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Popular Screening Tools for Aspergers and Autism

Question

What kind of assessment tools do clinicians use when they are trying to determine whether or not a child or teen has Aspergers or Autism?

Answer

There are many (with new ones coming along all the time) …so I have listed the “most used” screening tools to date. These include:

1. Aspergers/High Functioning Autism (HFA) Screening Tools
2. Autism Screening Tools
3. Developmental and Behavioral Screening Tools

Aspergers/HFA Screening Tools (4 years to adult) —

Most Aspergers/HFA screening tools are designed for use with older kids, and are used to differentiate these disorders from other ASDs and/or other developmental disorders (e.g., mental retardation and language delays). These tools concentrate on social and behavioral impairment in kids four years of age and older (up to adulthood), who usually develop without significant language delay. Qualitatively, these tools are quite different from the early childhood screening tools, highlighting more social-conversational and perseverative-behavioral concerns.
  • Australian Scale for Asperger Syndrome (ASAS) by Michelle Garnett, M. Clinical Psychology, Anthony Attwood, Ph.D. (for kids 5 and older)
  • Autism Spectrum Screening Questionnaire (ASSQ) by Stephen Ehlers, Ph.D., Christopher Gillberg, Ph.D., Lorna Wing, Ph.D. (Published in 1999 in the Journal of Autism and Developmental Disorders, 29,129-141) (for kids 7-16)
  • Social Communication Questionnaire (SCQ) by Catherine Lord, Ph.D., Sir Michael Rutter, Ph.D., et al. (for kids 4 and older)

Autism Screening Tools (4 years to adult) —

Most autism screening tools are designed to detect ASDs specifically, concentrate on social and communication impairment in kids 18 months of age and older, and focus on all three DSM-IV criteria for autism. Their limitations lie in the lack of highly validated autism screening tools available for kids under 18 months of age. Since autism screening ideally would follow a developmental screening that has indicated concerns, the administering clinician should directly observe the youngster in addition to using an autism screening tool questionnaire.
  • Modified Checklist for Autism in Toddlers (M-CHAT) by Diana Robins, M.A., Deborah Fein, Ph.D., et al. (for kids 16-30 months)

Developmental and Behavioral Screening Tools (Birth to 36 Months) —

Most developmental and behavioral screening tools have a wide application with kids of varying ages, allow flexibility to capture “parent report’ with minimal assistance, ask less threatening and more universal questions of mothers and fathers, and coordinate with hallmark developmental milestones. Because of their broad use, developmental and behavioral tools often lack the sensitivity to screen specifically for autism and therefore require follow up with an autism screening tool when a developmental screening raises concerns.
  • Ages and Stages Questionnaire (ASQ-3) by Jane Squires, Ph.D. & Diane Bricker, Ph.D. et al. (for kids 1-66 months)
  • Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) by Jane Squires, Ph.D. & Diane Bricker, Ph.D. & Elizabeth Twombly, M.S. (for kids 6-60 months)
  • Brief-Infant-Toddler Social-Emotional Assessment (BITSEA) by Margaret Briggs-Gowan, Ph.D. and Alice Carter, Ph.D. (for kids 12-36 months)
  • Child Development Inventory by Harold Ireton, Ph.D. et al. (for kids 0-6 years)
  • CSBS DP Infant-Toddler Checklist by Amy Wetherby, Ph.D. & Barry Prizant, Ph.D. (for kids 6-24 months)
  • Parents Evaluation of Developmental Status (PEDS) by Frances Page Glascoe, Ph.D. (for kids 0-8 years)
  • Parents Evaluation of Developmental Status-Developmental Milestones (PEDS:DM) by Frances Page Glascoe, Ph.D. (for kids 0-8 years)
  • Social-Emotional Growth Chart by Stanley I. Greenspan, MD (for kids 0-42 months)
  • Temperament and Atypical Behavior Scale (TABS) by Stephen J. Bagnato, Ed.D., John T. Neisworth, Ph.D., et al. (for kids 11-71 months)
The Aspergers Comprehensive Handbook

Aspergers and American Idol

During one of the episodes of the TV program “American Idol,” producers saved a “thriller” for the final audition spot. The “tough-luck” story told by James Durbin, 21, was almost too much to believe.

