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What is the best therapy for a child with Aspergers?

Question

What is the best therapy for a child with Aspergers?

Answer

Actually, there is no “best” therapy for Aspergers (High Functioning Autism). However, there are various standard courses of treatment. Each treatment modality addresses a different set of issues. When a youngster is first diagnosed with Aspergers, he may be referred for therapy. Aspergers, as you know, is not a condition that can be cured. It is a neuro-developmental condition that is treated with an individualized treatment plan that may include different therapies and medications. Here are some of the most common treatment options:

1. Cognitive-behavioral therapy is used to treat the emotional side of Aspergers (e.g., anxiety, depression, obsessions, etc.). This therapy helps form the connections between feelings, emotions, and behavior.

2. Occupational therapy is basically used to teach independence. Grasp, handwriting, social skills, and play skills are often included. This therapy may help your youngster learn to tie his shoes of zip his jacket.

3. Physical therapy addresses the physical awkwardness that sometimes comes with Aspergers. Awkward gait and lack of balance are common complaints. This therapy may help your youngster learn to kick a ball, walk up and down stairs, and ride a bicycle.

4. Sensory integration therapy may be included by the occupational therapist. Some occupational therapists are trained in sensory therapies and some are not. This therapy helps get your youngster’s sensory systems in synch.

5. Social skills training is a therapy that teaches kids with Aspergers how to relate to others, making and keeping friends, how to recognize social cues and gestures, and other details such as personal space and understanding slang.

6. Speech/language therapy covers speech articulation as well as pragmatics, or fluency. Language therapy covers social communication, and in some cases, social skills. Speech/language therapy will help your youngster learn to communicate verbally or nonverbally, if necessary, with the use of picture exchange and/or sign language.

7. Young kids are often treated with ABA therapy. Applied Behavioral Analysis is a form of therapy used to teach young kids basic skills in many different areas (e.g., can be used to teach young kids to make eye contact, to play with toys, and to identify shapes and colors).

Moms and dads need to fully support and participate in their youngster’s therapy. Aspergers therapies can be successfully performed by parents in the home with the proper support and training.  

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Aspergers/HFA Children and Sexual Curiosity

At this moment in time, I feel like my heart is broken. A good friend of ours contacted my husband today and said that last week our son K___, 14, said sexual things and showed dirty pictures. We asked K___ and he said nothing was said or done. When our friend came over with his 10 year old son, we all sat down and K___ just sat there as the 10 year old told how K___ put on a DVD where there were women kissing and two people having sex though they didn’t see anything. Along with the 10 year old was his 7 year old sister. K___ has a human body book and he showed the 7 y/o where the penis goes into the vagina. K___ also asked the 10 y/o if he knew that a man’s penis can go into another’s bum and did he want him to try it out on him. Needless to say, I felt nauseous and in shock. Our son has sex and puberty books, and as a rule, asks if he wants to know anything. I am totally gob smacked. I have read discussions on other websites and I know we are not alone. Other parents have young teens with an autism spectrum disorder who are sexually obsessed and confused. I really don’t know what to do. Please have you any advice you could give us.

Click here for some advice...
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Helping Angry Children on the Autism Spectrum: 15 Crucual Tips for Parents

Young people with ASD [High-Functioning Autism] respond with anger mostly because they feel frustrated - they feel helpless to understand the situation fully, and helpless to change it.

Parents need to understand that anger is not the same thing as aggression. Anger is a feeling, while aggression is a behavior. Anger is a temporary emotional state caused by frustration; aggression is often an attempt to hurt a person or to destroy property. Explain to your ASD child that anger is OK – aggression is not.

Dealing with your child’s anger requires first finding out what he is feeling. Ask him what happened, what went wrong, what he wants, and what he is feeling. He may - or may not - be able to tell you very clearly, and he may need your help to label his feelings.

Contrary to some popular opinions, punishment is not the most effective way to communicate to ASD children what we expect of them. Explaining, modeling, and setting rules are far more effective. However, expect your child to break a rule three or four times. This is how he learns which rules are serious ones, which ones you will enforce, and which ones can be broken under certain circumstances. Breaking rules often isn’t done in anger, but is a way of learning, of testing out the world around them.
 

Here are some tips for dealing with angry children on the autism spectrum:

1. Encourage these "special needs" children to see their strengths as well as their weaknesses. Help them to see that they can reach their goals.

