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Sensory Integration Dysfunction in Kids on the Autism Spectrum


"Is it common for children on the autism spectrum to react strongly to one or two things (certain noises for example) - yet not react at all to other things that ordinary kids would react strongly to (such as a broken bone)?"

Many young people with High-functioning Autism (HFA) have a dysfunctional sensory system. Oftentimes, one or more senses are either over-reactive or under-reactive to stimulation. Such sensory issues may be the underlying reason for certain behaviors associated with autism spectrum disorders (e.g., rocking, spinning, hand-flapping, etc.). Although the receptors for the senses are located in the peripheral nervous system, the problem appears to stem from neurological dysfunction in the central nervous system.

Sensory integration refers to the accurate interpretation of sensory stimulation from the environment by the child’s brain. Conversely, sensory integrative dysfunction is a disorder in which sensory input is not organized appropriately in the brain, thus producing varying degrees of problems in development, information processing, and behavior.

Sensory integration focuses primarily on 3 basic senses: (1) proprioceptive, (2) vestibular, and (3) tactile. Their interconnections start forming before birth and continue to develop as the child matures and interacts with his environment. These 3 senses are also connected with other systems in the brain, and even though they are less familiar than other senses (i.e., taste, smell, sight, and hearing), they are critical to basic survival.

==> Preventing Meltdowns and Tantrums in HFA Children

Dysfunction within these 3 senses manifests itself in many ways. For example, the child:
  • has an activity level that is either unusually high or unusually low
  • is in constant motion or fatigues easily 
  • is over- or under-responsive to sensory input
  • becomes impulsive, easily distractible, or shows a general lack of planning
  • experiences gross and/or fine motor coordination problems
  • has difficulty adjusting to new situations and may react with frustration, aggression, or withdrawal
  • has speech and/or language delays

Let’s look at each of these 3 senses in greater detail...

Proprioceptive—

The proprioceptive system refers to components of muscles, joints, and tendons that (a) provide the child with a subconscious awareness of her body position, which is automatically adjusted in different situations (e.g., sitting properly in a chair, stepping off a curb smoothly, etc.), and (b) allow the child to manipulate objects using fine motor movements (e.g., writing with a pen, using a spoon, buttoning a shirt, tying shoe laces, etc.). In addition, proprioception involves motor planning, which is the ability to plan and execute different motor tasks.



Some common signs of proprioceptive dysfunction include the following:
  • tendency to fall
  • resistance to new motor movement activities
  • odd body posturing
  • minimal crawling when young
  • lack of awareness of body position in space
  • eating in a sloppy manner
  • difficulty manipulating small objects (e.g., buttons, snaps)
  • clumsiness

Therapy may include:
  • bouncing on a trampoline or a large ball
  • skipping or pushing heavy objects
  • wearing weighted belts
  • weighted blankets
  • weighted vests

Vestibular—

The vestibular system refers to structures within the inner ear that detect movement and changes in the position of the head (e.g., tells the child when his head is upright or tilted, even with the eyes closed).

Dysfunction within the vestibular system may manifest itself in two different ways:
  1. Hyposensitivity: The HFA youngster may actively seek very intense sensory experiences (e.g., excessive body whirling, jumping, spinning, etc.). This type of youngster demonstrates signs of a hypo-reactive vestibular system (i.e., he is trying constantly to stimulate himself).
  2. Hypersensitivity: The youngster may (a) be extremely susceptible to vestibular stimulation; (b) have fearful reactions to ordinary movement activities (e.g., swings, slides, inclines, ramps. etc.); (c) have trouble learning to climb or descend stairs or hills; (d) be apprehensive about walking or crawling on uneven or unstable surfaces; and (e) appear clumsy.

Therapy can include:
  • cartwheels
  • dancing
  • hanging upside down
  • rocking chairs
  • rolling
  • somersaulting
  • spinning
  • swings

All of these actions involve the head moving in different ways that stimulate the vestibular system. The therapist will observe the youngster carefully to be sure the movement is not over-stimulating. The most stimulating movement tends to be rotational (i.e., spinning) and should be used carefully by the therapist. Merry-go-rounds, being tossed on to cushions, or jumping on trampolines can be favorite activities with some HFA kids. Back and forth movement is typically less stimulating than side-to-side movement. A rocking motion will usually calm a youngster, while vigorous motions like spinning will be stimulating. Ideally, therapy will provide a variety of these movements.




 ==> Discipline for Defiant HFA Teens

Tactile—

The tactile system includes nerves under the skin's surface that send information to the brain (e.g., light touch, pain, pressure, temperature, etc.), which plays an important role in perceiving the environment – and protective reactions for survival.

Dysfunction in the tactile system can be seen in the following:
  • avoiding getting one's hands dirty (e.g., with glue, sand, mud, finger-paint, etc.)
  • complaining about having one's hair or face washed
  • refusing to eat certain textured foods 
  • refusing to wear certain types of clothing
  • using one's finger tips rather than whole hands to manipulate objects
  • walking with heels of the feet off the floor
  • withdrawing when being touched

A dysfunctional tactile system can lead to a misperception of touch and pain, and may lead to self-imposed isolation, general irritability, hyperactivity, and distractibility. Tactile defensiveness is a condition in which the child is extremely sensitive to touch, which can result in behavior problems, inability to concentrate, and negative emotional response to touch sensations.

Therapy may include the following:

For HFA kids who enjoy the feel of sticky textures, the therapist may use certain materials (e.g., glue, stickers, play dough, rubber toys, sticky tape, water, beans, rice, and sand). On the other hand, kids who are very sensitive to touch may go through a brushing program that attempts to desensitize them to touch by systematically brushing their body at regular intervals throughout the day.

Some HFA kids enjoy a sense of firm overall pressure. This can be provided by weighted blankets, weighted belts, being squeezed by pillows, and firm hugs. Also, making tunnels or tents from blankets over furniture can be soothing to these “special needs” children.

