMENTS:

•    Anonymous said… Bossy can be a trait of aspie, I had to take control back of my son instead of him controlling me with his less than manageable behaviour. As our special educator said, bossy boys become bossy men. So it's very important things are done on your terms not his. Lastly, is he sleeping? If not, look into it. My boy was so overtired nothing was ever going to settle until that was sorted. Diagnosis is overwhelming too. Be gentle and kind to yourself.
•    Anonymous said… Heavy work activities work well too. Have him help you carry or go up and down the stairs for stuff.
•    Anonymous said… I found that my Aspie daughter (when she was young) would act out when she was emotionally overwhelmed. Happy or sad it was too much sensory input for her. I would get her to let me hold her and put my hands over her ears. Don't know why but the closeness and lack of hearing was calming for her emotions. She is 18 now and when she is very upset, she still wants me to hold her ears. Can't hurt to try it?
•    Anonymous said… I would look for another diagnosis. My son didn't have anger issues or jealousy issues. We did not coddle him nor did we excuse his behavior. He received the same discipline as his sister. He is 32 now and has two college degrees. I suggest you nip this behavior in the bud. Oh and Aspies do not respond to punitive punishment. You have to use logic. Reasoning and bargaining does not word either.
•    Anonymous said… ive looked into essential oils to help my daughter, she is 6 years old, we have been using Doterra 100% pure CPTG oils. Balance, serenity (diffuse in the house and apply to her feet) and ive just bought Intune (rollerball) on really bad days i put a few drops in her bath. we have found they really helped with her sleep and calming her.
•    Anonymous said… My little one is having a lot of success with primitive reflex integration therapy. I don't know if this is helpful for all Aspie's, but it is definitely worth looking into. I agree that the 1, 2, 3 Magic was very helpful. I also agree that amount of sleep makes a huge impact. I know my Aspie needs more sleep than her age peers, and it can be challenging to figure out what the best sleep schedule is for any child.
•    Anonymous said… My mother always said if I was at my end to cope Just give him love , give him rescue drops or pills and camel mild tea
•    Anonymous said… OT for sensory issues will help a ton! He needs lots of physical activity!
•    Anonymous said… Setting very clear boundaries, and exiting the situation (grocery store, birthday party, park day) and going home let her know that I was serious.
•    Anonymous said… Talk to your pediatrician about autism support. Your state probably has some things in place. Also ask for information about parent support groups and play groups. Find a friend or neighbor who would be willing to take him for an hour or two when you are at your wit's end.

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How to Stop Overwhelming Your Child on the Autism Spectrum

“I have two children, one age 4 - the other age 7. Both are on the autism spectrum (high functioning). The oldest is easily overwhelmed by even the smallest of problems, most of which can result in a meltdown depending on his general mood of the day (shirt is too tight, younger brother is too pesky, poor loser playing board games, hates the shower with a passion, and on and on we go). What are some things I can say or do to save him from getting so stressed out?”

High-Functioning Autism is a developmental disorder that results in several ongoing challenges: (a) two-way social interaction, (b) verbal and nonverbal communication, (c) a reluctance to accept change, (d) inflexibility of thought, and (e) an all-absorbing narrow area of interest. Also, there is a range of severity of symptoms within the disorder (e.g., the very mildly affected youngster often goes undiagnosed and may just appear odd or eccentric).

In general, kids with High-Functioning Autism (HFA) and Asperger’s are happiest with routines and a structured environment. They love praise, winning and being first, but find losing, imperfection and criticism very difficult to take. Problem behavior often stems from an inability to communicate their frustrations and anxieties. If we, as parents, can help break through to the HFA child’s “own little world,” we can help him or her to cope a little better in day-to-day activities.

There are many things we can do to help our “special needs” children better understand the world, and in doing so, help them to feel less overwhelmed in certain situations. 

Here are a few suggestions:

1. Use turn-taking activities as much as possible, not only in games, but in other areas at home too.

2. Try to get confirmation that they understand what you are talking about (or asking). Don't rely on a stock ‘yes’ or ‘no’ that they like to answer with.

==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism

3. HFA kids have a need to finish tasks they have started. Strategies can be developed to reduce the stress they experience at such times. Warnings that an activity is to finish in x minutes can help. With younger kids, attempts to “save” the task can help (e.g., videoing a program, mark in a book, etc.).

4. Model an “always looking for the positive” mindset. If you look for the positive in situations, so will your youngster. Kids learn behaviors from watching their parents. So, when you think about your youngster's psychological well-being, think about your own as well.