James grew up barely knowing his bass-playing father, who was always on the road, and was raised by his mother after his dad died of a drug overdose. Durbin reveals that he was never able to spend much time with his father, who was always away touring. James stated, “People say that I get my musical talent from my dad. Well, I’ll never know.”

Later diagnosed with both Tourettes and Aspergers, James turned to music to help deal with his stress. Both Tourettes and Aspergers are extremely debilitating neurological disorders that can result in behavioral tics and extreme social awkwardness. Durbin is classified as "high-functioning” (i.e., his symptoms are milder, he's able to handle social situations with more tolerance than others with Tourettes or Aspergers, and his facial and vocal tics should become more manageable with time).

Tourettes and Aspergers are lifelong conditions, but experts say that adults "can learn to understand their own strengths and weaknesses." As living proof, James Durbin says he does his best to "suppress" the negative effects and play up what he's best at – “singing.”

Durbin hasn’t let his disorders slow him down as a performer. He’s gone on to star in productions of Singing in the Rain, Grease, Beauty and the Beast, West Side Story, Sweet Charity, Fiddler on the Roof, and My Fair Lady. He was also the lead singer for the band Hollywood Scars and jammed alongside a teen music ensemble known as Guitarmy.

James views “the stage” as a form of therapy, a place that allows him to put aside his tics and obsessions. He went on to meet his fiancĂ©, Heidi, and the two went on to have a son. The singer credits his family for helping him turn his life around.

James Durbin has a pitch-perfect voice and a hard rocker’s attitude. American Idol footage shows James ‘tearing-it-up’ with Led Zeppelin’s “Whole Lotta Love.” Another clip has him floating his way through the Beatles’ “While My Guitar Gently Weeps” with equal power. His versatile voice has already earned him comparison to American Idol favorite Adam Lambert.

On the show, James stated, "I have Tourettes and Aspergers, but Tourettes and Aspergers don't have me. I'm doing what I can to suppress it. I don't let it take advantage of me. It's not who I am. You need to give it 210 percent. The reason why I can be the next 'American Idol' is because I believe. From day one, all I've been doing is believing …believing that I can …believing that I have the power to do something real.”

So, what does this mean for Aspergers awareness? Clearly, as was dramatically demonstrated on American Idol, Durbin has talent. American Idol truly found a genuine San Francisco rocker in the form of James Durbin.


James Durbin performing While My Guitar Gently Weeps:

Aspergers Children and Summer Vacation: 25 Tips for Parents

You're trying to find things for your child to do all summer that are safe, entertaining, and maybe if you're lucky, have some educational value. If you're like most moms and dads, you're trying to hold down a job at the same time. Now, add “Aspergers” (high functioning autism) to the equation and things have just gotten exponentially more complicated.

Your Aspergers youngster needs structure and routine during the summer, and you're at a loss to think of activities that can give it to them. You fear a summer full of meltdowns and regression. What can you do?

Not to worry, the list below will include plenty of tips for ensuring a successful summer for both you and your youngster with Aspergers or High-Functioning Autism:

1. Ask your Aspergers youngster about what he plans or expects to happen when out of school or on vacation. Doing so will help clear up any misconceptions about the things you either agree on or disagree about.

2. Avoid springing things on your Aspergers youngster. It causes confusion and distress. There go those insecurity-control issues again. Prepare him for changes as far in advance as possible.

3. Bring a Discman or MP3 player so he can listen to music on the plane or in the car or a favorite toy – and definitely favorite foods. Try to imagine possible problems that might come up and how you will solve them—and what materials you will need to solve them. Take books, video players or anything else you think will help for distraction during those difficult moments. If you're going on a long car trip, you might want to look up some car games to play, such as trying to spot letters on license plates, 20 questions, or other games one can play in the car to pass the time and keep your youngster occupied.

4. Discuss fear of the unknown or uncontrolled event with your quiet Aspergers youngster. Aspergers kids don’t like the unexpected and they really need the security of knowing when, where, how, and why. They are generally very comfortable in their usual surroundings (school, home, friend’s house), but may become anxious about traveling, staying in hotels or camping “in the wild!”

