Aspergers Teens and Online Gaming Obsessions

Question

Our 15y/o son has always ‘marched to his own drummer,’ we just never really had a label for it. He is very smart and the computer became his life. In November, I ended up taking his computer away because he was failing his classes (we home school and he was taking some on-line classes), he was spending too much time on-line gaming and he was very involved with an on-line gaming clan that was appearing to be a very negative influence. (He has a history of ADHD treated with meds.)

After taking away the computer he had a major meltdown and refused to eat, leave his bed, participates in school/outside activities. We didn't know what to do. Consulted with several treatment centers, none of which would work with him b/c he is not violent, not in trouble with the law and not on drugs or alcohol. We are very thankful for that, but don't want to let it get to that point.

We met with a family counselor (we have tried counseling in the past without any progress) that was recommended and just couldn't seem to get anywhere so we insisted on a psychological evaluation - there had to be something we weren't seeing. His diagnosis came back as Aspergers, Depression and ADHD. We have had a lot of lying, refusal to do his responsibilities, refusal to do his school work etc... We have had to keep all computers and internet modems under lock and key. He can ‘hack’ into any password.

We have been working with Boy's Town in our home for the past two months. They have helped me a lot by being a sounding board, but nothing with my son. Their plan consisted of a parent class of which we watched the 5 or 6 videos, filled out an answer book and now they want us to find more in-depth work for his Aspergers because they don't feel trained in that.

I feel that the intense crisis is past but now we need to help our son learn to lead a responsible, successful life. I have been reading your handout that I purchased. Now where to begin...

Answer

Obsessions are one of the hallmarks of Aspergers, High-Functioning Autism, and other Autistic Spectrum Disorders. In order to cope with the anxieties and stresses about the chaotic world around them, Aspergers teens often obsess and ritualize their behaviors to comfort themselves.

Online gaming is a very popular obsession with Aspergers. However, don’t completely forbid your son to engage in this obsession. His use of the computer can be a great bargaining chip for you (i.e., he won’t work for what you want, but he will work for what he wants – and he wants to play computer games).

Breaking an obsession is like running a war campaign. If not planned wisely, or if you attempt to fight on many fronts, you're guaranteed to fail. The real issue here is the fact that your son spent too much time playing games, which resulted in poor academic performance. This resulted in a second issue, namely, his behavior took a turn for the worse after you took his computer away. Thus, he should be able to play video games, but within limits.

To make his games less seductive, find ways to minimize your son's downtime at home, especially those times when he is alone. Maybe he would be interested in arts and crafts, theater, martial arts, bowling, swimming, or movie-making. Maybe a social-skills group would be a good idea. Maybe he could join a youth group at your church or synagogue. Help your son find some activity that he likes and a place where he can do it.

Children with Aspergers and ADHD often lack the "internal controls" needed to regulate how much time they spend playing computer games. It's up to moms and dads to rein-in the use of the games. The first step is often the hardest. Both parents must agree on a set of rules:

• How much time may be spent on a weekend day?
• How much time may be spent playing the games on school nights?
• If the child plays Internet-based games, which sites are acceptable?
• Must chores be done first?
• Must homework be done first?
• Which games are taboo, and which are O.K.?

Once parents agree, sit down with your son and discuss the rules. Make it clear which rules are negotiable and which are not. Then announce that the rules start right now. Be sure you can enforce the rules (e.g., if your child is allowed to spend 30 minutes at computer games on school nights - and only after homework and chores are done - the game and game controls must be physically unavailable when he gets home from school). If games involve a computer or a television set, find a way to secure the system until its use is permitted. When the 30 minutes of playing are up, retake the controls. If he balks, he loses the privilege to play the game the following day. If you come into his bedroom and find him playing the game under the covers, he might lose the privilege for several days.

Give warning times: "You have 15 more minutes... You now have 10 minutes... There are only five minutes left." A timer that is visible to your son can be helpful. When the buzzer rings, say, "I know you need to reach a point where you can save the game. If you need a few more minutes, I will wait here and let you have them." If he continues to play despite your step-by-step warnings, do not shout or grab the game or disconnect the power. Calmly remind him of the rules, and then announce that for each minute he continues to play, one minute will be subtracted from the time allowed the next day (or days). Once you get the game back, lock it up. When he finally regains the privilege to play, you can say, "Would you like to try again to follow the family rules?"