2. Ignore inappropriate behavior that you can tolerate.

3. Keep in mind that hugs can often make strong emotions less difficult for a child on the autism spectrum. You don’t hug to make the anger go away though; hug to let the child know you understand his anger and that you take it seriously.

4. Limits should be explained clearly and enforced consistently.

5. Provide physical outlets and exercise. ASD kids need physical activity to let off steam.

6. Recognize failures and setbacks are part and parcel of life.

7. Say “NO” clearly and firmly as needed.

8. Sometimes children on the spectrum do get aggressive or destructive when frustrated by difficult tasks, like studying. Parents can move in, acknowledge the difficulty of the task and the feelings of frustration or failure it causes, and offer help.

9. Take an interest in your child’s activities. Attention and pride can often make negative emotions easier to deal with. Failures and frustrations often mean less when a child knows his parents love him and are proud of him for others things he does and knows.

10. Use bargaining as needed. We, as parents, often control our own behavior by doing this (e.g., “After a day like this, I deserve a really good meal”). This reward system may help us curb our own temper when needed. This is not the same as bribery or blackmail. Know what your child likes and what is important enough to him to serve as a good motivator to manage anger.
 

11. Use humor. Teasing or kidding can often defuse an angry situation and allow a child to “save face.” Don’t use humor to ridicule your child; use it to make fun of the situation.

12. Use modeling. Moms and dads should be aware of the powerful influence of their actions on a child’s behavior. If you curse when angry, don’t be surprised when your child does. If you count to ten when angry, don’t be surprised if your child follows this good example too.

13. When you decide to bend the rules and say “yes,” explain why that moment is appropriate. Knowing when it is acceptable to break the rules is just as important as knowing when it is not.

14. While spanking likely won’t help your child, other physical interventions might. Sometimes the child can’t stop once a tantrum has begun, and physically removing the child from the scene or intervening isn’t a type of punishment – it’s a way to help him stop his behavior long enough to gain some control over it.

15. Observant and involved parents can find dozens of things they like about their child’s behavior. Comment on your child’s behavior when it is good, for example:
  • “I appreciate you hanging up your clothes even though you were in a hurry to play outside.”
  • “I know it was difficult for you to wait your turn, and I’m pleased that you could do it.”
  • “I like the way you come in for dinner without being reminded.”
  • “I like the way you handled your brother when he took your stuff.”
  • “I like the way you’re able to think of others.”
  • “I’m glad you shared your snack with your sister.”
  • “Thank you for telling the truth about what really happened.”
  • “Thanks for sitting in your seat quietly.”
  • “You were really patient while I was on the phone.”
  • “You worked hard on your homework, and I admire your effort.”
 
==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance
 
The Role of Discipline—

Good discipline includes:
  • explaining the rules and sticking to them in a neutral way
  • setting limits, but being flexible when needed
  • setting your own anger aside as much as possible
  • understanding why your child is angry and responding appropriately

Bad discipline involves:
  • punishment as a means of exacting revenge
  • punishment which is unduly harsh
  • punishment which is unpredictably meted out
  • raging at your child
  • sarcasm and ridicule

Tips for Children with Asperger's and High Functioning Autism—

You can learn to handle your anger in several ways. Remember that some angry episodes take longer than others to solve. Here are some ways to help you when you're angry (or about to get angry):

1. DO SOMETHING PHYSICAL. Do something with your body such as stomp your feet, run around the house, or punch a pillow. You can also play with play dough, clay, or bread dough, which can be rolled out, pounded, twisted, and pulled apart. Any of these physical activities can help you focus your anger on something else and help you to calm down.

2. TALK ABOUT YOUR FEELINGS. Talk to a parent, brother or sister, grandparent, a child care provider or a friend about what is making you angry. Talking helps some people work through their anger so they can accept what is making them angry, or solve the problem in a positive way. If you can't or won't talk to a person, then you can talk to a family pet, a puppet, or an imaginary friend.

3. SING A SONG. Make up words to a song or poem that expresses what you are feeling. Words from a favorite song can be substituted with this "un-mad" song. For example, the words "I'm so mad 'cause I can't play. Go away, go away, day!" can be sung to a familiar or made-up tune.

4. ASK OTHER PEOPLE HOW THEY COPE WITH THEIR FEELINGS OF ANGER. Collect ideas from other people on how to cope with anger. Decide which ones might work for you. For example, some people take a fast walk to drain off anger, while others take deep breaths when they get angry.

