How To Avoid Child-Meltdowns At The Doctor's Office

“Do you have any advice on how we can make my 6 year old daughter’s upcoming visit to our doctor less stressful? She was diagnosed with high functioning autism recently, and has a history of not doing well while being examined, crying hysterically from start to finish. It’s a real ordeal for all of us, including the doc! Also, my daughter has pica.”

Most children with Asperger’s and High Functioning Autism have difficulties with social interaction, communication, and accepting novelty. Therefore, spending the extra time to acclimate the “special needs” child to the new environment/experience will be crucial, for example:

• Allow ample time while talking before touching the child
• Allow the child to manipulate instruments and materials
• Exaggerate social cues
• Familiarize the child with the office setting and staff
• Have family and/or familiar staff available
• Keep instructions simple, using visual cues and supports
• Slow down the pace of the overall doctor’s visit

These accommodations will be helpful in reducing the obstacles to health care provision presented by the child’s social skills deficits and resistance to new and unusual encounters.

Often, more time is required for outpatient appointments. In a nationally representative sample, it was found that kids on the autism spectrum spent twice as much time with the doctor per outpatient visit compared with kids in control groups.

RE: Pica— Asperger’s children with pica or persistent mouthing of fingers or objects should be monitored for elevated blood lead concentrations, particularly if the history suggests potential for environmental exposure. Pica often goes away in a few months without treatment.

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

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Is 'high functioning' autism simply a different way of perceiving and relating to people?

That remains to be seen, is the short answer here (and it's certainly an interesting idea). Some people do believe that High-Functioning Autism (HFA) is indeed nothing more than a “different way of thinking” (i.e., a variation of "normal"). This notion is quite believable due to the fact that everyone has some characteristics of the "disorder." All the traits that typify HFA - and Asperger's - can be found in varying degrees in the “typical” population.

For example, collecting objects (rocks, stamps, old glass bottles, etc.) are socially accepted hobbies; individuals differ in their levels of skill in social interaction and in their ability to read nonverbal social cues; people who are capable and independent as grown-ups have special interests that they pursue with marked enthusiasm; and, there is an equally wide distribution in motor skills.

As with any disorder identifiable only from a pattern of “abnormal” behavior (with each trait varying in degrees of severity), it is possible to find numerous individuals on the borderlines of Asperger’s and HFA whose diagnosis is particularly difficult. While the usual case can be recognized with ease by professionals with experience in the field of Autism Spectrum Disorders, in practice, the disorder blends into eccentric normality and into certain other clinical pictures. Until more is known about the underlying mechanism at play, it should be accepted that no precise cut-off points can be defined. 

As an experiment, take a moment to scan through the following traits associated with Asperger’s and HFA (count the number of traits that apply to you)...

Social traits of Asperger’s and HFA include:

1. Abrupt and strong expression of likes and dislikes
2. Apparent absence of relaxation, recreational, or “time out” activities
3. Bizarre sense of humor (often stemming from a “private” internal thread of humor being inserted in public conversation without preparation or warming others up to the reason for the “punchline”)
4. Bluntness in emotional expression
5. Constant anxiety about performance and acceptance, despite recognition and commendation
6. Difficulty in accepting criticism or correction
7. Difficulty in distinguishing between acquaintance and friendship
8. Difficulty in forming friendships and intimate relationships
9. Difficulty in offering correction or criticism without appearing harsh, pedantic or insensitive
10. Difficulty in perceiving and applying unwritten social rules or protocols
11. Difficulty judging others’ personal space
12. Difficulty with adopting a social mask to obscure real feelings, moods, reactions
13. Difficulty with reciprocal displays of pleasantries and greetings
14. Discomfort manipulating or “playing games” with others
15. Excessive talk
16. Failure to distinguish between private and public personal care habits (e.g., brushing, public attention to skin problems, nose picking, teeth picking, ear canal cleaning, clothing arrangement)
17. Flash temper
18. Flat affect
19. Immature manners
20. Known for single-mindedness
21. Lack of trust in others
22. Limited by intensely pursued interests
23. Limited clothing preference (e.g., discomfort with formal attire or uniforms)
24. Low or no conversational participation in group meetings or conferences
25. Low to medium level of paranoia
26. Low to no apparent sense of humor
27. Often perceived as “being in their own world”
28. Pouting frequently
29. Preference for bland or bare environments in living arrangements
30. Problems expressing empathy or comfort to/with others (e.g., sadness, condolence, congratulations)
31. Rigid adherence to rules and social conventions where flexibility is desirable
32. Ruminating (i.e., fixating on bad experiences with people or events for an inordinate length of time)
33. Scrupulous honesty, often expressed in an apparently disarming or inappropriate manner or setting
34. Serious all the time
35. Shyness
36. Social isolation and intense concern for privacy
37. Tantrums
38. Unmodulated reaction in being manipulated, patronized, or “handled” by others