Other therapeutic approaches for HFA children with dysfunctional sensory systems may include the following:
  • Difficulty with using both sides of the body simultaneously can occur in some of these young people. The therapist may encourage the youngster with hopscotch, crawling, skipping, playing musical instruments, playing catch, or bouncing balls with both hands to help with bilateral integration.
  • Hand and eye coordination can be improved with activities such as popping bubbles, hitting a ball with a bat, beanbags and balloons, and throwing/catching balls. 
  • Skills such as riding a bike or tying shoe laces can be difficult for some HFA children, because they involve sequences of movements. Therapy to help in this area may include obstacle courses, swimming, mazes, constructional toys, and building blocks.

Evaluation and treatment of sensory integrative dysfunction is performed by an occupational and/or physical therapist. The therapist's general goals are to: 
  • assist the youngster in inhibiting and/or modulating sensory information
  • assist the youngster in processing a more organized response to sensory stimuli
  • provide the youngster with sensory information which helps organize the central nervous system

Sensory processing functions on a continuum. Everyone has difficulty processing certain sensory stimuli (e.g., a certain touch, taste, smell, sound, movement etc.) – and everyone has sensory preferences. Processing difficulties only become a Sensory Processing Disorder when an individual is on extreme ends of the continuum or experiences disruptive, unpredictable fluctuations which significantly impact developmental skills and everyday functioning.

If you believe your HFA child may be experiencing some form of sensory integration dysfunction, ask your child’s doctor for a referral to an occupational and/or physical therapist for treatment.

 
 
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Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

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16 Simple Ways to "Prevent" Meltdowns in Kids on the Autism Spectrum

"Is there a way for parents of children with ASD to prevent meltdowns from happening in the first place? I ask because once my autistic son (level 1) gets up a head of steam, there's no way of getting him to calm down."

It is much easier to prevent meltdowns than it is to manage them once they have erupted.

Here are 16 tips for preventing meltdowns and some things parents can say to their high-functioning autistic children:


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

2. Signal kids on the autism spectrum 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.”

3. Reward them 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.”

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

5. Make sure that kids on the spectrum 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.”

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

6. 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.

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

8. 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.

9. Give them 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?”

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

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

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

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

14. Choose your battles. Teach these "special needs" children 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.”

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

16. Avoid boredom. Say, “You have been working for a long time. Let’s take a break and do something fun.”
Resources for parents of children and teens on the autism spectrum:
 
By

Effective Social Interventions and Supports for Children on the Autism Spectrum

Kids and teens with Asperger’s (AS) and High-Functioning Autism (HFA) often have difficulty understanding social situations, which can cause stress and anxiety. Social situations that seem to be most problematic include:
  • Interpreting nonliteral language (e.g., idioms and metaphors)
  • Knowing how and when to use turn-taking skills (e.g., focusing on the interests of peers)
  • Recognizing that others' intentions do not always match their verbalizations
  • Understanding facial expressions and gestures
  • Understanding the “hidden curriculum” (i.e., those complex social rules that often are not directly taught)

Even when a youngster with AS or HFA receives effective instruction in social skills, situations will arise that require “interpretation.” Unless interpreted, these situations become a source of stress and do not support future learning. However, with interpretation, perceptions of seemingly random actions can be altered into meaningful interactions. Interpretive strategies include:
  1. the Situation-Options-Consequences-Choices-Strategies-Simulation (SOCCSS) strategy
  2. the Power Card
  3. Social Autopsies
  4. Cartooning





Situation-Options-Consequences-Choices-Strategies-Simulation—

One interpretive technique, the Situation, Options, Consequences, Choices, Strategies, Simulation (SOCCSS) strategy, was developed to help AS and HFA kids with social interaction problems put interpersonal relationships into a sequential form. It helps them understand problem situations and lets them see that they have to make choices about a given situation, with each choice having a consequence. The steps of SOCCSS are:

1. Situation: When a social problem arises, the parent or teacher helps the youngster to understand the situation by first identifying:
  • who was involved
  • what happened
  • the date, day, and time of occurrence
  • reasons for the present situation

2. Options: The youngster, with the assistance of the parent or teacher, brainstorms several options for behavior. At this point, the parent or teacher accepts all of the child’s responses and does not evaluate them. This step encourages him or her to see more than one perspective and to realize that any one situation presents several behavioral options.

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

3. Consequences: Then the youngster and parent or teacher work together to evaluate each of the options generated. The parent or teacher is a facilitator, helping the youngster to develop consequences for each option rather than dictating them.

4. Choices: The youngster selects the option(s) that will have the most desirable consequences for him or her.

5. Strategy. Next the youngster and parent or teacher develop an action plan to implement the selected option.

6. Simulation: Finally the youngster is given an opportunity to role-play the selected alternative. Simulation may be in the form of:
  • writing a plan
  • visualization
  • talking with a peer
  • role play

The SOCCSS strategy offers many benefits to the AS or HFA child. It allows him or her to:
  • understand that many options may be available in any given situation
  • realize that each option has a naturally occurring consequence
  • develop a sense of empowerment by acting on the environment (i.e., these children realize that they have choices, and by selecting one, they can directly determine the consequences of their actions).

The Power Card—

Figure 1 - Click to enlarge
The Power Card is a visual aid that helps AS and HFA kids and teens make sense of social situations, routines, and the meaning of language. The Power Card uses their “special interests” to help them make sense of a specific situation and motivates them to engage in a targeted behavior.

In using this strategy, the parent or teacher develops a brief script written at the youngster's level of comprehension, which details a problem situation or a target behavior and its relationship to the youngster's special interest. Power Cards also provide a solution, relying on the youngster's special interest. This solution then is generalized back to the youngster. A card the size of a business card or trading card containing a picture of the special interest – and a summary of the solution – can be carried with the youngster to promote generalization.