5. DRAIN THE ANGER FROM YOUR BODY. Relax with some water play activities or finger-painting. You can also scribble as hard as you can on a scrap of paper and throw the paper away as if throwing the anger away. Or you can write a story about what has made you angry and give the story to an adult and have the adult read it back. Then you can crumple up the paper and throw it away.
 

 
 
COMMENTS:

Kmarie said...Thank you so much for these reminders. I needed to hear them. I really appreciate this blog.
 
Anonymous said...Thank you. This was very helpful. I have used several of these strategies with my students and I am learning which ones are the most effective. Question regarding a young man who does not show emotion when corrected. He has no sense of right/wrong and often repeats what is said. I am starting to see a change in his recognition of my facial expression when he states “Boucher disappointed I steal cards.” His behavior is taking a deck of cards off of teacher’s desks. There is no pattern. We tried 5 point scale, taking his cards, letting him have his own cards and rewards when he does not steal cards. There is a slight improvement with regard to understanding but then he laughs and thinks it to be a game. Any thoughts or ideas? I would greatly appreciate your assistance.

Anonymous said...I am a single parent of a 7 yr. old little girl that has been diagnosed with Asperger's Disorder since Feb. 2010, and it was done by The Child Diagnostic center in Worcester, MA, they are a part of UMass Medical Center. She experiences frequent meltdowns, sometimes over a friend having to leave to go home, or sometimes with no particular trigger, which would equal out to everything and anything can set her off. I try not to yell, but i just can't seem to find an effective way to respond to her while she's in her meltdowns. She is a challenge when the meltdowns are so frequent. The first severe meltdown i've seen so far is the one that lasted over an hour and it was triggered by her friend wanting to go home.
 
Anonymous said...I also am a mother of a seven year old girl with Asperger. She has frequent meltdowns over little things. She also hurts herself when she gets angry. It is very hard to deal with, she can be so sweet one moment and than so angry and frustrated the next. I also don´t know how to react. It makes me very sad seeing her so upset, but she can also not influence in a negative way the whole atmosphere at home. It looks like it gets worse with her becoming older and the pressure of school.

Anonymous said...My son Ryan is 14. He was diagnosed with AS right before his 10th birthday. He is very high-functioning and most people can't tell he has any challenges. Until he gets angry. His diagnosis manifests itself mainly in frustration. He gets to the point where his frustration is too overwhelming then has meltdowns. He has been going to a therapist once a week for 4 years now, and they mainly deal with the "what could you have done differently?" scenario. Ryan's anger flares in 2.3 milliseconds and he lashes out. Usually very physically. He throws things, breaks things, screams, curses, hits. I really think his major problem - what everything else stems from - is his misinterpretation of the world around him. We call it, "The world according to Ryan." Because of his misinterpretation, he thinks fun teasing is bullying, people hate him, no one understands him, etc. He just finished a stint at an alternative school program for having too many offenses at school. He's either shoving someone, cursing them out, or not doing what he's supposed to be doing because he's upset about something else. I keep telling him he cannot change the world. He can only change his reaction to it. That sometimes you just have to stop and try to see the other side to something, not just react. He never instigates anything, he only reacts. I'm not sure what my question is exactly. Maybe - at what point do they get it through their heads that only THEY can learn to control this? He hates being an aspy, hates being different, threatens to kill himself (although I do not believe he means that). But I think he's waiting for everyone else to fix the problem. How do I make him understand that he gives his power away every time someone makes him mad. That he needs to take the power back and control this himself?

Cheryl Lynne said...I think we gave birth to the same child. You're not alone. Positive energy and strength to you.

Unknown said...My 14yr old daughter is autiatic and her step dad thinks shes fine that shes normal and that shes just manipulating me all the time all he does is yell at her and take her phone away constantly he does not understand autism and its very frustrating watching him fight back and forth with her constantly what can i do ?

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Understanding the Aspergers Child - Part 2

The way kids with Aspergers (Aspies) perceive the world makes sense to them, and for the most part, they can’t change the way they think or act. However, with assistance, they are able to adjust their behavior so as not to cause conflict and confusion with parents, teachers, and peers.

Here are some common issues that will need to be dealt with when working with an Aspergers (high functioning autistic) child:

• Aspergers kids don’t take much notice of the reaction of the people listening to them and may ramble on regardless of the listener’s interest, thus appearing insensitive to other’s wants, needs, and feelings.