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

Physical  traits of Asperger’s and HFA include: 

1. Anxiety
2. Bad or unusual personal hygiene
3. Balance difficulties
4. Clumsiness
5. Depression
6. Difficulty expressing anger (i.e., either excessive or “bottled up”)
7. Difficulty in judging distances, height, depth
8. Difficulty in recognizing others’ faces (i.e., prosopagnosia)
9. Difficulty with initiating or maintaining eye contact
10. Elevated voice volume during periods of stress and frustration
11. Flat or monotone vocal expression (i.e., limited range of inflection)
12. Gross or fine motor coordination problems
13. Low apparent sexual interest
14. Nail-biting
15. Self-injurious or disfiguring behaviors
16. Sleep difficulties
17. Stims (i.e., self-stimulatory behavior serving to reduce anxiety, stress, or to express pleasure)
18. Strong food preferences and aversions
19. Strong sensory sensitivities (e.g., touch and tactile sensations, sounds, lighting and colors, odors, taste
20. Unusual and rigidly adhered to eating behaviors
21. Unusual gait, stance, posture
22. Verbosity

Cognitive traits of Asperger’s and HFA include:

1. An apparent lack of “common sense”
2. Compelling need to finish one task completely before starting another
3. Concrete thinking
4. Dependence on step-by-step learning procedures (note: disorientation occurs when a step is assumed, deleted, or otherwise overlooked in instruction)
5. Difficulty in assessing cause and effect relationships (e.g., behaviors and consequences)
6. Difficulty in assessing relative importance of details (an aspect of the trees/forest problem)
7. Difficulty in drawing relationships between an activity or event and ideas
8. Difficulty in estimating time to complete tasks
9. Difficulty in expressing emotions
10. Difficulty in generalizing
11. Difficulty in imagining others’ thoughts in a similar or identical event or circumstance that are different from one’s own (“theory of mind” issues)
12. Difficulty in interpreting meaning to others’ activities
13. Difficulty in learning self-monitoring techniques
14. Difficulty in understanding rules for games of social entertainment
15. Difficulty with organizing and sequencing (i.e., planning and execution; successful performance of tasks in a logical order)
16. Disinclination to produce expected results in an orthodox manner
17. Distractibility due to focus on external or internal sensations, thoughts, and/or sensory input (e.g., appearing to be in a world of one’s own or day-dreaming)
18. Exquisite attention to detail, principally visual, or details which can be visualized (“thinking in pictures”) or cognitive details (often those learned by rote)
19. Extreme reaction to changes in routine, surroundings, people
20. Generalized confusion during periods of stress
21. Impulsiveness
22. Insensitivity to the non-verbal cues of others (e.g., stance, posture, facial expressions)
23. Interpreting words and phrases literally (e.g., problem with colloquialisms, clichés, neologism, turns of phrase, common humorous expressions)
24. Literal interpretation of instructions (e.g., failure to read between the lines)
25. Low understanding of the reciprocal rules of conversation (e.g., interrupting, dominating, minimum participation, difficult in shifting topics, problem with initiating or terminating conversation, subject perseveration)
26. Mental shutdown response to conflicting demands and multi-tasking
27. Missing or misconstruing others’ agendas, priorities, preferences
28. Perseveration best characterized by the term “bulldog tenacity”
29. Poor judgment of when a task is finished (often attributable to perfectionism or an apparent unwillingness to follow differential standards for quality)
30. Preference for repetitive, often simple routines
31. Preference for visually oriented instruction and training
32. Psychometric testing shows great deviance between verbal and performance results
33. Rage, tantrum, shutdown, self-isolating reactions appearing “out of nowhere”
34. Relaxation techniques and developing recreational “release” interest may require formal instruction
35. Resistance to or failure to respond to talk therapy
36. Rigid adherence to rules and routines
37. Stilted, pedantic conversational style (“the little professor” concept)
38. Substantial hidden self-anger, anger towards others, and resentment
39. Susceptibility to distraction