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

The Power Card can be carried in a pocket, purse, or wallet, or it can be velcroed inside a book, notebook, or locker. It also may be placed on the corner of the youngster's desk. Figure 1 provides an example of a Power Card for a 6-year-old female student with HFA who had problems focusing. Her special interest was Dora the Explorer.

Social Autopsies—

Figure 2 - Click to enlarge
This technique was created to help AS and HFA children with severe learning and social problems to develop an understanding of social mistakes. In the traditional sense, an autopsy is the examination and inspection of a dead body to discover the cause of death, determine damage, and prevent recurrence.

Similarly, a social autopsy is an examination and inspection of a social error to discover the cause of the error, determine the damage, and prevent it from happening again. When a social mistake occurs, the youngster meets with the parent or teacher to discuss it.

Together, in a non-judgmental way, they identify the mistake. Then they discuss who was harmed by the error. The final step of the autopsy is to develop a plan to ensure that the error does not occur again. Figure 2 is an example of a social autopsy worksheet.
Cartooning—
Figure 3 - Click to enlarge

The visual area is a strength for kids on the autism spectrum. Therefore, visual systems often enhance their ability to understand their environment. One type of visual support is cartooning. This strategy has been implemented by speech/language pathologists for many years to enhance their clients’ understanding.

Cartoon figures play an integral role in a number of other intervention techniques (e.g., pragmaticism, mind-reading, and comic strip conversations). Each of these strategies promotes social understanding by using simple figures and other symbols (e.g., conversation and thought bubbles) in a comic strip-like format. This visual representation of a conversation helps AS and HFA kids analyze the social exchange.

Although cartooning has limited scientific verification, some evidence suggests that learners with AS and HFA may be good candidates for social learning based on using a comic format to dissect and interpret social situations and interactions. Figure 3 provides a cartoon depicting a social interchange.


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
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Problems with "Disruption of Routine" in Kids with Asperger’s and HFA

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Parents' Problem-Solving Skills for Hostile Teens with Autism Spectrum Disorder

“My wife and I are struggling dealing with our angry, increasingly aggressive 14 yr old son with high functioning autism. He's now refusing to hand over his electronics at night and shouting occurs. He is testing the boundaries, of course, but physical confrontation is something we don't know how to cope with.”

Addressing hostility and aggressiveness in teens with Asperger’s (AS) and High-Functioning Autism (HFA) can be a frustrating and demanding process. The challenge for parents and teachers is to address the behavior in a constructive manner, rather than simply reacting to it.

When AS and HFA teens are exhibiting hostile behaviors, it is often a sign that they are not receiving adequate support in mastering their environments, both at home and school. In addition, their aggressiveness does not necessarily reflect willfulness, rather they lack the social skills needed to “fit-in” and to be accepted by others – especially their peers.



What makes AS and HFA teens act-out may lie in the way they process social information, including what aspects of the social environment they pay attention to, and how they interpret what they perceive. These “special needs” teens need help in altering the way they process social information so that they do not view hostility as justified or useful.

The development of an “emotions vocabulary” is an important component in addressing aggressive behaviors so that feelings can be put into words leading to social skills development, identifying feelings, fostering cooperation, emphasis on empathy, discussions of future desires, conflict resolution, and assertive communication.

If the AS or HFA adolescent is acting-out, it is irrational for parents and teachers to assume that he knows more favorable alternatives. If adults are always telling this adolescent what NOT to do, when are they telling him what he SHOULD be doing and helping him to learn how?

Why Teens with Asperger's and HFA Can Be Moody and Depressed--




 ==> Disciplinary Strategies for Asperger's and HFA Teens


Teaching Problem-Solving Skills—

Developmental deficits in cognitive processes are often associated with aggressive behavior, and social development requires mastery of cognitive and behavioral skills for communicating with others, assessing social circumstances, and resolving conflicts without aggressiveness. These skills empower AS and HFA teens to make friends and flourish socially.

Teaching problem-solving skills is useful in addressing hostility and aggressiveness in these adolescents. Below are 6 effective steps to teaching problem-solving skills. Each step requires different approaches to discovering - and linking - the missing skills in social situations.

Step 1: Help the teen to attend to social cues that are often missed or misinterpreted.

Methods: 
  • Help the teen identify his own feeling states through self-report and observation.
  • Enhance sensitivity to verbal and nonverbal social cues through games and role play, teaching the teen to identify social cues in body language and pitch of voice.
  • Have the teen make a video of his own nonverbal cues, and then have him explain his feelings on the basis of cues demonstrated in the video (e.g., hand gestures, facial expressions, voice intonation, and other indicators of social intent).

Step 2: Help the teen to assign meaning to social cues. This step is necessary because hostile teens commonly interpret neutral interactions as threatening – and then respond defensively. Unlike “typical” teenagers, AS and HFA teens do not intuitively know how to exhibit socially acceptable behavior, and the level of their required assistance depends on the social supports they have previously encountered.

Methods: 
  • With the help of videotapes of social encounters, the teen should be taught to identify the sources of the problems and the feelings of participants with emphasis on correctly identifying friendly and neutral – as well as hostile – intent on the part of others.
  • The teen should learn to identify and classify social cues by friendly, neutral, and hostile categories of intent. The teen can practice by assuming the roles of his peers in disputes.

Step 3: Help the teen to define goals that enhance social relationships with an awareness of the consequences of behavior.

Methods: 
  • Brainstorming example: The teen is rewarded for having ideas about goals for various situations. Goals can be rated as to whether they are likely to enhance or damage interpersonal relationships with peers.
  • The teen should be given opportunities to practice identifying and fitting pro-social goals to various situations.

 ==> Disciplinary Strategies for Asperger's and HFA Teens

Step 4: Help the teen to develop ideas about how to respond to each social circumstance he encounters. This step is necessary because compared with “typical” teens, AS and HFA teens identify fewer alternatives and seem unaware of the various options that may be open to them when confronted by a social problem. These “special needs” teens need help identifying their options and possible outcomes (this is why constantly telling them what they are doing wrong does not increase the likelihood of improved future performance).

Methods: 
  • Help the teen to develop skills to control arousal and to generate behavioral responses in which anger and use of force are only two of many response possibilities.
  • Help to increase the teen’s skill in identifying alternatives to the use of force to solve social problems.

Step 5: Help the teen to assess likely outcomes of potential responses and to select a response that can be initiated given the limitations of the situation. Compared to non-hostile teens, hostile ones tend to evaluate pro-social responses less favorably. Thus, they are not behaving a certain way to purposely hurt those around them, rather they are simply making decisions based on social skills deficits.

Methods: 
  • Evaluation of each alternative: The teen should be given opportunities to discuss likely gains and losses associated with each identified alternative in specific social situations.
  • Like goals, gains may be described as short and long term, material and social, or affective and concrete.
  • In addition to benefits, look at costs (i.e., negative outcomes) of each alternative.

Step 6: Help the teen to implement a response. This step is where a teen with hostile tendencies joins a group, negotiates deals, offers and/or receives positive feedback, and bargains for the exchange of social opportunities by implementing a strategy from previous steps. Practicing this step will be intimidating and challenging for the AS or HFA teen. Any attempts – successful or not – should be praised and reviewed to identify areas of strength as well as need for improvement.

The development of problem-solving skills includes the AS or HFA teen as a contributor in planning and execution. Thus, be sure to include his input in all the steps listed above. The methods described are something you are doing WITH the teen, rather than TO him. Addressing hostility in these “special needs” young people demands an understanding of their perspective. Any approach to correcting hostility that does not include the teen himself is not going to have long-term benefits.

Behind every behavioral problem is a skill deficit – and a need to acquire that skill. Identifying with whom, over what, where and when behavioral problems occur will highlight specific circumstances so that appropriate problem-solving skills can be taught. Including the teen in the plan to address his aggression and hostility is allowing him to be assertive in a positive way; it gives him a sense of control that is often craved when he is lacking a skill and acting-out aggressively.
 

 
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Understanding Meltdowns in Children with Level 1 Autism

"I'd like to figure out what causes my child's meltdowns. She's autistic (level 1) and is getting more out-of-control lately. My suspicion is that she is dreading going back to school (starts 5th grade). We had several bad experiences last year, and she may be thinking that it's going to be more of the same this year - IDK."

Level 1 Autism, or high-functioning autism, is a neurological condition. The brain is wired differently, making this disorder a lifelong condition. It affects communication, social interaction and sensory issues.

Level 1 Autism is often referred to as the "invisible disorder" because of the internal struggles these kids have without outwardly demonstrating any real noticeable symptoms. Thus, difficultly assessing someone with Level 1 Autism is even more impacted.



Kids with high-functioning autism and Asperger's struggle with a problem and internalize their feelings until their emotions boil over, leading to a complete meltdown. These outbursts are not a typical temper tantrum. For children with Level 1 Autism (and for their parents), these episodes are much worse.

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

Many Level 1 Autistic kids may appear under-receptive or over-receptive to sensory stimulation and therefore may be suspected of having vision or hearing problems. Therefore, it's not unusual for parents or teachers to recommend hearing and vision tests. Some kids may avoid gentle physical contact such as hugs, yet they react positively to rough-and-tumble games. Some Level 1 Autism kids have a high pain tolerance, yet they may not like to walk barefoot in grass.

There are nine different types of temperaments in Level 1 Autistic children:
  1. Distractible temperament predisposes the child to pay more attention to his or her surroundings than to the parent.
  2. High intensity level temperament moves the child to yell, scream, or hit hard when feeling threatened.
  3. Hyperactive temperament predisposes the child to respond with fine- or gross-motor activity.
  4. Initial withdrawal temperament is found when children get clingy, shy, and unresponsive in new situations and around unfamiliar people.
  5. Irregular temperament moves the child to escape the source of stress by needing to eat, drink, sleep, or use the bathroom at irregular times when he or she does not really have the need.
  6. Low sensory threshold temperament is evident when the child complains about tight clothes and people staring and refuses to be touched by others.
  7. Negative mood temperament is found when children appear lethargic, sad, and lack the energy to perform a task.
  8. Negative persistent temperament is seen when the child seems stuck in his or her whining and complaining.
  9. Poor adaptability temperament shows itself when children resist, shut down, and become passive-aggressive when asked to change activities.

Some meltdowns are worse than others, but all leave both parent and kid exhausted. Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it ends, both you and your child are totally exhausted. But… don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day, and sometimes into the next, the meltdown can return full force.

Meltdowns are overwhelming emotions and quite common in Level 1 Autistic kids. They can be caused by anything from a very minor incident to something more traumatic. They last until the kid is either completely exhausted, or he gains control of his emotions, which is not easy for him to do.

If your child suffers from Autism, expect her to experience both minor and major meltdowns over incidents that are part of daily life. She may have a major meltdown over a very small incident, or may experience a minor meltdown over something that is major. There is no way of telling how she is going to react about certain situations. However, there are some ways to help your daughter learn to control her emotions.

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

Autistic children don’t really have the knowledge to decipher when their actions are inappropriate. When your daughter is calm and relaxed, talk to her about her meltdowns if she is of an age where she can reason and learn to work with you. This will probably not be until the kid is seven or eight years old. Then, tell her that sometimes she does things that are not appropriate. Have her talk to you about a sign you can give her to let her know when this happens.

All you can do is be patient with your daughter while she is having a meltdown, though they are emotionally exhausting for you as well as he. Never punish her for experiencing a meltdown. Overwhelming emotions are part of the Autism traits, but if you work with your daughter, she will eventually learn to control them somewhat.

Level 1 Autistic kids don’t like surprises and some don’t like to be touched. Never rush to your daughter and give her a hug. If you want to hug her, tell her exactly what you are going to do. A surprise hug can send her into an even worse meltdown than she is already experiencing.

These young people like to be left alone to cope with emotions. If your daughter says something like, “I just want to be left alone,” respect her wishes for at least a while. You can always go back in ten minutes and ask if you can help. Do not be hurt if she refuses.

Work with your daughter as she grows older to help her learn to cope with daily life. Remember, she sees the world much differently than we do and needs help deciphering exactly how we see the world. While working with her on this, she will give you clues as to how she sees the world and a firmer bond will be established.

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

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Autistic Children and Their Abnormal Reaction to Pain and Discomfort

As parents of kids with high-functioning autism, we may be familiar with the mystery of their unequal reaction to pain and discomfort. A stubbed toe or paper cut may set off a disproportionate pain response (e.g., hysterical crying or screaming). 
 
But, a burst ear drum or broken arm may go seemingly unnoticed. As moms and dads of kids on the spectrum, we may be baffled by this unequal response to pain stimuli. Anecdotal evidence from parents worldwide is full of reports on this topic.

Some of the perplexing behaviors that such children exhibit include: 
  • Crashing into walls and/or people
  • Having an unusually high or low pain threshold
  • Putting inedible things (e.g., rocks, paint) into their mouth
  • Screaming if their face gets wet
  • Throwing tantrums when parents try to get them dressed

These and other abnormal behaviors may reflect sensory processing problems in which the high-functioning autistic child is overwhelmed because of difficulty integrating information from the senses. Sensory processing issues are considered a symptom of the disorder because the majority of kids on the spectrum also have significant sensory problems.



One response to being overwhelmed is to flee. For example, if a high-functioning autistic youngster dashes across the street (oblivious to the danger), it should be a “red flag” that he may be heading away from something distressing (which may not be apparent to the mother or father), or toward an environment or sensation that will calm his system. Many kids on the spectrum gravitate toward the sensations and environments they find calming or stimulating. However, their self-regulation is lacking, so safety takes a back seat to their need to get a calming experience (e.g., jumping in a pond, sometimes resulting in drowning).

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

This fight-or-flight response is why a child with sensory problems will shut down, escape the situation quickly, or become aggressive when in sensory overload. The child is having a neurological panic response to everyday sensations that “typical” kids take for granted.

So, what is behind this perplexing dilemma? The answer has to do with dopamine levels.

“Typical” (i.e., non-autistic) people are physiologically equipped to limit the amount of stimuli entering their brain, thus preventing the brain from becoming overloaded. However, people with autism have a hyper- or hypo-sensitivity to stimuli (i.e., they are either under-stimulated or over-stimulated).

The enzyme “dopamine beta hydroxylase” (DBH) is released from nerve endings during “stimulation” via the five senses (i.e., touch, sight, taste, smell, sound). 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 research has shown that people with autism have much higher levels of DBH in their system than found in “ordinary” people. The presence of this enzyme is also linked to certain behaviors (e.g., repetition, agitation, aggression, etc.).

Repetitious activity (e.g., rocking, flapping, pacing, etc.) results in the release of endorphins through the system. Endorphins reduce the sensation of pain and have the ability to block pain. Through the use of repetitious activity, kids on the spectrum have the ability to purposely (but unknowingly) overload their sensory system in order to shut it down completely.

Blocking out all sensation by the production of endorphins may seem like an easy way to cope with sensory over-stimulation; however, in caring for autistic kids, parents need to realize that reaction to ALL sensation becomes limited. Such children may not recognize hunger, tiredness, body temperature (which carries with it the risk of overheating), a full bladder or bowel, pain, etc.

They display agitation through use of repetitious behaviors (e.g., rocking, flapping, pacing, head-banging, staring, screaming, spinning, chanting, humming, etc.). The parents’ job is to recognize these signals of agitation. These repetitive behaviors are used to block out over-stimulation from the environment, certain emotions, and responses to pain. The behaviors also may serve to calm the youngster (if their use is monitored rather than unlimited).

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

For high-functioning autistic kids, the build-up of these endorphins throughout the day also needs to be taken into consideration. This is why those children who have accidents may not show pain or appear 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. Thus, exercise (e.g., walking, running, swimming, etc.) is extremely beneficial in the youngster's daily routine as a preventative measure. Exercise may be used during periods of agitation to help calm the youngster. In this way, it is used to develop an appropriate social responses (e.g., it is more acceptable to jump on a trampoline rather than on the furniture).

Parents should monitor their 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 the child will miss much of what he or she is supposed to be learning from the environment. Also, parents need to realize that these repetitive behaviors have social consequences for kids with high-functioning autism. 
 
They are a visual reminder that these young people are different from their “typical” peers. Parents should take into account the youngster's socializing skills and ability when monitoring and setting limits on the use of repetitive behaviors (e.g., tell him or her the times and places when repetitive behaviors are acceptable, for controlled periods of time).

Parents do not need to eliminate sensory stimulation in order to protect their youngster. Without stimulation, the world will become meaningless to the child. Instead, parents should attempt to provide their child with a safe sensory environment (e.g., dim lights, softer noises and voices, reduced odors, etc.), thus giving him or her the opportunity to learn and respond appropriately to the environment.


More resources for parents of children and teens on the autism spectrum:
 
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Fretfulness in Kids on the Autism Spectrum

“My youngest child has high functioning autism and has been officially diagnosed with anxiety disorder. She is clearly a child who reacts to stress with anxiety, constantly fretting about something which then often converts to meltdowns. Anyone else having this issue, and what do you think might help in situations like this?”

The benefit of being a kid is not having a care in the world, yet for many children with ASD or High-Functioning Autism, worry is a reality and something that takes a toll on the joy of childhood. What’s even more alarming is that many moms and dads are completely unaware that their “special needs” child is even feeling this way.