5. Promises and threats you make will have to be kept. So, try not to make them too lightly.

6. Pre-warn them of any changes, and give warning prompts if you want them to finish a task (e.g., “when you have colored that in, we are going shopping”).

7. Limit any choices to two or three items.

8. Let them know that you love them - warts and all - and that you are proud of them. It can be very easy with a youngster who acts-out behaviorally not to tell him or her all the things you feel inside.

9. Keep all your speech simple to a level they understand.

10. Model “self-care strategies.” If you take care of yourself and schedule time for your own needs, your youngster will learn that self-care is an important part of life.

11. In some kids who appear not to listen, the act of singing your words can have a beneficial effect.

12. Limit their “special interest” time to set amounts of time each day.

13. Try to build in some flexibility in their routine. If they learn early that things do change - and often without warning - it can help.

14. Don't always expect them to “act their age.” They are usually immature as compared to their same-age peer group, and you should make some allowances for this.

15. Try to identify stress-triggers and avoid them if possible. Be ready to distract with some alternative (e.g., “come and see this”).

16. Begin early to teach the difference between private and public places and actions, so that they can develop ways of coping with more complex social rules later in life.

17. Keep instructions simple. For complicated jobs, use lists or pictures.

18. Model “approach behavior.” Your HFA youngster will do what you do. So, if you avoid anxiety-provoking situations, so will he or she. If you face your fears, so will your youngster.

19. As kids on the autism spectrum mature, some problems will get easier. But, like all other kids, new problems will emerge. Social skills will have to be taught in an effort for them to find a place in the world. So, take all opportunities to explain situations time and time again.

20. Lastly, remember that kids on the spectrum are kids just like the rest. They have their own personalities, abilities, likes and dislikes. They just need extra support, patience and understanding from everyone around them.

 
 
By

Kids on the Autism Spectrum: Reasons for Their Behavior

“I would like to better understand my son, who is on the high functioning end of the autism spectrum. I want to understand how he thinks, how he interprets what is going on, and how his deficits cause problems. Thanks in advance!”

This is a very good question, because a lot of parents of kids on the autism spectrum will rush into action before they have collected enough information and analyzed what is going on. If you do not know the reasons behind the behavior, you may very likely do the wrong thing. If you know what is going on, you can help things go better.

Realizing that your son will not be a good observer of his behavior is your first step. The youngster with High-Functioning Autism (HFA) or Asperger’s (AS) often does not know what to do in a situation. He does not know the appropriate behavior because he doesn't understand how the world works. Or, if he knows a better solution, he cannot use it because he becomes "stuck."

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

Not knowing what to do - or being unable to do what is appropriate - results in anxiety that leads to additional ineffective and inappropriate actions. Autistic-like behavior is usually a result of this anxiety, which leads to difficulty moving on and letting go of an issue and "getting stuck" on something. This is rigidity, and it is the most common reason for behavioral problems. See the sidebar for a list of reasons for rigidity. You must deal with rigidity and replace it with flexibility early on in your plan to help your son. Flexibility is a skill that can be taught, and you will make this a major part of your efforts to help him.

Reasons for Rigidity—

1. A misunderstanding or misinterpretation of another's action.

2. A violation of a rule or ritual – changing something from the way it is supposed to be. Someone is violating a rule and this is unacceptable to the youngster.

3. Anxiety about a current or upcoming event, no matter how trivial it might appear to you.

4. Immediate gratification of a need.

5. Lack of knowledge about how something is done. By not knowing how the world works with regard to specific situations and events, the youngster will act inappropriately instead.

6. Other internal issues, such as sensory, inattention (ADHD), oppositional tendency (ODD), or other psychiatric issues may also be causes of behavior.

7. The need to avoid or escape from a nonpreferred activity, often something difficult or undesirable. Often, if your son cannot be perfect, she does not want to engage in an activity.

8. The need to control a situation.

9. The need to engage in or continue a preferred activity, usually an obsessive action or fantasy.

10. Transitioning from one activity to another. This is usually a problem because it may mean ending an activity before he is finished with it.

[Note: Attention-getting is very rarely seen. It should not be considered as a reason for rigidity until all of the above reasons have been considered and eliminated.]

Understanding your son involves knowing the characteristics discussed earlier and how they manifest themselves in everyday behaviors. How does he see the world, think about matters, and react to what is going on around him? The following reasons will help you understand "why he acts the way he does."