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

Work-related traits of Asperger’s and HFA include:

1. Avoids socializing or small talk, on and off the job
2. Deliberate withholding of peak performance due to belief that one’s best efforts may remain unrecognized, unrewarded, or appropriated by others
3. Difficult in starting project
4. Difficult with unstructured time
5. Difficulty in accepting compliments, often responding with quizzical or self-deprecatory language
6. Difficulty in handling relationships with authority figures
7. Difficulty in negotiating either in conflict situations or as a self-advocate
8. Difficulty with “teamwork”
9. Difficulty with writing and reports
10. Discomfort with competition
11. Excessive questions
12. Great concern about order and appearance of personal work area
13. Intense pride in expertise or performance, often perceived by others as “flouting behavior”
14. Low motivation to perform tasks of no immediate personal interest
15. Low sensitivity to risks in the environment to self and/or others
16. Often viewed as vulnerable or less able to resist harassment and badgering by others
17. Out-of-scale reactions to losing
18. Oversight or forgetting of tasks without formal reminders (e.g., lists or schedules)
19. Perfectionism
20. Punctual and conscientious
21. Reliance on internal speech process to “talk” oneself through a task or procedure
22. Reluctance to accept positions of authority or supervision
23. Reluctance to ask for help or seek comfort
24. Sarcasm, negativism, criticism
25. Slow performance
26. Stress, frustration and anger reaction to interruptions
27. Strong desire to coach or mentor newcomers
28. Tendency to “lose it” during sensory overload, multitask demands, or when contradictory and confusing priorities have been set
29. Very low level of assertiveness

If you were honest with yourself, you found that many of the traits listed above directly apply to you. Does that mean you are technically located somewhere on the autism spectrum? Some will argue that the answer to that question is a profound “yes.” Also, many professionals are now noticing that the younger population (approximately ages 5 – 25) is becoming more “autistic-like” due to their significant obsession with digital devices (e.g., iPhones, iPads, computers, etc.).

These young people are literally (a) living in an altered reality (i.e., digital rather than real life experience), (b) spending inordinate amounts of time with their “special interest,” and (c) engaging in far fewer face-to-face social interactions – all of which are considered autistic traits. So, is autism on the rise, or are there simply more “normal” people engaging in “autistic-like” behavior (in the higher-functioning form)?

To complicate the matter of coming to an accurate diagnosis even further, there is the issue of “differential diagnosis.” For example, the lack of empathy, single-mindedness, odd communication, social isolation and over-sensitivity of individuals with Asperger’s and HFA are features that are also included in the definitions of Schizoid Personality Disorder (SPD).

To demonstrate this point, I had a client (19 year-old male) diagnosed with SPD who had no friends at college, he was odd and awkward in social interaction, always had difficulty with speech, never took part in rough games, was oversensitive, and very unhappy being away from home. He thought-out incredible digital inventions and, together with his younger brother, invented a detailed imaginary world. Sounds like Asperger’s – doesn’t it?

There is no question that HFA and Asperger’s can be viewed as a form of Schizoid Personality; however, the question is whether this grouping is of any value. The capacity to withdraw into an inner world of one's own special interests is available in a greater or lesser measure to everyone. This skill MUST be present in those who are highly creative (e.g., inventors, artists, scientists, etc.).

However, the difference between an individual with Asperger’s or HFA and the “typical” individual who has a complex inner world is that the latter DOES take part appropriately in two-way social interaction at times, while the former does NOT. Also, the “typical” individual, no matter how elaborate her inner world, is influenced by her social experiences, while the individual with Asperger’s or HFA seems cut-off from the effects of outside contacts.

Many “typical” grown-ups have excellent rote memories – and even retain eidetic imagery into adult life. Pedantic speech and a tendency to take things literally can also be found in “typical” individuals. Some individuals could be classified as having Asperger’s or HFA because they are at the extreme end of the normal continuum on all these traits. In other people, one particular characteristic may be so marked that it affects the whole of their functioning.

Even though Asperger’s and HFA do appear to merge into the normal continuum, there are many cases where the difficulties are so striking that the suggestion of a distinct disorder seems to be a more credible explanation than a “variant of normality.”