5. Do not try “breaking habits” while on vacation. I know a mother who tried to break her Aspergers son’s annoying habit of drumming his feet and fingers on just about everything. She reasoned that since she would be constantly with the boy while on a family trip to the beach, she could break him of the habit by catching him and threatening dire consequences if he didn’t stop. I later learned that the entire trip was a disaster. Instead of focusing on family fun and relaxation, it became a constant battle of “who was in control!”

6. Don't be alarmed if your youngster doesn't want to do much during the summer. But by the same token, do try to plan some regular activities and outings so that they are still engaged with the world. Find areas of interest. If your youngster is interested in movies, see if there is a movie-making class or club that meets nearby; if they are into reading, then find a book club. Most towns have town-sponsored recreation programs that are offered during the summer at low cost, and this can be a great place to start. There is everything from sports to arts and crafts and things in between. Some towns even have programs specifically for special needs children.

7. Don't try to fit your youngster into a mold of what they "should" want, or what you think should be typical for their age; pay attention to what their actual needs and wants are to ensure a more successful vacation.

8. Give your Aspie as much control about “what happens” during his vacation and out-of-school time as possible. Remember, all Aspergers children have control issues. If they feel out of control, they feel threatened.

9. Help your Aspergers adolescent find work. A part-time job is a rewarding way for an adolescent to spend some of his summer. Few things work better in building a sense of maturity, independence, and personal competence. The structure a job affords is a plus for children with Aspergers, and the extra spending money is, of course, an added bonus. While some Aspergers teens are capable of finding a job for themselves, most need guidance and encouragement. Start by defining work goals for your youngster, such as earning money or learning a new skill. Discuss the right types of jobs, based on his skills, organizational ability, and attention capability. Then help him choose where to apply. It doesn't hurt to work on interview skills; role-play business owners and managers with him. Your encouragement and support may be just what your adolescent needs to follow through on a job search.

10. If you can, try to choose the least-busy times to do any given activity. Do things early or late in the day when most individuals haven't left yet or have already gone home. If a summer vacation can wait until fall or be taken in early spring, then by all means do it at those times. If you follow these tips, for any vacation you might consider, your Aspergers youngster will be in a better state of mind to be able to enjoy him or herself, and your chances of a peaceful vacation will increase.

11. If you’re striving for an educational experience, it had better be “fun” and not boring. If not, then try to use personal methods such as search and name games to help make them fun and different.

12. Keep a calendar (but leave some blank spaces). Even during the languorous summer months, Aspergers kids need structure to feel secure and have a sense of what to expect. A simple calendar of events lets your youngster see what's coming. Fill in ahead of time a mix of major summer activities, such as the family vacation or trips to visit relatives, and casual recreational activities, such as a weekend trip to the zoo or museum. You may also want to prearrange and mark down play dates. Of course, summer should still be a time to relax, so try not to over schedule. One planned event a weekend is great, three or four can feel rushed and hectic. Leave room for down time every day, when your youngster can do whatever he wants — even nothing at all. And make time at the end of the day for the family to relax, read, and talk.

13. Loosen the reins, but stay on course. The summer months cry out for flexibility. That being said, you don't want to relinquish basic family rules and routines. It's tempting to let children stay up later in summer, and a bit of that is OK. But remember that even a little sleep deprivation can lead to irritability and meltdowns at any time of year. Try to maintain basic bedtime habits. Stick to scheduled chores, too, as well as other established behaviors. A whole day in front of the TV should remain taboo even during summer months.

14. Maybe you don't have the time or money for a vacation, or you don't want the stress of dealing with one. If you're sticking around the house this summer, don't despair, there are lots of things you can do around the house to keep your little one engaged.

15. Money is not a requirement for fun. Take your youngster to a local pool (but try to go during the off hours when there won't be as many individuals), or hold pool parties in your yard if you have your own pool, and increase your youngster's socialization skills at the same time. Look on your town calendar to see if there are any free concerts in parks, which is often the case. Some towns have outdoor movie nights in parks as well, or a local library might have them. Use the library or a cheap Netflix subscription to rent movies for the family to watch. Also, summer is a great time for festivals; if your youngster can handle the crowds and sensory stimulation, of course. Festivals do not usually cost anything to get into, and provide lots of entertainment and visual stimulation. Another idea is to go to a craft store or a store that recycles old materials and sells them for craft projects, and have an arts and crafts day.

16. One of the hardest parts for Aspergers children in summertime is the change in routine. Even if they don't particularly like school, the routine of the school day (getting up at a certain time, going to classes which are usually in the same order, coming home and doing homework, etc.) is comforting to them. They might be at a loss for what to do with their time when summer comes, and they may feel lost and adrift with no routine to anchor them. This is normal for children with Aspergers. Try to create a loose routine for your Aspergers youngster if you can. Post it on the wall as a visual reminder. Such a schedule could go something like this: "Breakfast, morning activity, lunch, afternoon activity, TV/video game period (if allowed), dinner, pre-bedtime activities. You can create a list of activities that the youngster can choose from and post those as well so that the youngster has some idea of what could or might happen, or you could decide ahead of time and post them for the week. Things like going to the park, going to the library, arts and crafts, some kind of sports if your youngster is interested, baking, reading, whatever you can come up with can be on the list, and you can rotate activities. In some ways, you could make it like a loosely structured, non-academic home school, which might make your youngster feel more comfortable and reduce behavior problems that might stem from anxiety over loss of routine.

17. Play after work. During the school year, you set a regular study time for your Aspergers youngster because it helps him get his work done. In the same way, scheduled playtimes in summer — for children and moms and dads together — will insure fun as well as family bonding. So play catch in the backyard, take a bike ride, or go out for ice cream. These relaxed times provide just the change of pace you and your youngster need to de-stress after nine months of school, or even a day's work.

18. Since most children with Aspergers are visual learners and they have a need to know what is going to happen ahead of time, social stories work well. To make a social story, you simply need to make or find pictures of the places you will be going to do and the things you will be doing and write out a story that illustrates what your daily activities will be like. The story should give the details of the daily routine so that your youngster can plan ahead and have a sense of what to expect. Talk about how you are going to get to your vacation spot, who will be coming with you, and what some of the activities will be. Make sure to think of the details when planning your trip.

19. Some Aspergers children are sensitive to the heat, and will be uncomfortable and irritable during the day when the sun is at its peak. If this is a problem, try to choose events where you can go in the evening, or go out on cloudy days.

20. Some structure during summer vacation is important. But so is unstructured downtime. Most Aspergers kids can be amazingly creative in finding ways to have fun. With your encouragement, the freedom to do nothing opens up countless possibilities to do anything. Moms and dads needn't be constant entertainment directors in the summer. It may be more helpful to express confidence in your youngster's ability to be creative and inventive — and then let him. So go ahead and schedule some activities, then get out of the way and let your youngster do what comes naturally.

21. There is nothing more stressful to a youngster with Aspergers than not knowing what is going to happen. For example, if you're at a beach, maybe schedule swimming time in the morning, a walk on the boardwalk at lunch, time to see nearby attractions or play on any available playgrounds in the afternoon… try to have the day loosely planned out a day ahead of time or at least in the morning of that day so your youngster knows what to expect. Most individuals enjoy the feeling of unstructured free time, but Aspergers children are so worried about what might happen next, and how they will cope with it, that they need to have an idea of what is happening. The schedule can be modified to some degree if you need to, but giving your youngster some advance notice of this (or planning a favored activity for after the change of plans) will have the best results. Be aware that individuals will always talk, and most individuals don't know what they're talking about.

22. Think very carefully about where you want to go. You want a place that will be Aspergers friendly. For many individuals, this means a place that is not too loud or does not offend other sensory quirks of your youngster. For example, if your kid has tactile issues with sand, you might not want to go to the beach. If they're scared of large animals, you don't want to go to the circus, for example. Choose a place that matches your youngster's interests and ability levels.

23. Use community resources. Take advantage of the summer recreational and educational opportunities that most towns offer. Find a youth sports league, or sign up for day camp. Many local recreation centers offer swimming, gymnastics, even computer classes. Encourage your artistic youngster to join a kid's theater group or sign up for community art or jewelry-making courses. In addition, visit local zoos and museums, and find out where and when summer festivals are scheduled in your area. Don't forget to add selected activities to your calendar. When you plan ahead and write it down, you're more likely to do it.

24. Whatever keeps your Aspergers kid happy at home will probably work when he is away from home. If hand-held games are acceptable distractions, then by all means take them with you.

25. You want to make sure that you very carefully choose the place that you will be staying. Whether you're staying at a hotel, a camp site, a motel, or renting a house, there are different issues to consider. If your youngster has a lot of food issues and sensitivities, you might want to choose a place where you'll have your own kitchen, so you can make your own food. This could include hotel rooms with a small kitchen area, or a rented house with kitchen facilities. If noise is a factor, you want to make sure you're not in a crowded hotel with thin walls where you can hear your neighbors fighting and the ice machine, or elevator, makes noise all night. On the other hand, if your youngster hates bugs and getting dirty, camping might not be such a good choice.

My Aspergers Child: Preventing Meltdowns

How to Make Homework Tolerable for Kids on the Spectrum

Aspergers and High-Functioning Autistic kids are noted for having an obsession with just one or two activities – and homework is usually NOT one of them. Some moms and dads have great difficulty in getting their youngster to shift from their “obsessive interest” to “homework.”

We recently took a poll here on MyAspergersChild.com. Moms and dads (300 in total) of kids on the autism spectrum were asked about homework-related problems. Here are the results:
  • 8% said that their youngster hated school because of homework
  • 10% had no problem getting their youngster to do their homework
  • 16% reported that homework often caused a meltdown
  • 18% had to remind their youngster to do their homework
  • 48% said that homework was a daily family battle

What are we to do if our "special needs" youngsters hate homework? Unfortunately that answer is not straightforward. It depends on the reasons WHY your youngster does not want to do homework. Here are five reasons these children hate homework and what you can do about them:

1. Problem - Books needed for homework are left at school. Solution - If this happens often, it is a sure sign that your youngster is struggling to learn and feels that the homework is too hard. Talk to your youngster's educator and try to set up a system to remind your youngster what books are needed but also tell the educator if your youngster is struggling with homework.

2. Problem - Doing homework takes time, time that you youngster would rather spend doing his fun thing. Solution - Set a limit to the time your youngster spends doing homework and stick to it. If your youngster knows he can stop working at a certain time he will be more motivated to do the work.

3. Problem - Homework is 'boring'. Solution - This is a difficult one, because homework often is boring. Again, setting time limits AND talking to your youngster's educator about the issue may help. Kids use the word 'boring' to cover a variety of situations. You might need to check out why your youngster thinks homework is boring.

4. Problem - Homework is left to the last minute. Solution - Help your youngster keep a homework agenda complete with dates for when work has to be handed in. Mark dates on a calendar and work backwards to decide when your youngster should to start work. Then let your youngster be responsible for getting the work done on time. Don't let your youngster let his problem (no time left to complete homework) become your problem.

5. Problem - The homework is too hard and your youngster does not know how to do it. Solution - Tell your youngster's educator that your youngster couldn't do it so that the educator can review the work.

The amount of benefit your youngster gets from finishing a homework assignment NEVER outweighs the importance of your relationship with your youngster. The amount of time you spend cajoling and coercing your youngster to do their work is counterproductive. There is no way that homework should create tension in a family, and definitely not the kind of meltdowns the survey suggests. Here are some tips:

1. Add variety to the daily routine of your kids. You can alternate their study sessions with an outdoor activity which they particularly enjoy. This balanced daily routine can help you sustain their energy and interest in their homework or assignments. Make sure to manage your time properly so that you are able to join them in their outdoor activities.

2. Ask your youngster’s teacher for suggestions. After spending the majority of the day with your youngster, she might be able to offer some valuable insight. Moms and dads, kids, and educators all working together can change the horror of homework into somewhat of a pleasant experience.

3. Be firm and consistent when it is time to begin homework. It might take a couple of days to fall into a routine. Part of that routine is creating a designated area for homework. Usually the best place is somewhere removed from the noise of the house. If non-school age siblings are playing and having fun while another youngster is trying to complete an assignment, it makes concentrating difficult.

4. Consult your children when deciding the best home for your family. Perhaps, you may allow them to make their best pick when it comes to the study room and play room. In this way, you are making sure that there is a part of your home that your kids can consider their own and where they can enjoy studying their lessons.

5. Create a reward system for homework assignments. You can reward your youngster with one hour of TV time or PSP game time after homework is done. Food is not good compensation; the association of food with reward will create a bad health habit. Avoid giving chocolate chip cookies and other sweets in particular, but generally avoid food as rewards. You can up the fun by giving bigger rewards to higher achievements. You can offer a trip to your youngster's favorite park or take the family on a mini-excursion if an "A" is on the homework result. The best reward is sometimes not games, or toys; sincere warm hugs are oftentimes the perfect incentive for a studious youngster. Be careful not to use praise too often; this will teach kids to seek outside approval. A youngster who is able to feel internal satisfaction for a job well done will be better equipped to ward off peer pressure during the teen years. Thus, it is better to ask kids how they feel about doing a good job (helps to internalize it).

6. Do not go into arguments with your children. It is essential that you develop a positive relationship with your kids while guiding them to establish healthy learning habits. Be a good listener and give your children some leeway in making their own choices. Remember that your role is to guide them as they try to develop their own learning habits.

7. Eradicate distractions. You can help your youngster focus by making the homework the most enjoyable activity available for that moment; hide things that compete with the attention of your kid. Cell phones, television, computer, PSPs and MP3 players must be turned off. Let them appreciate these items as luxuries and not daily privileges.

8. Explore the possibility of giving exercises and simulated tests first. Once your kid is able to learn the concepts, do away with the busywork and cut down on the monotony of the study session.

9. Give him a snack to munch on - or some gum to chew - while doing homework. Also, allow him to take a few breaks (not too many).

10. If your youngster is averse to writing then you may start out by being their dedicated scribe. You may also have them play with their nimble hands by using your PC desktop in your writing sessions. You have to understand that reading and writing activities are done in school because these are basic components of the curriculum. However, you have opportunity to tap other learning tools and approaches at home in order to help them understand their lessons from different perspectives.

11. Incorporate music with games and songs. This tactic is effective especially if your youngster is activity-oriented. Math, Science and English are some of the subjects that tend to be monotonous for kids. Jazz up the study scene a little bit with songs and games (e.g., memorize the whole multiplication table to the tune of "Ten little Indians" or play "Bring Me" for things that start with the letter "N").

12. Inject fun and interesting activities in your study sessions. Avoid those boring reading sessions and try to add activities that are participative in nature. You can use alternative teaching aids such as video, Internet as well as action and board games.

13. Instill reading values. The best way to encourage a homework-friendly life is to instill reading time as part of the family routine. Reading perks up the youngster's interest for information. Reading opens up kid's hunger for learning; homework will not be enough of an outlet to quench this knowledge thirst. Reading will encourage a youngster to fulfill career dreams and is a driving force to make homework fun. Reading to your kids also helps to improve vocabulary, which will make their homework assignments easier. Mothers/fathers need to communicate openly with kids so they understand the value of the activity first. When kids are treated as being capable and responsible, they will start to do it themselves without nagging (nagging tells them that it is your responsibility and not theirs).

14. Join them in their homework. Surprise them once in a while by joining them at their study table. When they see that you are interested, they will think that it is "cool" for them to be involved with the subject too. In this situation, you will have the opportunity to monitor study habits and any improvements. Don't, however, overdo this practice. It is good to guide them in the areas that are difficult, but when you nag, kids are choked as they try to meet your standards; that's not a fun way to learn.

15. Keep a close eye on the time and check on your youngster periodically. Kids need to know that you trust their capabilities to do their work. Standing over their shoulders only invites insecurities to develop. Backing away and then checking later instills independence in kids. It is important for kids to believe they can do things on their own and still know that someone will be there to answer any questions that come up.

16. Let your youngster burn some pent up energy. It is absolutely draining using your brain as much as kids do in school. On top of learning, sitting still for most of the day can be difficult for some kids. Allow some outdoor fun for a half an hour after snack to let some steam off. Kids will be able to concentrate on their homework and will be less likely to rush through the assignments if they are allowed to see some friends and have some down time first.

17. Make sure that your kids participate in the decision-making. Allow them to decide on the topic that they have to tackle first as well as their preferred place and time for the study session. This means that if your kid wants to study math today, then make sure that you start your study session working on numbers. Children will also have their own preferred time and place to study. Give them this leverage as imposing on them can be counterproductive.