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

Not Understanding How the World Works—

The HFA or AS youngster has a neurocognitive disorder that affects many areas of functioning. This includes a difficulty with the basic understanding of the rules of society, especially if they are not obvious. Life has many of these rules. Some are written, some are spoken, and some are learned through observation and intuition. Your son only knows what has been directly taught to him through books, movies, TV shows, the Internet, and explicit instructions. He is not able to sit in a room, observe what is happening, and understand social cues, implied directions, or how to "read between the lines," and as he is growing up, he does not learn how to do this. Instead, he learns facts. He does not "take in" what is happening around him that involves the rest of the world, only what directly impacts him.

Many of the conversations he has had have generally been about knowledge and facts, not about feelings, opinions, and interactions. As a result, he does not really know how the world works and what one is supposed to do in various situations. This can apply to even the smallest situations you might take for granted. Not knowing the unspoken rules of situations causes anxiety and upset. This leads to many of the behavioral issues that appear as the HFA or AS youngster tries to impose his own sense of order on a world he doesn't understand.

The HFA or AS youngster creates his own set of rules for everyday functioning to keep things from changing and thereby minimize his anxiety. Sometimes, he just makes up the rules when it is convenient. Other times, he attempts to make them up by looking for patterns, rules, or the logic of a situation to make it less chaotic for him and more predictable and understandable. If there are no rules for an event or situation, he will create them from his own experiences based on what he has read, seen, or heard. He will often have a great deal of information to use in reaching his conclusions and forming his opinions and feelings. As a result, some of his conclusions are correct and some are wrong.

He will rarely consider someone else's point of view if he does not consider them to be an "expert." The fewer people he sees as experts, the more behavioral difficulty you will see. He might consider teachers and others to be experts, but his parents will rarely be seen as such. Therefore, he will argue with you about your opinions if different from his own. He thinks that his opinion is as good as yours, so he chooses his. This represents his rigid thinking. He finds it difficult to be flexible and consider alternate views, especially if he has already reached a conclusion. New ideas can be difficult to accept ("I'd rather do it the way I've always done it"). Being forced to think differently can cause a lot of anxiety.

You must never overestimate the HFA or AS youngster's understanding of a situation because of his high intellectual ability or his other strengths. Your son is a boy who needs to figure out how the world works. He needs a road map and the set of instructions, one example at a time.

Frames of Reference—

In trying to understand how the world works, your son tries to make sense of your explanations, but sometimes is not able to do this. As a result, your effort at intervening falls short. This can occur because your explanation has no meaning. Each HFA or AS youngster can only understand things for which they have a frame of reference, meaning they have a picture or idea about this from other sources or from prior discussions. They cannot understand what you will tell them without this frame of reference. For example, when I asked a teenage boy if he missed his parents when he was at overnight camp for a week, he replied that it was not all that long. When I asked him again if he missed them, he said he could e-mail them whenever he wanted. After my third attempt to get an answer he finally said to me, "I can't answer that question. Since I have never missed anyone before, I have nothing against which I can compare my feelings to know what missing feels like." In the next few chapters we will explain how to give your son or adolescent a new frame of reference.

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


Preferred and Nonpreferred Activities—

For all children on the autism spectrum, life tends to be divided into two categories – preferred and nonpreferred activities. Preferred activities are those things he engages in frequently and with great intensity. He seeks them out without any external motivation. However, not all of his preferred activities are equal. Some are much more highly desired and prized. An activity that is lower on the list can never be used as a motivator for one that is higher. For example, you cannot get him to substitute his video game playing by offering a food reward if the game playing is higher on his list.

Any activity that is not preferred can be considered nonpreferred. They are less desirable and many are avoided. The lower they are on the list of desirability, the more he will resist or avoid doing them. Sometimes an activity or task becomes nonpreferred because it is made to compete with one that is much more highly valued. For example, taking a bath could be enjoyable, but if the child is reading, and reading is higher on his list, he will resist or throw a tantrum.

Preferred and nonpreferred activities are always problem areas. Your son will always want to engage in preferred activities even when you have something more important for him to do. He does not want to end preferred activities and your attempts to have him end them can produce upset of one kind or another. On the other hand, trying to get him to do nonpreferred activities, such as interacting socially, can also be difficult. If many nonpreferred elements are combined together, the problem can become a nightmare, such as with homework.

