Search This Blog

Characteristics of Females with ASD Level 1

"We think our daughter may have a form of autism due to her severe shyness, excessive need to have things just so, certain rituals she has with food, major touch sensitivity, a lot of anxiety, just to name a few. What are some of the signs to look for to help us decide if an assessment is in order?"

Females with ASD, or High-Functioning Autism. often present with a unique set of characteristics that can make diagnosing their disorder very difficult. In addition, their strengths often mask their deficits.

There has been considerable discussion among professionals about the way girls with ASD demonstrate their major characteristics. Some girls have obvious social difficulties, whereas others appear to have excellent skills because they imitate the behaviors of others (often without understanding them).



There are many females who do not receive a diagnosis, possibly because, compared to males, (a) they have fairly good social skills (particularly when interacting with adults in a one-to-one situation), (b) their special interests are different, and (c) their clinical presentation is different.

Sometime during childhood, a female with autistic traits will begin to know she is different compared to her peers. For example:

1. Due to adopting an alternative persona, she may begin to have problems of self-identity and low self-esteem

2. Due to observing and analyzing social behavior and trying not to make a social error, she may become emotionally exhausted

3. During the stress of adolescence, she may develop routines and rituals around food and a special interest in calories and nutrition that develops into the signs of an eating disorder

4. Her interests may be different to her peers in terms of intensity and quality of play

5. She may be an avid observer of human behavior and try to decipher what she is supposed to do or say

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism
 
6. She may be extremely sensitive to the emotional atmosphere at a social gathering

7. She may be like a chameleon, changing persona according to the situation

8. She may be more likely to apologize and appease when making a social error

9. She may be overly well-behaved and compliant at school so as not to be noticed or recognized as a different.

10. She may be vulnerable to “peer predators” who take advantage of her social immaturity

11. She may become increasingly aware of her social confusion and frequent faux pas, and thus prefer to be on the periphery of social situations

12. She may enjoy living in a fantasy world and creating a new persona

13. She may escape into the world of nature, having an intuitive understanding of animals, but not people

14. She may fear that her “true self” must remain secret because she is defective, thus she is almost always acting like someone else

15. She may have a pet that she views as a loyal friend

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

16. She may have a single - but intense – friendship with another female who may provide guidance for her in social situations

17. She may have a strong desire to collect and organize her toys (e.g., dolls) rather than to share her toys with friends

18. She may have an aversion to the traditional concept of femininity

19. She may have an encyclopedic knowledge of specific topics

20. She may have an intense interest in reading and escaping into fiction

21. She may have an interest in ancient civilizations to find an old world in which she would feel at home

22. She may have an interest in other countries (e.g., France) where she would be accepted

23. She may identify with a fictional character (e.g., Harry Potter), who faces adversity but has special powers and friends

24. She may not be interested in the latest craze among her peers to be 'cool' and popular

25. She may not identify with her peers

26. She may not play with her toys in conventional ways

27. She may not want to play cooperatively with her peers

28. She may prefer non-gender specific toys (e.g., Lego)

29. She may prefer to play alone so that she can play her way

30. She may prefer to play with males, whose play is more constructive and adventurous than emotional and conversational

==> Teaching Social Skills and Emotion Management to Children and Teens with ASD

31. She may suffer social confusion in silence and isolation in the classroom or playground, but she may be a different character at home

32. She may talk to imaginary friends, or write fiction at an early age

33. She may think that the way her peers play is stupid and boring

34. She may use imaginary friends that can provide companionship, support and comfort when she feels lonely

35. She may use passive-aggressive behaviors in order to control her family and/or social experiences


  
As young girls, many (but not all) females with ASD:

1. Apologize frequently and want to please others

2. Are an expert on certain topics

3. Are determined

4. Are honest

5. Are involved in social play, but are led by their peers rather than initiating social contact

6. Are kind

7. Are misunderstood by peers

8. Are more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of autism
 
9. Are more aware of - and feel a need to - interact socially

10. Are perfectionists

11. Are so successful at "faking it" that they only come to the attention of a therapist when a secondary mood disorder emerges

12. Are specially gifted in the areas of mathematics and engineering

13. Are very good at art

14. Are visual thinkers

15. Are well-liked by adults

16. Become a target of teasing

17. Do not ‘do social chit chat’ or make ‘meaningless’ comments in order to facilitate social communication

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

18. Enjoy solitude

19. Have a faster rate of learning social skills than males

20. Have a single friend who provides guidance and security for them

21. Have a special interest that is more likely to be unusual in terms of intensity rather than focus

22. Have difficulty knowing what someone else may be thinking or feeling

23. Have difficulty making friends

24. Have difficulty managing feelings

25. Have difficulty showing as much affection as others expect

26. Have difficulty taking advice

27. Have difficulty with writing skills

28. Have extremely detailed imaginary worlds

29. Have imaginary friends

30. Have interests that are very similar to those of neurotypical girls (e.g., animals, dolls, classical literature), and therefore are not seen as unusual