18. Make sure your child has a nice and cozy spot where he can relax. This will help him do his homework better.

19. Usually kids are ready for a break when they get out of school. So much information is crammed into one day which makes homework as appealing as cleaning the kitty litter. The only thing most children want as soon as they get home is a snack. Help your youngster refuel his brain and his body by preparing healthy snacks ahead of time. This way when hunger strikes and being patient is not possible, there will be a fast, easy, and most important, healthy choice to devour.

20. Be patient with your child. Some days will go smoothly when it comes to homework. Other days, it will feel like a war-zone. Maybe he is having a bad day. Tomorrow is a new day that brings another opportunity to teach study skills to your child.

==> Preventing Meltdowns and Tantrums in Kids on the Autism Spectrum


Parents' Comments:
  • I swear I wrote the book on this support group...I am beginning to understand my HFA (undiagnosed)...and how lucky I was to become obsessed with things that can shape my future,, aspies have the most unbelievable insight on subjects..If you can ever get them to become obsessed with things that help there future,,they will excel beyond there peers. 
  • I try to use his obsession to get the homework done. Example: I have three dinosaurs and you give me 2, how many do I have now? Of course he is in 1st grade and I'm sure this will not work for long, but it is now! 

How to Manage Meltdowns in Kids on the Autism Spectrum

A meltdown is an intense emotional and behavioral response to “over-stimulation” (a form of distress for the child). Meltdowns are triggered by a fight-or-flight response, which releases adrenaline into the blood stream, creating heightened anxiety and causing the Asperger's (AS) or High-Functioning Autistic (HFA) child to switch to an instinctual survival mode.

Common Features of Meltdowns—
  • after the meltdown, there may be intense feelings of shame, remorse or humiliation, and a fear that relationships have been harmed beyond repair
  • children in the middle of a meltdown will likely become hyposensitive or hypersensitive to pain
  • cognitive dysfunction, perceptual distortion, and narrowing of sensory experience are associated with meltdowns
  • meltdowns are a reaction to severe stress, although the stress may not be readily apparent to an observer
  • meltdowns are caused by sensory or mental overload, sometime in conjunction with each other
  • meltdowns are due to overwhelming stimulation
  • meltdowns are time-limited
  • novel situations or sudden change can elicit a meltdown
  • transitions may trigger a meltdown (e.g., going from class to class, change in topic, change in teacher s, etc.)

Causes of Meltdown—
  • child does not receive understandable answers to questions
  • child does not understand the reason for sudden change
  • child has a sensory overload
  • child is given open-ended or vaguely defined tasks
  • child is given too many choices
  • child is taken by surprise

Warning Signs of Meltdowns—
  • becoming mute
  • experience difficulty answering questions (cognitive breakdown)
  • extreme resistance to disengaging from a ritual or routine
  • increasing self-stimulatory behaviors (e.g., flapping hands)
  • pacing back in forth or in circles
  • perseverating on one topic
  • repeating words or phrases over and over
  • stuttering or showing pressured speech

What Parents Can Do—

1. Don't reward the meltdown with a lot of attention. Obviously, you don't want your AS or HFA youngster to learn that this is a good way to impress you.

2. Give the youngster a warning before the end of an activity, which gives him a chance to readjust.

3. Give the youngster some control over small decisions so that he can feel he can make a choice (e.g., "Do you want us to read your book before you put your pajamas on or after?").

4. Give your youngster permission to have a major meltdown (e.g., "Joey, I know you usually have a meltdown when this happens, and I want you to know that it is ok for you to do that now."). This is a reverse-psychology approach.

5. If meltdowns are more frequent than about once a week and don't lessen as the youngster grows older, you may want to consider seeking professional advice.

6. Meltdowns are a sign of frustration that a youngster can't do something comfortably. Know what your youngster's tolerance level is and try not to push him beyond what he's capable of doing. Tolerance levels vary; he may be able to handle a situation one day and not the next. Try to identify the situations that trigger meltdowns and change them.