• Aspergers kids look just like their peers, and they often have average or above average intelligence, but they have difficulty understanding and relating to others in a way other non-Aspergers kids of their age do.

• Aspies can be assumed to be selfish, because most would just rather play by themselves with a special interest of their own.

• Aspies do not see themselves as a member of a particular group. They follow their own interest rather than that of the other kids at school, which can lead to total social isolation.

• Aspies often take everything others say in a literal sense, and as a result, they may be frightened by statements such as “she bit my head off.”

• Kids with Aspergers can get quite confused when they listen to other people who are telling jokes, or using exaggerated language and metaphors.

• Non-Aspergers kids usually don’t understand -- or tolerate -- Aspergers-like behavior. As a result, the Aspies is often ostracized from the peer-group.

• Often times, parents, teachers and peers don’t understand why Aspies have a lack of desire to interact with others and why they have an inability to understand simple social cues.

Social issues that Aspies experience include:

• Are inflexible and incapable of coping with change
• By school age express desire to fit in socially
• Described as being "in their world”
• Described as operating "on their own terms"
• Difficulties making social connections
• Easily stressed and emotionally vulnerable
• Frequently described as "odd" or selfish
• Highly frustrated by their social awkwardness/alienation
• Lack effective interaction skills
• Lack understanding of human relations and rules of social convention
• Naïve and lack common sense
• Preoccupied with own agenda
• Seldom interested in other’s interests/concerns
• Unable to "read" others’ needs and perspectives
• Unable to appropriately respond to social cues

Language issues that Aspies experience include:

• Concrete language rather than abstract
• Difficulty understanding humor
• Excessively formal or pedantic language
• Highly developed vocabularies
• Hyper-verbal
• Laugh at the "wrong time" with jokes or interactions
• Many have good sense of humor
• Misused or not used cultural slang or social idioms
• Problems with taking turns in conversations
• Prosody (i.e., speech volume, intonation, inflection, rate) is frequently deficient or unusual
• Repetitive phrases or language or stock phrases from memorized material
• Rote skills are strong
• Some have normal or early language development while others have speech delays, then rapidly catch up, making diagnosis between Aspergers difficult
• Typically revert to favorite topic area
• Usually like word games and puns
• Weak pragmatic -- conversational -- skills

Some of the areas that Aspies can be obsessed about include:

• astronomy
• dinosaurs
• extraterrestrials
• geography
• history
• machines or machinery
• maps
• math
• metereology
• music
• reading
• science
• social studies
• space travel
• trains
• weather

Practical suggestions for parents and teachers include:

• Be sure that the challenging behavior is no longer effective in getting the Aspie’s needs met (e.g., ignore problem behaviors; provide prompt for the "new" appropriate behavior; if the Aspie screams to avoid situation, prompt her/him to use an appropriate phrase; do NOT allow him/her to leave the situation while he/she is screaming

• Create cooperative learning situations

• Educate peers 

• Encourage participation in conversations 

• Help the Aspie develop appropriate ways of conveying requests/needs

• If screaming when confused by a task, teach Aspie to raise hand, ring a bell, or say "I need help with this...this is too hard"

• If the Aspie asks to leave the situation, provide him/her with immediate break

• If the Aspie needs attention, stop what you’re doing and provide some time/interest

• If the Aspie requests help, assist immediately

• Know that insensitive or inappropriate comments from Aspergers children are usually innocent 

• Model more appropriate phrase or nonverbal signals, have the Aspie practice the "new phrase" or behavior, and during the situation, remind (prompt) child to use new phrase or behavior 

• Model two-way interactions 

• Praise classmates when supportive 

• Promote empathy and tolerance 

• Rehearse proper response repertoires 

• Shield them from bullying and teasing

• Teach and support proper reaction to social cues

• Teach WHAT to say, WHEN, and HOW to say it

• Teach/model correct emotional responding

• Teaching WHY & WHAT response is appropriate is necessary

• Use the Aspies strengths in exchange for liabilities to foster acceptance 

• When the Aspie becomes overwhelmed or over-stimulated, try reducing the amount of time in the situation, or avoid it in future

• When the Aspie gets confused, consider how to make the situation easier to understand – make it more concrete, routine, or predictable

The Aspergers Comprehensive Handbook
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