The HFA or AS youngster rarely has activities he just likes. He tends to either love or hate an activity. The middle ground is usually missing. Teaching a middle ground or shades of gray can be a goal and will be discussed later. Also, as you try to teach him something new, you will encounter resistance because you are asking him to do something that's not a preferred activity. But, as he outgrows younger interests, he will need to learn new ones in order to have some common interests with his peers. He needs to experience new things to see if he likes them, but may not want to do this just because you're asking him to do something new. He already has his list of preferred interests and will rarely see the need for anything new. Quite often, his preferred list will include computer or video games. However, the more he is on the computer or the more he plays video games, the less available he is to be in the real world and learn something new. Most likely, you will have to control his access to preferred activities if new ones are to be introduced.

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

Obsessive-Compulsive Behaviors and Anxiety—

Obsessive-compulsive issues, also referred to as rituals, rigidity, perseverations, rules, or black-and-white thinking, originate in the HFA or AS child's difficulty understanding the world around him or her. This creates anxiety, the underlying cause for his/her obsessive-compulsive behaviors. You will see anxiety in many different ways, depending on how your son manifests it. Some kids will show it in obvious ways, such as crying, hiding under furniture, or clinging to you. Others show it by trying to control the situation and bossing people around. Some may hit or throw a tantrum. Some may act silly. No matter how your son displays his anxiety, you need to recognize that it is there and not assume it is due to some other cause such as attention seeking or just plain misbehavior.

Anxiety can occur for the smallest reason. Don't judge anxiety-producing situations by your own reaction to an event. Your son will be much more sensitive to situations than you will be, and often there will be no logical reason for his anxiety. Something that you would be anxious about causes no anxiety in your son, while a small event causes him to be quite anxious. When events change, he never knows what is going to come next and he becomes confused and upset, leading to some form of inappropriate behavior.

Your son's first reaction is to try to reduce or eliminate his anxiety. He must do something, and one of the most effective means is to take all changes, uncertainty, and variability out of the equation. This can be accomplished by obsessions. If everything is done a certain way, if there is a definite and unbreakable rule for every event, and if everyone does as he wishes, everything will be fine. Anxiety is then diminished or reduced, and no upset, tantrums, or meltdowns occur.

Unfortunately, it is virtually impossible to do this in the real world. Nevertheless, anxiety needs to be dealt with in some manner. This is the first order of business in planning for many interventions. If you move ahead before this has been settled, it will continue to be a significant interfering factor. Let's look at some examples of this.

Allen, age seventeen, won't leave the house because he wants to have his nails in a certain condition. This condition requires many hours of grooming that interfere with sleeping, eating, and doing just about anything else. This is obsessive-compulsive behavior. Any attempt to get him to leave the house or stop his nail maintenance causes anxiety and is rarely successful.

Anytime Craig, age eleven, hears an answer that he does not like, he becomes upset. If he asks a question or makes a request and the other person's response is not what he expected, he starts to argue with them, often acting out physically. He must have certain answers that are to his liking. This is rigidity in thought and it is also obsessive-compulsive.

Each of these cases has a cognitive and a behavioral component, and both must be considered. Each youngster must learn to get "unstuck" or let go of an issue and move on. They also need to learn how to change their thinking so that it doesn't become a problem to begin with.

Behavioral Manifestations of Anxiety—
  • Becoming easily overwhelmed and having difficulty calming down.
  • Creating their own set of rules for doing something.
  • Demanding unrealistic perfection in their handwriting, or wanting to avoid doing any writing.
  • Demonstrating unusual fears, anxiety, tantrums, and showing resistance to directions from others.
  • Displaying a good deal of silly behaviors because they are anxious or do not know what to do in a situation.
  • Eating a narrow range of foods.
  • Having a narrow range of interests, and becoming fixated on certain topics and/or routines.
  • Having trouble playing and socializing well with peers or avoiding socializing altogether. They prefer to be alone because others do not do things exactly as they do.
  • Insisting on having things and/or events occur in a certain way.
  • Intensely disliking loud noises and crowds.
  • Lecturing others or engaging in a monologue rather than having a reciprocal conversation.
  • Preferring to do the same things over and over.
  • Reacting poorly to new events, transitions, or changes.
  • Remaining in a fantasy world a good deal of the time and appearing unaware of events around them.
  • Tending to conserve energy and put forth the least effort they can, except with highly preferred activities.
  • Wanting things to go their way, when they want them to, no matter what anyone else may want. They may argue, throw a tantrum, ignore you, growl, refuse to yield, etc.