Discipline for Defiant Aspergers Teens
 
COMMENTS:

•    Anonymous said... As a parent of two sons with Asperger Syndrome, I learned that children have a very heightened sense of justice. Instead of giving ultimatums, give them fair choices. Children know when a choice is not really a choice but a parent leveraging a demand. My two sons are grown adults now, 30s. Oppositional Defiant Disorder is part of the puzzle here: so it is important to give them choices, reward for good choices, and lots of routine and structure. My oldest son with Asperger could not function without his computer. Taking it away completely would cause a meltdown of cosmic significance--you might as well melt the sun. Instead, time at the computer was earned. Having visual written cues to transition from one thing to the next, rewards for completing. Once we learned about O.D.D.S. and how that works into O.C.D. and the Pervasive Depressive Disorder, I learned as a parent, to provide routine, structure, and fair choices not ultimatums. Putting an Asperger child into a meltdown by taking away their only means of real communication or escape (cocooning) would perhaps cause my oldest son to end his life. In fact, it wasn't until my son was in his second hospitalization for suicidal intent that the psychiatrist who debriefed us explained the 7 major components of Asperger Syndrome and explained some very important parenting styles which would help our son function much more smoothly in our world. Accepting that my sons are different and not forcing them into social situations where their peers hurt them and made fun of them, but only in structured social activities where they are not at risk was important. If any of this is helpful, hope it gives hope and that your son feels better soon.
•    Anonymous said... I've endured many harsh ignorant comments from family, church members, etc. who only see biological age but do not understand that my two sons are at about 8-10 years old as to mental maturity and they will never be like other adults. They can't live on their own because they don't have a sense of personal safety, don't understand money, time management, and would be extremely at risk for unscrupulous folks who might hurt them or take advantage of them. In my case, I am so thankful their older brother grew up and matured and he and his wife stepped in. The boys' father and step-mother have called my two sons idiots, lazy, rebellious...they were cruel. I'm am glad to read all the wonderful gifts and abilities your son has. My family participated in the U of WA Family Study of Autism with Dr. Geraldine Dawson and Dr. Julie Osterling--both very highly respected. I've learned so much over the last two decades. Very little, almost zero support back then for my boys and for parents. It has been a long road. My sons suffered so much from peers in school. And even a year or so ago, the one did not want to participate in board games and his older brother made a comment. I waited until the room was clear and said to my oldest, "Do you understand that for your brother, he loses these games every single time and it is not fun for him? Please do not ridicule or ever taunt him like that again. Look at it from his point of view." That is why I think they like their computers so much, because for the first time they can WIN at something and they don't have to try to be normal and fit in. I'm glad I could share anything about what I've been through and with my two sons if it helps. I got help 11 years ago from the DSHS here in my state for Phil's SSI from a social worker. My two sons are so smart and gifted musically, artistically, writing, and total masters of the computer and they're so nice and kind and just great young men. Praying you will make sure you get enough sleep and eat well, take your vitamins, and set a goal for getting the SSI application completed. Ask for help. Here we have an organization called WAPAS and they advocate for people with disabilities. Have you asked the ARC for help?
•    Anonymous said... I've met too many moms on these groups in the same boat as me and we all feel hopeless. People don't understand. They think he is full of excuses and lazy. I've seen my sons pain. They haven't. He says he isn't normal and life is too hard for him so why bother. He has in home therapy but is refusing services. I've been so occupied I haven't had the time or energy for an ssi application. I hear lots get denied. My son is so smart. He's a gifted writer and artist and I just want for him to be able too live independently some day. I recently went to court to gain guardianship of him because his functioning is very low. Thank you for your story. It gives me hope
•    Anonymous said... We got our son to the local community college at age 16 and he took the test for his HS diploma, passed with flying colors and began college at 16. Needed 504 Accommodations so we went through the college disability office. Is there counseling available? Someone who can come to the home through a community health care organization? I remember watching Rain Man, the movie, and understanding that these young men must be allowed to have their support systems. The computer seems to be the most non-threatening form of social communication. If you can, make peace with your son over his connection with his computer and ask him what he would like. If he understands that his computer will never be taken away, he may be much more willing to take the other little baby steps in his life. We make lists and do our best to avoid showdowns and do not give ultimatums. ODDS, OCD, and Pervasive Depressive Disorder are part of the Asperger 7 major components of behavior...so I heartily recommend that as the parent, you get as much support and help as you can. Also, introducing your son to other Asperger young men his age who are also computer nerds would help. My oldest son and his wife opened their home to the two with Asperger so they are no longer living with me and that seems to help also. Because sometimes I found my relationship with my oldest, who was the most depressed and most connected to his computer, needed some space of his own. He is doing much better. But the teen years and early 20s were a challenge. I had to learn to accept that my son's computer attachment represented an escape from what is mostly too much stimulation from the real world that he could not handle. And we regularly replace his 16" Peekachoo plush "friend" as that is his dearest companion that my son uses to talk to and he can express himself to that Peekachoo that he can't to people. These kids are so ignored by their peers or bullied by their peers and mostly invisible. It's hard on them. When the they know they are "different" they can get very depressed. But when they can reach out to others through their computers, that helps. Did you get SSI for your son? Hope so. We did and that pays for his medical and prescriptions. Hope this is helpful...in no way meant to soapbox...but having been through this, it is a long road but so worth it. My two sons are multi-geniuses and such wonderful kind individuals. But take away their computers would be like declaring WWIII, so once that issue was resolved, they could see the rest of life with a lot more cooperation They are both happy today and although they'll always live with their older brother and his wife, through their older brother they have friends. And the friends they make online through their music, animation and artistic gifts, are a blessing also.
•    Anonymous said... Your oldest son sounds like my 18 yo son. He threatens self harm at any attempt to take way his computer. He hadn't completed past 9th grade, isn't going to school or working or leaving the house and now not participating in in home therapy or behavior services. What's a parent to do? I worry about his future immensely

Post your comment below…

Vitamins to Treat Aspergers

Question

Are there any vitamins that can be used to treat or alleviate unwanted symptoms of Aspergers and other autistic spectrum disorders?

Answer

Behavioral nutrition and alterations to diet have been shown to improve brain function as well as decrease symptoms. While using vitamins can be a sole form of treatment or used in conjunction with prescribed medications and therapy, it is very important to discuss all nutritive considerations with your child’s doctor first.

Vitamin C— Vitamin C is a powerful antioxidant that has been optimistically regarded for this reason in Aspergers (high-functioning autistic) children and traditional autism. According to Regional Medical Clinic, vitamin C is usually used as a complementary treatment combined with other vitamins and carnosine. The Autism Society of America substantiates these claims while adding that vitamin C has shown marked improvements for kids in clinical trials. Research findings suggest that vitamin C improves brain function, symptoms of confusion and depression and improves the severity of behavioral problems significantly.

There are several theories regarding vitamin C’s benefits for those with Autistic Spectrum Disorders (ASDs):

• One theory regarding vitamin C’s effects focuses on the benefits of its antioxidant properties. Some researchers believe that those with ASDs have more difficulty in managing free radicals. Free radicals can damage the immune system, the brain and other areas of the body. As an antioxidant, vitamin C provides some protection against the effects of free radicals.
• Children with ASDs are deficient in vitamin C. This theory was supported by a study which found lower levels of vitamin C in Aspergers and Autistic children.
• Vitamin C’s benefits are due to its effects on the brain’s response to the neurotransmitter dopamine. Vitamin C supplementation has a calming effect on people with ASDs and reduces stereotyped behavior.

Of 201 parent ratings of vitamin C provided to the Autism Research Institute, 46% reported improvements using the supplement, 51% saw no change and 2% said that their children grew worse.

B6 with Magnesium— It is believed that those with ASDs may suffer from a deficiency of vitamin B6 and magnesium. Research shows that levels of magnesium in their blood are lower than those of children without ASDs. Magnesium has also proven beneficial for some children with ADHD. Vitamin B6 and magnesium deficiencies are common among both Aspergers and traditional autistics of varying functionality. B6 and magnesium related deficiencies can cause symptoms in this population, manifested through bouts of agitation, aggressive behaviors, irritability and depression.

In a meta-analysis from the Autism Research Institute, 21 of 22 clinical studies from 1965 to 2005 showed that when vitamin B6 with and without magnesium added was given to autistics, major improvements were made. Supplementation was reported as highly beneficial in reducing problem behaviors as well as providing additional benefits to auditory-visual and auditory-tactile pervasive and developmental conditions.

Parents rate vitamin B6 and magnesium highly as a treatment for ASDs. Of 321 parent ratings provided to the Autism Research Institute, 50% saw improvements with vitamin B6 and magnesium supplementation, while 45% saw no effects and 5% said that their kids grew worse. Magnesium on its own was not as effective, with improvements noted in just 16% of cases.

Minor side effects of large doses of vitamin B6 may include nausea, diarrhea or hyperactivity. However, these effects are uncommon and more likely to occur only when the dose is too high or increased too rapidly. Nausea can also result from taking B vitamins on an empty stomach, so kids should take vitamin supplements with meals.

Omega-3 Fatty Acids— Omega-3 makes the cell membrane elastic, allowing nutrients to enter the cell and the waste to exit the cell. In addition, the long omega-3s (EPA and DHA from fatty fish) attach to cell membrane receptors, helping the cells communicate with each other. This is why the benefits of omega-3 fish oil are so diverse – it helps every cell in the body do its best work.

Omega-3 fatty acids are considered essential nutrients that are not produced by the body. Therefore, the only options are to obtain them through a diet rich in leafy greens, oily fish, flax seeds, hemp seeds, walnuts or canola oil or supplement them. In Aspergers, omega-3 fatty acids play an integral role in countering the effects of a common fatty acid deficiency. Additionally, studies report that eating a diet with considerable fish intake or omega-3 fatty acids can also decrease the depressive symptoms by up to 50 percent and benefit both erratic behaviors and brain function.

Emerging research studies indicate that omega-3 may be beneficial for relieving ASD symptoms. One study conducted on children in the autistic spectrum suggested that omega-3 was helpful in stemming hyperactivity and stereotypy as compared to placebo.

Aspergers can create a lonely world, especially when friendships are difficult to form. Sometimes, the inability to connect with peers can cause the loneliness and frustration to bubble into depression. Omega-3 can help with depression. A study on the impact of omega-3 on children with depression found a significant improvement for the children who were given omega-3 fish oil versus the children who were given placebo. Omega-3 may also have a positive impact on Aspies who struggle with controlling their anger. Eleven studies to date suggest that omega-3 can help regulate and control aggressive behavior and hostility. Although more research is needed, omega-3 could be instrumental in stemming the daily meltdowns and temper tantrums.

The Aspergers Comprehensive Handbook

Aspergers Plus ADHD

Question

My daughter is 9 and has ADHD and Asperger's. She takes Methylphenidate twice a day so that she may focus at school, but when the second dose wears off she becomes uncontrollable. She is loud & completely disobedient. I have a 6 year old son also and am a single mother. I am at my wits end. I feel like I have tried everything and nothing works. She talks back to me always. There is not one time that I ask her to do something that she doesn't argue back. Please help me :o)

Answer

It sounds like she does fine until her meds wear-off. We’ll start there…

Have you tried sustained release forms of ADHD medication, or one of the long acting stimulants?

Sustained release forms of these medications have the benefit that the medication is often still working after school, as your youngster is trying to do his homework. The sustained release pills must be swallowed whole (except for Adderall XR).The long acting stimulants generally have the duration of 8-12 hours and can be used just once a day. They are especially useful for kids who are unable or unwilling to take a dose at school.

At least 80% of kids will respond to one of the ADHD stimulants, so if 1 or 2 medications don't work or have unwanted side effects, then a third might be tried. It can help if you are aware of the different medications that are available. Stimulants are considered to be first line treatments, and antidepressants are second line treatments and might be considered if 2 or 3 stimulant medications don't work for your youngster.

Here is a list of long acting stimulants to explore with your youngster’s doctor:

• Adderall XR— Adderall XR is approved for use in kids over the age of six years, although regular Adderall can be used in younger kids from 3-5 years of age. Adderall XR is a sustained release form of Adderall, a popular stimulant which contains dextroamphetamine and amphetamine. It is available as a 10mg, 15mg, 20mg, 25mg, and 30mg capsule, and unlike many of the other sustained release products, the capsule can be opened and sprinkled onto applesauce if your youngster can't swallow a pill.

• Concerta— Concerta is a sustained release form of methyphenidate (Ritalin). It is available as a 18mg, 36mg and 54mg tablet and is designed to work for 12 hours. Teens can take two 36mg tablets to get to a dose of 72mg. Like Adderall XR, it is only approved for kids over the age of six years.

• Daytrana— Daytrana is a methyphenidate or Ritalin patch. The patch is available in 10mg, 15mg, 20mg, and 30mg dosages, which are worn for about nine hours at a time on a youngster's hip. The medication in your youngster's system then continues to work for a few more hours once you take the patch off, although you may have to figure how the patch works best for your youngster. One benefit of the Ritalin patch, in addition to working well for kids who don't like to take medicine, is that it gives you a lot of flexibility. For example, on some days your youngster could just wear the Daytrana patch for a few hours and on other days he could wear it a little longer if he has extra homework (as long it doesn't interfere with bedtime).

• Focalin XR— An extended release form of Focalin, with the active ingredient dexmethylphenidate hydrocholoride, which is also found in methylphenidate (Ritalin). It is available in an 5mg, 10mg, 15mg, and 20mg capsule.

• Metadate CD— This is also a long acting form of methylphenidate (Ritalin).

• Ritalin LA— This is is a new long acting form of methylphenidate (Ritalin). It is available in 10, 20, 30, and 40mg capsules. Unlike the other long acting forms of methylphenidate, the Ritalin LA capsules can be opened and sprinkled on something if your youngster can't swallow them whole.

• Vyvanse— The latest medication to get approval to treat ADHD is Vyvanse, a long acting stimulant that is similar to Adderall. In fact, its main ingredient is lisdexamfetamine dimesylate, a derivative of one of the ingredients in Adderall. Initially available in 30mg, 50mg, and 70mg capsules, newer 20mg, 40mg, and 60mg capsules should be available soon.

Side effects of stimulants can include a decreased appetite, headaches, stomachaches, trouble getting to sleep, jitteriness, and social withdrawal, and can usually be managed by adjusting the dosage or when the medication is given. Other side effects may occur in kids on too high a dosage or those that are overly sensitive to stimulants and might cause them to be over-focused on the medication or appear dull or overly restricted. Some moms and dads are resistant to using a stimulant because they don't want their youngster to be a 'zombie,' but it is important to remember that these are unwanted side effects and can usually be treated by lowering the dosage of medication or changing to a different medication.

Here are several points to keep in mind with regard to medication for Aspergers and High-Functioning Autism:

• Anti-Depressants May Be Needed— While many kids with Aspergers present with hyperactivity, there is a tendency for teenagers to suffer from depression. There are various reasons why depression may be so common. For example, teens with Aspergers generally want to fit in socially. They can become depressed when they fail to fit into society's molds or norms or can't grasp the importance of its rules. Depression may also hit as they deal with anxiety and obsessive behaviors.

• Consider non-Medical Therapies— There are several therapies that are proven to be effective in treating and improving behaviors in children with Aspergers. Behavioral therapies help the child learn to cope with obsessive tendencies, deal with tantrums, cope with anxiety or control angry outbursts. Social skills classes help them to understand more of the back-and-forth nature of communication. Speech therapy can help them understand different uses of language. Occupational therapy improves the clumsiness or lack of co-ordination problems.

• Diet and Vitamin Treatments Improve Symptoms— Nutritional deficiencies and mal-absorption problems are common in Aspergers children. Many parents report success with a restricted diet or adding vitamin supplements. Other parents report success with the gluten and casein-free diet or a low-sugar, low-yeast diet. It is best to get a blood or stool test to check for any food intolerances or vitamin deficiencies. Consult a nutritional therapist if you want to go this route. After testing, some common vitamins that Aspergers children often use include: B vitamins, zinc, magnesium, Vitamin C and cod liver oil supplements.

• Medications for Anti-Anxiety or ADD/ADHD are Useful— Anxiety and stress are usually elevated in Aspergers children and teens. They often require medications to cope with the anxiety. Children with Aspergers also struggle with concentration, hyperactivity, focus and attention. Medicines to target ADD or ADHD have proven useful for Aspergers. There can be side effects with new behaviors showing up, however, so any medication use needs to be closely monitored.