7. Prescribe the behaviors that your youngster usually does in this situation when agitated. You'll continue talking after telling your youngster it is o.k. to have a meltdown and list what the youngster normally does (e.g., “When you are feeling this way, you usually start swearing, kicking, screaming, and blowing snot so go ahead and get started.").

8. Remember to reward good behavior (e.g., "You were so good today when we had to stand in line at the post office.").

9. Think about whether your youngster may be acting up because he's not getting enough attention; even negative attention is better than none.

10. Scolding or shouting back simply won't work, although you may feel like having a meltdown yourself. Remember, moms and dads are models of appropriate behavior.

11. Stay cool. Acknowledge the youngster's emotions (e.g., frustrated, bored, tired) without a long discussion and say something like, "Tell me in your own words what's bothering you, and let's try to work it out" …or "I know you're frustrated and want to leave, but I would like for you to wait a few more minutes." It's important to let the youngster know you're willing to work this out reasonably, what your expectation is, and what you want him to do.

12. Always have some form of distraction available to get your child off the meltdown track.

The process of turning things around involves helping moms and dads to:
  • address the frustrations of the AS or HFA child’s siblings
  • create a more predictable and structured environment for the youngster
  • establish a belief that this problem can be solved but it will take persistence on their part
  • establish consequences to reinforce desired behavior and not reinforce undesirable behavior
  • focus on the game plan long enough for it to take effect
  • help the youngster to improve his social skills
  • learn what accommodations are needed to reflect the youngster’s weaknesses
  • learn what actions will promote the youngster’s growth in flexibility
  • re-establishing their role as authoritative parents
  • refocus on the youngster’s strengths
  • stop blaming each other and themselves
  • prioritize what is really important

The issue of prioritizing is particularly critical. Too often there are struggles about cleaning rooms, finishing meals, practicing piano or completing homework that are simply not worth the consequences. Some of those issues can be addressed when things are improved. Also, if some situations are just too difficult to manage right now (e.g., taking the youngster on a family activity), then arrange a sitter or a drop-off at a friend’s. In this way, you avoid ruining everyone’s experience. Explain to your youngster that you are working with him to fix the problem and eventually he’ll be able to come along. Again, this is about setting priorities and either targeting behaviors that can result in initial success or behaviors where safety/health is a concern.

Typically the parents have intuitively tried some very appropriate strategies to deal with the meltdowns, but have given up too quickly because they didn’t see change right away. When moms and dads begin to reassert their roles as being in charge and working with their youngster to improve his ability to be more flexible, the youngster will likely respond initially by getting worse. Even though he doesn’t really want the old system to remain in place, it is his natural instinct to try to hold on to what he knows rather that commit to uncharted waters. Moms and dads must believe in what they are doing and remain persistent, which is hard after having developed a sense of failure about trying to manage meltdowns up to this point.

Footnote:

I would like to point out the very rarely understood fact that basically this disorder is nothing but having little to no intuition. Kids on the autism spectrum do pretty much everything they do consciously, including facial expressions and body posture. That's why they tend to have fairly emotionless faces, awkward body postures and why they are horrible both are social interactions and organizing their daily lives. That's also why they have trouble with sensory overload or sensitivity to specific sensory impulses. It's also why their hobbies tend to be so extreme and specific as those are the only activities that stimulate their barely existing intuition to sufficiently feel a sense of satisfaction in their lives.

Because it does so many things consciously, the AS or HFA brain is much more engaged in reflective (conscious) processing of information than the "neurotypical" brain. Meltdowns are the consequence of AS and HFA kids suffering from cognitive overload. It's like a traffic jam in the brain. The brain tries to process more data than it can handle and the response to that is to create an emotional short circuit and cognitive standstill. To put it simply, nothing goes in, and intense emotions come out. The frequency and intensity of meltdowns is strongly related with how much data the child can process at the same time and thus also with his/her intelligence.

It's important to realize that the level of stress is directly correlated with the amount of data that needs to be processed, and the amount of data that needs to be processes is directly correlated to how much sensory data is picked up and the complexity of the child's personal planning. To relieve stress, it is important to adjust the amount of sensory data to a comfortable level and to adjust the child's planning in a way that is easily maintained. A logical and consistent structure often helps.

==> Preventing Meltdowns and Tantrums in Aspergers and HFA Children

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