31. Have what is classified as a "male brain"

32. Make reliable and trustworthy friends

33. Mimic or even try to take on all the characteristics of someone they are trying to emulate

34. Notice sounds that others do not hear

35. Read fiction to help them learn about inner thoughts, feelings and motivations

36. Show little interest in fashion

37. Speak their minds (sometimes to the point of being rude)

38. Still need to be directly taught certain social skills

39. Try to understand a situation before they make the first step

40. Use doll play to replay and understand social situations

By

Repetitive Routines and Rituals in Kids with Autism Spectrum Disorder [ASD]

Some kids with ASD [High-Functioning Autism] develop a resistance to (or fear of) change, that then involves being rigid in their approach to their environment. Insistence on sameness, routines and rituals begin. For example:
  • Particular silverware and plates must be used or the ASD youngster refuses to eat or drink.
  • Objects may be stacked or lined up in a repetitive manner.
  • Certain routes must be followed to and from familiar places.
  • Certain items must be placed in particular places and not moved.

Confusion about coping in a world that is overwhelming influences this behavior, so the youngster with ASD responds to this uncertainty by being in control of their immediate environment, the objects in that environment, and the people in it. Repetitive motor mannerisms may occur when some kids are excited, anxious, or worried. For others, sensory sensitivities and physical enjoyment may drive repetitive jumping, arm flapping, twiddling of fingers in front of their eyes and covering ears and eyes with their hands.



Repetitive behaviors and mannerisms in ASD children is a somewhat neglected area of research. In the past, these behaviors were associated with lower levels of functioning, because repetitive motor mannerisms are also seen in kids with intellectual disability who do not have autism. These behaviors were also thought to increase during the preschool years. There is now some evidence that repetitive motor mannerisms develop differently to insistence on sameness and these behaviors follow different paths over time.


Restricted and repetitive behaviors show different patterns of stability in autistic kids based partly on the ‘subtype’ they belong to. Young kids with low NVIQ (i.e., non verbal IQ) scores often have persistent motor mannerisms. However, these behaviors often improve in kids with higher nonverbal IQ scores. Many kids who do not have “insistence-on-sameness behaviors” at a young age acquire them as they got older, and some kids who had these behaviors sometimes loss them. 

What should moms and dads do about routines, rituals and repetitive motor mannerisms?

First, ask yourself the questions: “How much of a problem is it?” and “”Who for?” The answer is often that these behaviors are a problem for the mother or father, educators and counselors rather than the youngster himself (who is quite happy to be preoccupied in these ways). Therefore, it is unlikely that the youngster will want to change his behavior. The rules of thumb when making decisions about whether or not to intervene or change routines, rituals and repetitive motor mannerisms are to ask yourself:
  • Will the behavior be acceptable in 5 years time?
  • Does the behavior interfere with or preclude participation in enjoyable activities and an education program?
  • Does the behavior increase the likelihood of social rejection or isolation?
  • Does the behavior endanger the youngster or others?

In preschoolers with ASD, adherence to non-functional routines and rituals and displaying repetitive motor mannerisms may be judged inappropriate because they fall into one or more of these categories, or may be tolerated by the family and others and are not seen as problematic.


The most successful treatments for ASD children with repetitive rituals are behavioral therapy and medication. Behavioral therapy, also known as cognitive-behavioral psychotherapy (CBT), helps children learn to change thoughts and feelings by first changing behavior. It involves gradually exposing children to their fears, with the agreement that they will not perform rituals, to help them recognize that their anxiety will eventually decrease and that no disastrous outcome will occur.

Some treatment plans involve having the youngster "bossing back" the repetitive rituals, giving it a nasty nickname, and visualizing it as something he can control. Over time, the anxiety provoked by certain unwanted stimuli in the environment and the urge to perform rituals gradually disappear. The youngster also gains confidence that he can "fight" repetitive rituals.

Repetitive rituals and routines can sometimes worsen if it's not treated in a consistent, logical, and supportive manner. So it's important to find a therapist who has training and experience in treating this issue. Just talking about the rituals and fears has not been shown to help repetitive rituals, and may actually make it worse by reinforcing the fears and prompting extra rituals. Family support and cooperation also go a long way toward helping a youngster cope with repetitive rituals.

Many children can do well with behavioral therapy alone while others will need a combination of behavioral therapy and medication. Therapy can help your youngster and family learn strategies to manage the ebb and flow of symptoms, while medication often can reduce the impulse to perform rituals.