Black-and-White Thinking and Mindblindness--

The obsessive-compulsive approach to life results in the narrow range of interests and insistence on set routines typical of an HFA or AS youngster. However, it usually starts as a cognitive (thinking) issue before it becomes a behavioral one. Cognitive issues, such as the inability to take someone else's perspective (mindblindness) and the lack of cognitive flexibility (black-and-white thinking), cause many of the behaviors we see. We know there is a cognitive element by looking at the youngster's behaviors. There is always some distress, anxiety, or obsession manifested in every inappropriate behavior.

As mentioned, your son's cognitive difficulties lead to inaccurate interpretations and understanding of the world. How someone interprets a situation determines how he will respond to it. Many times, the interpretation of an event is either not an accurate one or not one that leads to positive or prosocial actions. If the event can be reinterpreted for him, it might lead to a more productive outcome. In doing this, we must first try to understand how the child interprets a situation. All of the child's behaviors are filtered through his perception of the way the world works.

Remember, details are extremely important in trying to understand what is happening and what to do about it. Do not try to intervene until you understand, at least to a small degree, what is happening with your son. Changing thinking becomes a paramount issue, but one that is often neglected. However, successful changes in thinking will dramatically increase the success rate of any strategy you use.

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

Questions to Ask about the Child’s Behavior—

To help you determine the reasons why your son acts the way he does, you should ask yourself the following questions:

1. Because a situation was one way the first time, does he feel it has to be that way always? (Being rule bound.)

2. Does he need to be taught a better way to deal with a problem? (He does not understand the way the world works.)

3. Does he see only two choices to a situation rather than many options? (Black-and-white thinking.)

4. Has he made a rule that can't be followed? (He sees only one way to solve a problem. He cannot see alternatives.)

5. Is he blaming you for something that is beyond your control? (He feels that you must solve the problem for him/her even when it involves issues you have no control over.)

6. Is he exaggerating the importance of an event? There are no small events …everything that goes wrong is a catastrophe. (Black-and-white thinking.)

7. Is he expecting perfection in him/herself? (Black-and-white thinking.)

8. Is he misunderstanding what is happening and assuming something that isn't true? (Misinterpretation.)

9. Is he stuck on an idea and can't let it go? (He does not know how to let go and move on when there is a problem.)



==> 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

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.
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Students on the Autism Spectrum: Strategies that Can Guarantee Their Academic Success

In an ideal world (which none of us will ever experience), your child’s educational experience would include the strategies listed below, all of which will optimize the potential for academic success – intellectually, emotionally and socially.

Strategies that can guarantee the success of kids with High-Functioning Autism (HFA) and Asperger’s (AS) include the following:

1.  In an ideal world, the HFA or AS youngster’s school has an extensive, in-depth knowledge of autism spectrum disorders (e.g., principal, vice principal, dean, teachers, administration staff, etc.). This guarantees that whoever has contact with your youngster in the course of the school day is aware of his or her needs and understands that the disorder is neurobiological in nature – and not a behavioral issue.

So, ask what specific training the staff at your youngster’s school has had, and check that this is updated regularly. This is particularly relevant for your child’s classroom teacher. If no specific training has been undertaken at your youngster’s school, insist that this is rectified promptly.

2.  Check the anti-bullying policy of your youngster’s school. This should be a whole-school policy that has a proven and consistent grievance-address policy, with successful follow-up procedures. The policy needs to tackle the needs of victims and actions of perpetrators alike. 
 
==> The Complete Guide to Teaching Students with Aspergers and High-Functioning Autism

3.  Hopefully, your youngster’s school recognizes the need for continuous, open communication between home and school. This can be achieved by a daily phone call between special-education staff and parents each day, with relevant information being relayed to your youngster’s teacher. Most parents of kids on the autism spectrum understand that sometimes seemingly harmless incidents in their youngster’s day (e.g., before, during, or after school) can have a huge impact on his or her behavior.

Knowing that all behavior is a form of communication, one can’t possibly hope to understand the message the “special needs” youngster is trying to convey unless one has all the facts. Continual communication gives those caring for the HFA or AS youngster at school and home the “big picture."

4.  It will be very helpful if your youngster’s classroom is aesthetically autism-friendly (e.g., using visual aids, maintaining a low sensory “volume" in the classroom – such as minimizing noise, light, smell, and extremes in temperature).

5.  Kids on the autism spectrum cope best in schools with small class sizes. This option is less a reality these days, when education systems worldwide are struggling to survive with less funding. However, there are many other procedures parents can monitor to make certain their “special needs” youngster is being educated in an optimal setting.

6.  Most children with HFA and AS experience periods of excess energy and will benefit from regular energy “burns" throughout the day. This could be in the form of a brisk walk, a short jog, or a set of star jumps or other callisthenic exercise (e.g., skipping, hopping, etc.). The need to burn excess energy usually occurs about halfway through each classroom session (i.e., morning, middle, and afternoon).

Your youngster’s successful behavior in the classroom can be greatly enhanced by implementing regular energy “burns" into his or her day. If the teacher or assistant isn’t available to supervise this, an alternative is having the youngster run errands or messages for the teacher.

7.  If possible, your youngster’s school has a “safe space" that he or she can go to when stressed, anxious, angry or agitated. This space needs to be sensorily “quiet" with soft furnishings. Accessing this space should never be used as a form of punishment, rather the youngster should be encouraged to remove himself or herself from an escalating situation before overload and meltdown occur – and rewarded for using this strategy.

The youngster shouldn’t be “rushed" to return to the classroom, because this will only increase his or her agitation. All kids (including those on the autism spectrum) strive to be the same as their peers, and this “internal driving force" ensures the HFA or AS youngster will rejoin his or her class as soon as he/she is physically and emotionally able to.

8.  Ideally, the classroom teacher will be mindful of the fact that all social interaction will have a cumulative effect on your “special needs” youngster, which will affect the successful outcome of group activities, seating arrangements, and ‘buddy’ systems.

9.  Wouldn’t it be great if your youngster’s school had a strong Social-Skills program in place that he or she participates in at least once a week for a minimum of 1 ½ hours. This program would incorporate problem-solving and case-specific scenarios, physical activity, group and team work, developing friendship skills, and decoding language and facial expressions.
 
  • Developing group work skills enables kids on the spectrum to participate more successfully in activities in class and at home. The “mechanics" of group work need to be explained to the HFA or AS child in a step-by-step process for greatest understanding.
  • Discussions about what makes a good friend, what good friends do in various situations, how friends act, what friends say to each other, how they share, how they play together, how they include each other in games, etc., form the basis of teaching friendship skills.
  • Using real-life scenarios of incidents that happen in the playground at school helps kids on the spectrum to transfer their knowledge to their interactions with their peers.
  • Specific skills need to be directly taught about appropriate ways to join a game, co-operating with others, and turn-taking. 
  • Self-recognition by the HFA or AS youngster of his or her need for rigidness and rule-following – and highlighting that not all kids think this way – helps to explain the often confusing nature of the school environment to the “special needs” child.
  • Problem-solving specific scenarios that have occurred in the lives of kids on the spectrum helps them to develop a “bank" of appropriate responses and strategies to use in real-life situations.
  • The language component should aim to assist the youngster to recognize and decode literal or conflicting statements in language (e.g., idioms and oxymorons). It also assists the child in identifying the meanings of facial expressions and body language. This will help him or her to develop the use of more appropriate facial expressions and body language in interactions with peers.
  • The physical activity component will assist the youngster’s co-ordination, fine and gross motor skills, spatial awareness, vestibular systems imbalance, and physical fitness levels.

Regular access to an all-encompassing Social-Skills program such as this - in a group comprised of both kids on the autism spectrum and their neurotypical peers - provides the HFA or AS youngster with the building blocks of social dexterity for life. It also fosters tolerance and understanding in their neurotypical peers.

This list of school strategies is by no means comprehensive, nor is it intended to be. Rather, it’s meant to list the minimum accommodations every school should make for kids with HFA and AS. It’s a foundation to build on in partnering with your youngster’s school to create an IEP for your youngster that allows him or her to achieve his/her fullest potential.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:
 
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Kids on the Autism Spectrum and Their Reaction to Pain

As parents of kids with Aspergers (AS) and High-Functioning Autism (HFA), we are all familiar with the enigma of their unequal reaction to pain and injury. A stubbed toe or paper cut may set off a pain response (e.g., crying, screaming, and sobbing) such as is equaled by the loss of a limb, yet a burst ear drum or broken limb may go seemingly unnoticed.

Parents of children on the autism spectrum are often bewildered by this unequal response to pain stimuli. Anecdotal evidence from clients worldwide is full of reports on this topic. So, what's the answer to this confusing puzzle? The questions surrounding these kid's unequal response to pain can be explained scientifically.