Most children will experience worry at some point. For example, your youngster may have repetitive, exaggerated thoughts such as, “What if I fail English?” …or “What if no one likes me?” He may fear that someone will hurt him or his family, or he may become excessively worried at bedtime, at school, or in social situations. This is O.K. to an extent, because a small amount of apprehension can actually help prepare children to handle tough situations later on in life. 

The difference between normal worry and an Anxiety Disorder is the severity of the worrying. Although feeling fretful is a natural reaction to a stressful or dangerous situation, an AS or HFA youngster may need help if her fretfulness is out of proportion, if it persists, or if it interferes with her life and healthy development.



It's always painful to watch a youngster suffer from stress and worry, but it's especially difficult if you're not sure whether he is worrying “too much” and in need of assistance. So, how do you know if your youngster’s worries are cause for concern? Here are some signs that your child is a chronic worrier:
  • An ASD youngster who is overwhelmed by worries may not realize that those worries are unrealistic or exaggerated, and she may not express them – except by her behavior. For example, if she's fretful that something could happen to her mother or father, she may have trouble separating or falling asleep.
  • The youngster may say negative things, such as “I’m no good” …or “I hate myself” … or “I can’t do this.”
  • The youngster may have excessive concerns or irrational fears, complain of stomachaches, be nervous at school or refuse to go all together, be afraid to go to sleepovers or birthday parties, or have frequent headaches.
  • Kids who have severe angst will try to avoid the things that trigger it. For example, anxiety may be the culprit if the youngster spends a great deal of time in the school nurse's office, refuses to participate in activities other kids enjoy, throws a tantrum before every appointment with the dentist or doctor, or gets sick on Sunday nights due to worrying about going back to school on Monday morning.
  • If the youngster can't stop fretting about germs or getting sick, she may seek constant reassurance or wash her hands obsessively.

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

All kids want to be reassured, and they want to know they will be safe. Some need extra reassurance. If this is the case, routines and traditions can help calm these children. However, many autistic kids will not be calmed by the parent’s answers. It doesn’t matter how many times the parent reassures them or how many times they check on them, they still fret. Kids who have these kinds of worries often struggle in other situations, too. For example, they may not want to meet new peers or go to other’s homes because of their worries (e.g., “What if I need something?” …or “What if I don’t know what to do?”).

Obsessive-Compulsive Behaviors and Anxiety in Kids on the Autism Spectrum 




How to help the fretful ASD child:

1. Set aside a designated time for your child to fret. This is called “fret time.” If he frets about many things throughout the day, pick a special time for it. Set aside 10 minutes where your youngster can talk about his worries, or he can write his worries on paper and share them with you. Also, try to eliminate all distractions during “fret time.” If your youngster starts to fret at some time other than “fret time,” he can say to himself, “Stop. That is for my fret time.” Then he should do something else to distract himself. As a mother or father, you may need to help your youngster remember to wait for “fret time” by saying something like, “Save that for fret time. We’ll talk about it then. For now, how about playing a video game?”

2. Create a “fret jar.” Have your youngster picture a ‘jar with a lid’ in her mind. This is a “fret jar.” If she starts to fret, she can imagine opening the jar, putting the worrisome thought in the jar, screwing the lid on tightly, and sealing the worry there. Alternatively, you can create a real “fret jar” rather than an imaginary one, and encourage your youngster to write the anxiety-inducing thought on a piece of paper and put it in the jar. Then, she can talk about the worry during “fret time.” You can help with some techniques and ways to deal with the concern at that time.

3. Don’t allow your youngster to avoid everything that worries her. Fretfulness tends to peak at the beginning of a new or scary situation, then eases off. If parents can help their youngster get through the initial stage of high stress, she’s likely to have a positive experience, which will make it easier the next time.

4. Don’t model “excessive caution.” Overly-cautious moms and dads are likely to say things, such as “Be careful on the swing because you might fall and hurt yourself” without realizing that they are increasing the youngster’s fretfulness. It’s better to say confidently, “I’m sure you’ll have fun on the swing. I’m right over here if you need me.”

5. Increased exposure to the stressful situation is an effective strategy for overcoming anxiety.  For example, if your youngster is afraid of cats, start out by showing him pictures of cats, then visit an animal shelter, then go to someone’s house where they have cats, and finally, have your child pet a cat.  The important idea here is to take small steps and gradually expose your youngster to the fear.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism
 
6. Help your youngster put the worry outside of himself. It can help him to think of himself as being separate from the worry. For example, have him picture the worry as a funny looking monster. Help him create the image (e.g., furry with claws, a blob with a big mouth, etc.), and then have him draw a picture of the monster. Next, remind him to visualize the “worry monster” as something that is outside of himself. When your youngster starts to fret, he can picture the monster and can do something about it (e.g., talking back, standing up to it, etc.). Also, have him write down things to say to the “worry monster” (e.g., Get away! I don’t like you! Stop that!). The first few times your youngster does this, the monster will return. When this happens, he should repeat his message in a firm voice (either in is mind or aloud), or he can imagine catching the monster in a net and kicking it out of the house.

7. Help your child to find a distraction when he is in a state of anxiety. Being involved with some activity is key in keeping away worries. The way our minds are, we can’t be relaxed and stressed at the same time. This can be a powerful tool for helping children on the autism spectrum to keep worries away. If your youngster is drawing, reading, or playing a video game, there is little room for the “worry monster” to pester him. Your youngster may not feel like reading a book, for example, but help him understand that being active will help. He may have to force himself to get busy with some activity. As kids realize that staying busy helps keep worries away, it will be easier to want to engage in fun activities. Also, make a list of distracting activities to do (e.g., draw a picture, help dad with yard work, play a game, play music, read, run up and down the stairs, sing a song, take a pet for a walk, etc.), and post the list in a prominent place for all to see.

8. Never try to convince your youngster that her anxiety is unjustified. She’ll just become more convinced otherwise as she tries to prove to you that her worries are real. Instead, help her think about things realistically. For example, if she is worried that you might die, say something like, “Daddy is very healthy. I take good care of myself. I will be living a very long time.”

9. Practice deep breathing with your youngster at bedtime to provide her with a technique to use under stress (e.g., take a deep breath, hold it for a count of three, exhale through the mouth, then repeat). However, bear in mind that it won’t work to introduce deep breathing in the middle of a stressful situation. Your youngster needs to practice so that it becomes a natural response.

10. Don’t chastise your youngster for worrying or resisting something because he’s afraid. He needs your support and reassurance. However, excessive reassurance (e.g., delivering a constant stream of “You’ll be OK” …or “You can do it” …or “There’s nothing to worry about) can make your youngster feel even more fretful. So, don’t offer a bunch of false reassurance.

11. Use social stories, games and puppets to help your youngster learn to relax and manage stress and anxiety.

12. If all else fails, seek support and counsel from a professional who works with children on the autism spectrum.




If you’re concerned that your youngster’s worry is excessive, it’s important to recognize how often he or she experiences distress, how much anxiety it causes, and if it interferes with his or her everyday activities. The crucial issue is not that children worry; rather, it’s the combination that they worry – and it impairs their functioning. By using some of the tips listed above, you can help keep your child’s fretfulness to a minimum.

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

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

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Resources for Neurodiverse Couples:

 ==> Cassandra Syndrome Recovery for NT Wives

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Pressed for time? Watch these "less-than-one-minute" videos for on the go.

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The 6 Most Important Things Parents Can Do for Their Child with Asperger’s or High-Functioning Autism

“We recently got a diagnosis of high-functioning autism for our 6 y.o. son. After researching all the interventions that are recommended, my husband and I are feeling quite overwhelmed. Our son has so much to work on, and we simply don’t know where to begin. Please give us a starting point so we’ll know if we’re on the right path or not. We desperately want our son to be as happy and ‘functional’ as possible.”

Being a parent of a youngster with Asperger’s (AS) or High Functioning Autism (HFA) is both exhausting and rewarding. Whenever you feel confused, apprehensive or worried, know that you are not alone. The good news is this: armed with just a few simple “tools,” your course-of-action can run relatively smoothly.

Although there are many techniques parents will need to employ to successfully raise a child on the autism spectrum, here are the 6 most important ones to consider first:

1. Analyze your AS or HFA youngster’s strengths and weaknesses – and find the right tools to help him or her.

Think about what you know about your youngster before selecting any treatment options. Each youngster on the spectrum is different – there is no “one-size-fits-all” when it comes to interventions. What works wonderfully for one child may backfire drastically for another. Count on the fact that there will be some trial-and-error as you search for the right approach to dealing with your child’s challenges. As you stay the course, there will be clues and indicators of what will work best for YOUR child.

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

Pay close attention to your parental instincts. Just because you heard something worked for someone you know - and their youngster got much better - does NOT mean that the same intervention will work for your child. You will have the most success if you know your youngster’s strengths and weaknesses, and find a combination of techniques that are a good match for him or her.

2. Understand that your youngster will NOT know what to expect in social situations. So, teach him or her what to expect in various situations in a very clear and precise manner.

Imagine how a pajama party might seem to a child who has never been to one (e.g., kids running around laughing and jumping, popcorn all over the place, pillow fights, trying to sleep on the floor rather than in your own bed, and so on). Imagine how it would feel to go to your first day of elementary school when you’re around 30 other kids, you don’t know where the bathroom is, you don’t know how to ask the other kids if you can play with them, you’re not sure how to interact with peers in the unstructured environment of lunch time and recess, and so on.

Kids on the autism spectrum have social skills deficits. Thus, they do best when placed FIRST into social situations that interest them and have plenty of structure. As your child ages, expose him to more social situations, and provide him with information about what to expect and how to behave. For example, if your child is meeting his teacher for the first time, let him know exactly what it involves (e.g., going to the school, walking into the classroom, saying “Hi, my name is Max”, shaking the teacher’s hand, making eye contact, listening to the teacher introduce herself, and answering any questions she may have). Never feel that you are breaking things down too far for your AS or HFA child. The more detailed and concrete your instruction – the better!

3. Find activities that your AS or HFA youngster is highly interested in, and help him cultivate friendships within those activities.

Children on the spectrum have difficulty finding and keeping friends. For instance, Michael (a 6-year-old) is friends with James (also 6 years old). Michael has HFA and does not like to be in large groups of people. Michael likes soccer, but James likes to talk to his friends. Michael often becomes frustrated and is not sure what to say when James is around. Michael doesn’t read social cues, doesn’t know how to get into the conversation, and doesn’t like to talk about what James and his friends are talking about.

Because Michael enjoys soccer, finding a soccer team or class that he can attend regularly, and then role-playing and coaching him to help with social skills related to those relationships could evolve into people who know Michael and share an interest with him. In the future, those relationships will turn into friendships and into a network of advocates who will share Michael’s interests.

4. Become your child’s advocate.

As a mother or father, you’re the one who has spent the most time with your child, and you may have already figured out what works and what doesn’t (or are coming close to figuring it out). As an expert on your child, you may find yourself being his advocate all the time.

Much of this advocacy happens in the classroom. You’ll need to tell your child’s teacher what techniques work best, what triggers him, and what calms him down. If you find that the school system is just dragging your child along without actually educating him, you’ll need to advocate by talking to the principal, superintendent, or even a lawyer. It may take all of these people to get the school system to take your child’s education seriously.
 


5. Appreciate the benefits of consistency and routines.

Example: Shelley wakes up one morning and eats a bowl of cereal, brushes her teeth, gets dressed, then gets on the bus. The next morning, she wakes up and is surprised to find that she has to take a shower before getting dressed. She becomes agitated and has a meltdown. She starts slapping the wall and knocking stuff off of the counter on to the floor. Now all the kids are late to school – and stressed out!

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

By building in predictability when possible, your AS or HFA child does not have to find other ways to cope (e.g., meltdowns, tantrums, shutdowns, aggression, etc.). Of course, you can’t predict every situation in life, but having a core routine within the family, and preparing your “special needs” child for any upcoming change in routine, will cut down on family stress ten-fold.

In Shelley’s case, maybe she got extremely dirty the night before, but it was too late for her to take a shower. So, you had her get the shower the next morning before school. In this scenario, it would be important to tell her the night before what to expect the next morning. Preferably, you would make a schedule (written or with pictures) so she could visually see what to expect the next day.

Visual schedules are very important when changes in routines are necessary. However, be careful not to over-schedule the routine. Some kids on the spectrum become so dependent on their routines that it can be very upsetting to alter them when “life” happens. Thus, try to build adaptations and variations into your child’s regular routines. This will teach him to cope with the many changes in routines that happen all the time.

6. Take action as soon as possible.

Some therapists have reported working with kids 2 to 3 years old who were diagnosed very early with an autism spectrum disorder that looked like classic Autism (e.g., screaming, banging head into the wall, flapping arms all day with no initiation of communication, etc.) – but with early intervention and treatment, their symptoms fell more in line with high-functioning autism or mild Asperger’s by the time they were 5.

Kids who are already in elementary school and have never had services because the parents thought they were simply late talkers have missed the optimal time for intervention. Thus, the prognosis for improvement is less than ideal.

Parents must catch their child when he is very young and provide treatment. It’s better to help a child who would have been fine either way than to overlook him because you think he will “grow out of it.” Many therapists report working with children who are 5 years old, and the parent knew something was not coming together right for years. Getting help early works. Step through the fear and advocate for the services your youngster needs.

Conclusion–   

The initial period of learning about AS or HFA - and all of the necessary therapies and treatments - can be isolating. You may even feel sad at first, or angry that your life with a child on the spectrum is different than the one you dreamed of and different than the lives of most of those around you. Your ideal world will be very different from the world you actually live in. Still, there are many ways to work towards making your life more of how you want it to be.

As you begin to get more involved in the Autism community, there will be more activity and company of others. This involvement will help your situation feel more “normal” as it provides more chances for typical activity and interaction with others. Over time, life and ideals change, and you will begin to dream new dreams for your real world. 


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

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

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

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

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

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

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

The Severity Levels of Autism


RE: "What's the difference between level 1 autism and high-functioning autism?"

The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) specifies the severity levels of Autism as follows:

Level 1: Requiring Support—

• Social Communication: With supports in place, deficits in social communication cause noticeable impairments. Has difficulties initiating social interactions, and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. [Note: Level 1 autism is most commonly referred to as high-functioning autism.]

• Restricted Interests and Repetitive Behaviors: Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts. Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.

Level 2: Requiring Substantial Support—

• Social Communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with social supports in place; limited initiation of social interactions and reduced or abnormal response to social overtures from others.

• Restricted Interests and Repetitive Behaviors: RRB’s and/or preoccupations or fixated interests appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress or frustration is apparent when RRB’s are interrupted; difficult to redirect from fixated interest.

Level 3: Requiring Very Substantial Support—

• Social Communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning; very limited initiation of social interactions and minimal response to social overtures from others.

• Restricted Interests and Repetitive Behaviors: Preoccupations, fixated rituals and/or repetitive behaviors markedly interfere with functioning in all spheres. Marked distress when rituals or routines are interrupted; very difficult to redirect from fixated interest or returns to it quickly.



So as you can see, Level 1 would be considered high-functioning Autism. Disability will be common among children with Level 3 Autism and non-existent in Level 1 (where children currently diagnosed with Aspergers will be reclassified).

==> Parenting Children and Teens with High-Functioning Autism

The new method for diagnosing Autism replaces the five prior diagnoses: Asperger Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder, and Autistic Disorder. If a child has a pre-existing diagnosis of any of these disorders, he or she is automatically considered to have an Autism diagnosis. 

Children who are being newly diagnosed (or re-evaluated) and do not fit into the new criteria for Autism may receive a new diagnosis called Social Communication Disorder. This appears to be an extremely mild version of Autism (the child does not have sensory issues or repetitive behaviors) and is similar in many ways to the old PDD-NOS. 

The DSM-5 defines Autism as a single “spectrum disorder,” with a set of criteria describing symptoms in the areas of social communication, behavior, flexibility, and sensory sensitivity. If a child has symptoms in these areas, he or she will probably be diagnosed as “on the spectrum.” When a physician diagnoses a youngster with Autism, it's important to know the severity of the disorder. If the physician does give his/her opinion on the severity, it’s with the disclaimer that it’s only an opinion, not a medical diagnosis. Whether the opinion is that it's severe, or that it's mild, it has no bearing on the actual diagnosis. A youngster with Autism deemed as mild is just as autistic as one believed to be severe. The medical diagnosis for both is exactly the same.

Autistic kids have issues with social interactions, behavioral issues, restricted interests, self-stimulatory activities and sensory issues. So severity in each of these categories needs to be determined to assess severity as a whole. While the severity of Autism is not a diagnosis, physicians who specialize in Autism can tell where a youngster is in relation to the other kids they have treated. The same youngster will get different opinions of severity from different people. Since determining a “Level” is subjective and not a technical diagnosis, there is no right or wrong answer.

The severity of Autism changes not only day to day, but also situation to situation. For example, autistic kids may exhibit significant social deficits when trying to play with their peers on the playground -- but in the classroom, they may blend in perfectly with their peers. Autism severity is simply a place to start. It’s something to use to help the youngster make progress by getting more services and to help describe the youngster to therapists, teachers, etc. It’s just a snapshot, not something that reflects the future or the youngster in all situations.

==> Parenting Children and Teens with High-Functioning Autism
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2024 Statistics of Autism in Chinese Children

Autism Spectrum Disorder (ASD) has emerged as a significant public health concern worldwide, and China is no exception. As of 2024, new rese...