• There Is Not Just One Medication— While many of the symptoms of Aspergers can be treated with a variety of medications, there is not one magic pill for the syndrome. Aspergers children and teens often lack proper social skills, have obsessive tendencies and can be clumsy or awkward. Some medications can be used to improve specific behaviors associated with Aspergers, such as anxiety, hyperactivity or attention deficit.

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children


COMMENTS:

•    Anonymous said... I feel your pain.... I have 3 with ASD and complex behavior challenges including ADHD. Maybe there is a different dose that is more time released ? I am about to go the med route for my daughter. She is so difficult and has been since she was 1.5... She is six now. Ugh it's so draining!!!
•    Anonymous said... I'm familiar w this. Repeat every request and or argue for every little thing.
•    Anonymous said... We have three rules for our family. Each one has a clear consequence. By making these clear then following through discipline is simplified enough that we can spend most our energy on positive interactions with our son. Two years on this approach and he's got himself so much under control that he and his therapist weaned him off all meds. In his case he would take all the emotional power we would give him, so we just had to take the emotions out of correction and give him very clear expectations and hold him calmly to them. Then, we did all we could to let him know we adore and enjoy him just the way he is. In the end my belief is that the work is Gods inside our kids hearts, so prayer is the best thing you can do for your kids, but schedule, routine, clear expectations, calm correction, and happy parents are things that can benefit every family.
 
Post your comment below…

The Gluten-free Casein-free Diet: Does It Really Work?

A gluten-free, casein-free diet is definitely recommended for children with Aspergers and High Functioning Autism. Here’s why:

The molecular structure of partially undigested proteins, called peptides, resembles opiates. These peptides have an effect much like opiates (i.e., morphine, heroin) in the brain and nervous system. Long-term exposure to these opiate peptides can have many damaging effects on the developing brain and also affects behavior, just as any narcotic would. The opioid peptides involved are identified as casomorphines from casein, and gluten exorphines and gliadorphin from gluten.

Children with Aspergers and High Functioning Autism usually have gastrointestinal problems (e.g., reflux, constipation, diarrhea, vomiting, hiccups, etc.). Proteins found in wheat, rye, oats, barley and dairy products (gluten and casein) aren't completely broken down in the Aspergers child’s digestion process. These undigested proteins can leak into the bloodstream, potentially interfering with neurological processes by having an opiate-like effect upon their systems. These undigested proteins (peptides) can reach toxic levels, with the youngster seeming to "crave" milk and wheat products.

The results produced by the diet vary – but you can expect to see some result. Parents report a variety of outcomes such as:

• improved fine motor skills
• improved focus and attention span
• improved intestinal function
• improved personal hygiene habits
• improved sleep patterns
• improved social skills
• improved speech and communication
• increase in affection shown
• reduction of tantrums and irritability

With results like this, why would you NOT want to try it! A gluten-free, casein-free diet is definitely worth considering. You don't have to feel overwhelmed by the restrictive nature of the diet. Simply start slowly and eliminate one group (either gluten or casein) at a time. Once you're comfortable without wheat or dairy products, then you can tackle the next element. If you see a desirable result from eliminating one component, you may decide not to go any further. Simply substituting gluten-free flour in all recipes can be a highly effective action.

Many parents worry about removing wheat and dairy because these foods are the only ones their child will eat, and because prevailing attitudes in Western culture consider them an essential staple. However, Aspergers children who eat mostly wheat and dairy products may show remarkable improvement once a gluten-free, casein-free diet is implemented. Many families have found from experience that their children's menu options actually increase after the effects of eating gluten and casein have subsided.

A gluten-free, casein free diet usually has a detoxifying effect – not only on Aspergers children – but on the entire family. The benefits will be obvious. Some Aspergers children experience immediate improvement (although it may take as long as six months for gluten to clear out of the system - and one month for casein to clear). Advocates of the diet recommend trying it for at least a year, because it can take this long for some children to show improvement. The diet tends to make changes in the body at a cellular level and promote healing of the stomach and intestinal lining, both of which can take time.

The Aspergers Comprehensive Handbook