The assumption that, physiologically, humans are equipped to limit the amount of stimuli entering our brains thereby preventing the brain from becoming overloaded, has led to the establishment of a 'normal' range of feeling. However, those with an autistic spectrum disorder are recognized as having a hyper/hypo sensitivity to stimuli (i.e., above average range of feeling or super-sensitivity).

Accounts written by people with AS and HFA state that their disability is directly linked to their senses and their sensory processing. So let's look at the biochemical processes that occur when our senses are stimulated:

Stimulation from the environment enters our brain through our eyes, ears, skin, nose and mouths. Our nervous system passes this information around our brain and body by the use of biochemical neurotransmitters. The amount of stimulation felt is determined by the amount of neurotransmitter processed in each neuron. The enzyme dopamine beta hydroxylase is released from nerve endings during stimulation.

Dopamine beta hydroxylase (DBH) is essential for cell communication and regulating neurons in the central and peripheral nervous systems. An increase in stimulation results in an increase in the level of this enzyme. Scientific studies have shown that children on the autism spectrum have much higher levels of dopamine beta hydroxylase in their systems than in ordinary children. The presence of this enzyme is also linked to behaviors such as repetition, agitation and aggression.

Repetitious activity, such as rocking, flapping or pacing, results in the release of endorphins through the system. Endorphins reduce the sensation of pain and have the ability to block pain. In other words, when endorphins are present, the amount of sensory reaction is reduced or stopped completely. Kids on the spectrum have the ability to purposely, but unknowingly, overload their sensory system in order to shut it down completely (i.e., by rocking, flapping or pacing etc.).

Blocking out all sensation by the production of endorphins might seem like a simple and easy way of coping with sensory over-stimulation; however, in caring for kids on the spectrum, we must realize that reaction to ALL sensation becomes limited. They won't recognize hunger, tiredness, body temperature (risk of overheating), full bladder/bowel or pain. Kids on the spectrum display agitation through use of repetitious behaviors such as rocking, flapping, pacing, head-banging, staring, screaming, spinning, chanting or humming.

Our job as parents is to recognize these signals of agitation. These behaviors are used to block out: (a) over-stimulation from their environment, (b) their emotions, and (c) their response to pain. These repetitive behaviors also serve to calm them, if their use is monitored rather than unlimited.

For young people with AS and HFA, the build-up or cumulative effect of these endorphins throughout the day also needs to be taken into consideration. This is why those who suffer accidents in the afternoon or evening may not show pain or seem to feel it.

All physical exercise causes the release of natural endorphins into the system that can help to protect the youngster without switching off the sensory response. So, exercise such as walking, running, and swimming is extremely beneficial in the youngster's daily routine as a preventative measure. It may be used during periods of agitation to help calm him or her. In this way exercise is used to develop appropriate social responses (e.g., it is more acceptable to jump on a trampoline rather than on the furniture).

With this information revealed, it becomes obvious that we must monitor our youngster's production of endorphins, because the presence of excess endorphins causes him or her to lose the ability to respond to any stimulation. This means that kids on the autism spectrum miss much of what they are meant to be learning.

Also, we must realize that these stereotyped/repetitive behaviors have social consequences; they are a visual reminder that they are different from their peers. We must take into account the youngster's socializing skills and ability when monitoring and setting limits on the use of repetitive behaviors. (i.e., tell him or her the times and places when flapping, rocking or head-banging are acceptable, for controlled periods of time.

We should not attempt to eliminate sensory stimulation in order to protect children on the autism spectrum. Without stimulation, our world becomes meaningless to them. Rather we should attempt to provide them with a safe sensory environment (e.g., dim lights, softer noises/voices, reduced odors, etc.), giving them the opportunity to learn and respond appropriately.


Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> 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

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.



PARENTS' COMMENTS:

•    Anonymous said… As a little guy my son never complained about ear infections, they only bothered him when it got to the point of a ruptured eardrum. Now I know why!
•    Anonymous said… Had to really push to get X-ray and taken seriously when daughter was 7 as she just 'wasn't crying enough'. Wrist was broken. A&E doctors need to be made aware of this.
•    Anonymous said… i have always wondered about this interesting read my son when little would smash his head off a wall ove and over almost like he liked pain but then a little trip and a bumped knee would send him crazy i never know when hes really ill he dont say its like he dont understand what pain is i struggle to manage this side of his autism
•    Anonymous said… If involves any blood... Simple scrapes, paper cuts, lost a loose tooth...Screaming... Also if he's about to get "sick"... He starts screaming... But ear infections, headaches, bad falls... He may or may not really mention it. I don't know what to make of it...
•    Anonymous said… Interesting. My son has a high thresh hold for pain and does not seem to worry too much about small injuries either. He was once bitten by a bunch of stinging ants and barely said more than ow. Another child also stung by one ant screamed for an hour. I always know to check in with him when he has an accident because chances are he is worse off than he let's on. He saves his meltdowns for irritations such as hairbrushing (which he says is unbearably painful), and he can't stand to be asked what he deems to be stupid questions smile emoticon
•    Anonymous said… My boy never complains rarely eats or sleeps
•    Anonymous said… My son also has a very high pain threshold. He has to be really hurt to cry and really sick to tell us. Other things like itches, though, he cannot deal with.
•    Anonymous said… So true! My daughter went 11 days with an arm broken in two places and we had no idea. I felt like the worst mom ever, but she never complained.
•    Anonymous said… Story of my life! Glad my son isn't the only one!
•    Anonymous said… This is one of the hardest parts of all of this for us. Our son has been badly injured twice and both times had no response to the pain at all. This last time (at 17) he was burned at work. He tried to refuse treatment but thankfully, they called me anyway. He had a 2nd degree burn larger than the size of my hand on his back!! Never even asked for a Tylenol. But if he has a headache...LOOK OUT!!!
•    Anonymous said… Very informative. My son is 10 and just turning the corner on his anger tantrums. It's such a nice feeling to have weathered the "poker face" phase. Anyway, my husband are trying to prep for the teen years. Good to hear your advice. Thanks Mark.
•    Anonymous said… Yes the tiniest cut on my daughters finger is like it's been cut off!
•    Anonymous said... It is nice to finally have an explanation for why my son cries over the smallest bump, but wasn't worried when he sliced his hand open and needed stitches. Thank you!
•    Anonymous said... This is an amazing article...thank you so very much for posting it...:)
•    Anonymous said... My son broke his foot at 4 yrs old by knocking over a concrete block on it, barefoot!.. of coarse it broke n he didn't shed a tear, he was suppose to wear a hard cast 6 weeks n by the 3 rd week he had literally run it off.. it never healed properly n he is now 6 n the top of his foot is still red to this day...knowing if he's sick or hurting is always a question ...
•    Anonymous said... My oldest daughter fell and broke her front tooth down to the nerve and was acting like nothing happened... but yet she freaks out over shots and stubbing her toes. :/ I always wonder at every injury if she hasn't done more damage than she can express or even knows about.
•    Anonymous said... My Aspie (7), doesn't usually ever feel the pain unless he can see the injury like blood. Once he sees it, he freaks out, even if it is a simple paper cut. He had a bursted ear drum once and we never knew it because he never complains of pain.
•    Anonymous said... This is a great article. 20 years ago my son broke his arm at the elbow, he was so calm, didn't cry. The nurses in the emergency room were telling him he should be the one crying like the other kids in the other rooms. He has always taken that kind of pain so well, yet his back pain he is always obsessing about. Of course when he was 4 we didn't know he was an Aspie. This article made it so clear.
•    Anonymous said... When my son was 6 he almost died. He had a blood infection and internal bleeding. He never said a word.He never notices the pain from Ear infections and strep throat. If I ever even suspect an illness we go straight to the doctor. Nice to know I'm not alone.
•    Anonymous said... I am an adult aspie and I have been told that when I had my jabs as a baby I was the only one that did not cry lol. Apparently I just glared at the nurse.
•    Anonymous said... Can I please just tell you how much I love and appreciate what you do for us as parents of a newly diagnosed 11-year old with Asperger's? This is something our son exhibits all the time, but we didn't know it was related to the Asperger's. Thank you for helping us be patient and understanding.
•    Anonymous said... when i took my son to the doc he had a hole in his ear drum the doc. could not believe it kept asking are ya sure that does not hurt?!! but the smallest scratch and its tears and panic..
•    Unknown said... My 8 year old just started complaining of pain in her feet. She says it hurts so much that she doesnt want to stand up or walk. Im unsure of it could be and its helped to read this article. To be on the safe side, should I have her seen by her physician? Thanks Sienna's mom
•    Nicole said... My daughter is only 18 months. She has never reacted to pain or fear. This article opened my eyes to why she does alot of what she does. She is almost identical to my nephew who has this type of autism. They both have received 3rd degree burns on their hands and never even flinched. Shes seeing her doctor on Monday.

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