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

Loneliness in Kids with Autism Spectrum Disorder

It is hard to know if kids with ASD (high functioning autism) are as lonely as their moms and dads believe they are. Therapists do know that playing with a friend, making a friend and being with a friend are "overwhelming skills" for ASD children. Kids without autism make no sense to "autistics," because they are totally preoccupied with their own agendas.

Teaching ASD children social skills is a big task for moms and dads and educators. It is not like teaching the child how to ride a bicycle or tie a shoe, but rather trying to teach something no one formally taught you. How do you teach someone how to read a room, especially someone who has no understanding of other individual's emotions and body language? 

Kids with autism have no idea about how to reason socially and come up with proper courses of action in social situations (e.g., one guy with ASD level 1 got lost in the school corridors on his way to gym. He had forgotten the route, but he did not think to simply follow his classmates to the gym).

Yet therapists emphasize the need to teach ASD children social skills because they desperately need them to get along in life. The child's lack of social understanding virtually colors every other experience in his/her life. Yet the question of whether kids on the spectrum are truly lonely and want friends is a different discussion. Like all kids, some are extroverted and others are more withdrawn. Like all kids, they probably vary in their need for social interactions.


When researchers ask kids with ASD about friendship, they are usually very negative. They think of friendship with other kids as too much work and often prefer grown-ups. For example, when a teacher was forcing a six-year-old to participate in a playgroup with other kids, he said, "I hate kids. I don't play with kids. I'm not a kid. I was born a grown-up." 

Michael, a fourteen-year-old with Aspergers advises other Aspergers children, "If you like being on your own, then be happy with your own company and don't let anyone convince you its wrong." His advice to ‘pushy moms and dads’ is "Never force your youngster to socialize. Most ASD children and autistic individuals are happy to just be by themselves."

However, these kids might be happier by themselves because social activity has caused them so much pain in the past. In one study, gifted kids with ASD could not describe friendship in positive terms such as "a friend is someone who is nice to you." They had only negative associations such as "a friend is someone who does not hit you." These kids told interviewers only about how mean other children had been to them and seemed to lack any idea of what reciprocal friendship really means.

Yet as autistic children go through the teen years, most realize that they are missing out by not fitting in. It is at this point in their lives that they crave friendships with peers, yet this unfulfilled desire on top of high school pressure to conform, constant rejection and harassment can often cause depression in ASD teenagers. They grow more isolated even as they crave more interaction with other teenagers. Young kids with ASD often believe everyone in their class is the same and everyone is a potential friend. ASD teenagers know better.

Research shows that the more time a person with ASD spends socializing, the happier she is. Autistic children can and do form friendships. When they do, research shows that even one friendship will speed up their entire social development.


People married to someone with ASD often talk about their own feelings of loneliness. They tell counselors that marriage to a person with autism feels like living alone. An ASD husband/wife often does not attend to details like anniversaries, may not connect with the couple's kids on an emotional basis, and may not benefit from marriage counseling. A parent of a youngster with ASD may feel rejection when their youngster refuses to cuddle or express affection. 

The youngster's needs are unrelenting and yet the moms and dads' rewards are sometimes rare. Brothers and sisters hide their lonely feelings about living in a family where their autistic sibling monopolizes their moms and dads' precious time and they miss the normal give and take of sibling relationships. Many siblings believe that the ASD child's “disability” is an advantage …a passport to special attention, recognition and privilege.

Helping kids with autism spectrum disorder develop social skills will no doubt become easier in the future. Every day educators are developing better techniques. Researchers are closing in on the genetic and environmental causes of autism and may someday develop a cure. There is promising new research being conducted in a study on "Friendship and Loneliness in Individuals with ASD." Perhaps someday the answers will be clearer for individuals with autism and those who love them.

ASD Teens and Social Isolation—

In the teenage world where everyone feels insecure, teens that appear different are ostracized. Autistic teens often have odd mannerisms. For example, they may talk in a loud un-modulated voice, avoid eye contact, interrupt others, violate others’ physical space, and steer the conversation to their favorite “weird” topic. These teens may appear willful, selfish and aloof, mostly because they are unable to share thoughts and feelings with others. Isolated and alone, many of these adolescents are too anxious to initiate social contact.

Many teens on the spectrum are stiff and rule-oriented and act like little grown-ups – a deadly trait in any adolescent popularity contest. Friendship and all its nuances of reciprocity can be exhausting for a person with ASD, even though he wants it more than anything else.


By

Kids with ASD [level 1]: Gifted or Hyperlexic?

Parents who have discovered that their young child is "gifted" because he/she may be able to recite the alphabet at 18 months of age - or can read words by the age of 2 - may want to reassess the situation.

Hyperlexia often coexists with ASD level 1 [high-functioning autism]. Hyperlexia is not seen as a separate diagnosis; however, with current fMRI research revealing that hyperlexia affects the brain in a way completely opposite to that of dyslexia, a separate diagnosis may be on the horizon.



Children with hyperlexia may recite the alphabet as early as 18 months, and have the ability to read words by age two and sentences by age three. Many are overly fascinated with books, letters, and numbers. However, the child’s ability is looked at in a positive light, so many moms and dads delay in getting their “precocious” youngster any help because they believe that he/she is a blooming genius.

Hyperlexia has many characteristics similar to Autism, and because of its close association with Autism, hyperlexia is often misdiagnosed. The main characteristics of hyperlexia are an above normal ability to read coupled with a below normal ability to understand spoken language. Many of the social difficulties seen in hyperlexic children and teens are similar to those found in Autism. Often, hyperlexic kids will learn to speak only by rote memory and heavy repetition. They may also have difficulty learning the rules of language from examples or from trial and error.

Hyperlexic kids are often fascinated by letters or numbers. They are extremely good at decoding language and thus often become very early readers. Some hyperlexic kids learn to spell long words (e.g., elephant) before they are two years old and learn to read whole sentences before they turn three.

Hyperlexia may be the neurological opposite of dyslexia. Whereas dyslexic kids usually have poor word decoding abilities but average or above average reading comprehension skills, hyperlexic kids excel at word decoding but often have poor reading comprehension abilities.

Some experts denote three explicit types of hyperlexics, specifically:
  • Type 1: Neurotypical kids that are very early readers.
  • Type 2: Kids on the autism spectrum, which demonstrate very early reading as a splinter skill.
  • Type 3: Very early readers who are not on the autism spectrum though there are some “autistic-like” traits and behaviors which gradually fade as the youngster gets older.

The severity, frequency, and grouping of the following symptoms will determine an actual diagnosis of hyperlexia:
  • A precocious ability to read words far above what would be expected at a youngster’s age
  • Abnormal and awkward social skills
  • An intense need to keep routines, difficulty with transitions, ritualistic behavior
  • Auditory, olfactory and / or tactile sensitivity
  • Difficulty answering "Wh–" questions, such as "what," "where," "who," and "why"
  • Difficulty in socializing and interacting appropriately with people
  • Echolalia (repetition or echoing of a word or phrase just spoken by another person)
  • Fixation with letters or numbers
  • Listens selectively / appears to be deaf
  • Memorization of sentence structures without understanding the meaning
  • Normal development until 18-24 months, then regression
  • Self-stimulatory behavior (hand flapping, rocking, jumping up and down)
  • Significant difficulty in understanding verbal language
  • Specific or unusual fears
  • Strong auditory and visual memory
  • Think in concrete and literal terms, difficulty with abstract concepts
  • Youngster may appear gifted in some areas and extremely deficient in others

Hyperlexia appears to be different from what is known as hypergraphia (i.e., urge or compulsion to write), although as with many mental conditions or quirks, it is possible that this is more a matter of opinion than strict science.

Despite hyperlexic kid’s precocious reading ability, they may struggle to communicate. Their language may develop in an autistic fashion using echolalia, often repeating words and sentences. Often, the youngster has a large vocabulary and can identify many objects and pictures, but can’t put their language skills to good use. Spontaneous language is lacking and their pragmatic speech is delayed. Between the ages of 4 and 5, many kids make great strides in communicating and much previous stereotypical autistic behavior subsides.

Often, hyperlexic kids have a good sense of humor and may laugh if a portion of a word is covered to reveal a new word. Many prefer toys with letter or number buttons. They may have olfactory, tactile, and auditory sensory issues. Their diets may be picky, and often potty training can be difficult. Social skills lag tremendously. Social stories are extremely helpful in developing effective age-relative social skills, and setting a good example is crucial.

Many moms and dads have had their hyperlexic kids go through numerous evaluations, with various confusing and contradictory diagnoses applied – ranging from Autistic Disorder to ADHD, or language disorder. In other cases, there is no diagnosis applied except “precociousness” or “gifted.”

Controversy exists as to whether hyperlexia is a serious developmental disorder like autism, or whether it is in fact a speech or language disorder of a distinct and separate type, or, in some cases, it is simply advanced word recognition skills in a normal (neurotypical) youngster, especially when sometimes accompanying “autistic-like” symptoms are present.

Treatment—

The first step in treatment is to make the proper diagnosis. Then management of the condition follows. When precocious reading ability and extraordinary fascination with words presents itself in a young son or daughter – especially when accompanied by other language or social problems that might suggest an autistic spectrum disorder – a comprehensive assessment by a knowledgeable professional or team familiar with the differential diagnosis of the various forms of hyperlexia is indicated. 

By
Subscribe to: Posts (Atom)

Understanding Theory of Mind Deficits in Autistic Children: Misbehavior or Misunderstanding?

The concept of "theory of mind" refers to the ability to understand that others have their own beliefs, desires, and intentions, w...