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


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Seizures in Children with Autism Spectrum Disorders

“Is it common for children with Asperger syndrome and high functioning autism to have epileptic seizures? What signs should parents look for if they think their child may be having mild seizures?”

Some of the brain irregularities that are associated with autism spectrum disorders can contribute to seizures. These irregularities can cause changes in brain activity by interrupting neurons in the brain.

Neurons are cells that process and transmit information and send signals to the rest of the body. So overloads or instabilities in the activity of these neurons can result in imbalances that cause seizures.

The reported prevalence of epilepsy among children on the autism spectrum disorders ranges from 11% to 39%. The prevalence of epilepsy was higher in studies that included teens and young adults, because the onset of epilepsy in autism spectrum disorders has 2 peaks: one before 5 years of age and another in the teenage years.



Epileptiform abnormalities on electroencephalography are common in kids on the spectrum, with reported frequencies ranging from 10% to 72%. Due to the increased prevalence of seizures in this population, a high index of clinical suspicion needs to be maintained, and electroencephalography should be considered when there are clinical spells that might represent seizures.

Characteristic symptoms include:

• Facial twitching
• Involuntary jerking of limbs
• Marked and unexplained irritability or aggressiveness
• Regression in normal development
• Severe headaches
• Sleepiness or sleep disturbances
• Stiffening of muscles
• Unexplained confusion
• Unexplained staring spells

There are several types of seizures, each with somewhat different symptoms:

• Absence seizures can be difficult to recognize. Also known as petit mal seizures, they are marked by periods of unresponsiveness. The child may stare into space. He may or may not exhibit jerking or twitching.
• Atonic seizures involve sudden limpness, or loss of muscle tone. The child may fall or drop her head involuntarily.
• Clonic seizures involve repeated jerking movements on both sides of the body. 
• Myoclonic seizures involve jerking or twitching of the upper body, arms or legs. 
• Tonic seizures involve muscle stiffening alone. 
• Tonic-clonic seizures are the most common. Also known as gran mal seizures, they produce muscle stiffening followed by jerking. Gran mal seizures also produce loss of consciousness.

If you suspect your child may be having seizures, find a neurologist that specializes in seizure disorders. The neurologist will order an electroencephalogram, which is a non-invasive process that involves the placing of electrodes on the child’s head in order to monitor activity in the brain. By analyzing the activity patterns, the neurologist can determine if the child is having seizures.

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

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Getting Inside the Head of a Child with ASD Level 1 (High-Functioning Autism)

Don't over-estimate your ASD youngster's understanding of social situations just because of his high intellectual ability. He is a boy who needs to figure out how the real world works, one example at a time. 

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

Complementary and Alternative Medicine for Children on the Autism Spectrum

“Are there any natural or non-pharmaceutical ways to treat symptoms of high-functioning autism or Asperger syndrome?”

Alternative approaches to treating symptoms associated with autism spectrum disorders do exist. One such approach is Complementary and Alternative Medicine (CAM), which is defined as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.”

CAM therapies used to treat Asperger’s (AS) and High-Functioning Autism (HFA) have been categorized as “biological” or “nonbiological.” Let’s look at each of these in turn…



Examples of biological therapies include:

• detoxification therapies (e.g., chelation)
• dietary supplement regimens that are supposed to act by modulating neurotransmission or through immune factors (e.g., vitamin A, vitamin C, vitamin B6 and magnesium, folic acid, folinic acid, vitamin B12, dimethylglycine and trimethylglycine, carnosine, omega-3 fatty acids, inositol, various minerals, etc.)
• gastrointestinal treatments (e.g., digestive enzymes, antifungal agents, probiotics, yeast-free diet, gluten/casein-free diet, vancomycin)
• immunoregulatory interventions (e.g., dietary restriction of food allergens or administration of immunoglobulin or antiviral agents)

Examples of nonbiological interventions include treatments such as:

• music therapy
• facilitated communication
• dolphin-assisted therapy
• equine-assisted therapy
• craniosacral manipulation
• behavioral optometry
• auditory integration training

Moms and dads of kids with AS and HFA will understandably pursue interventions that they believe may offer some hope for symptom-relief, particularly if the therapies do not have any adverse side-effects.

Unfortunately, parents are sometimes exposed to unconfirmed theories and related clinical practices that may be ineffective or, in worst case scenarios, lead to physical, emotional, or financial harm. Thus, always consult with your doctor before starting any new or unorthodox treatment approach.

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


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism