Middle school and high school settings present new social challenges for Asperger’s (AS) and High Functioning Autistic (HFA) students. Researchers have addressed the craziness these “special needs” students encounter during classroom transitions.
Passing periods are a desirable time of socializing for “typical” students. But, for AS and HFA students, passing periods are a social zoo (e.g., a lot of disruption and noise). They often want to be able to socialize and to have friends, but simply don’t because they are not sure how to have a meaningful conversation with their peers or they are unable to interact "correctly." Friendships are an incredibly important tool for avoiding anxiety, and problems making friends can create social phobia and depression.
In addition to sensory overload, the passing period is prime time for many AS and HFA students to get mistreated (e.g., teased and bullied). Often it is intentional, but sometimes the bullying is by accident, where other students share some unkind words out of difficulty understanding their AS or HFA classmate.
The recommendation here is for teachers to permit AS and HFA students to leave 5 minutes early in order to avoid the overwhelming social interaction. Without such options, these “special needs” students may spend most of the next class trying to recover from the distressing sensory overload experience.
"I need some stress management techniques to use on my very anxious daughter with autism (high functioning). Thanks in advance."
Children with High-Functioning Autism (HFA) are prone to greater stress in their daily lives than their “typical” peers. Social interaction – especially with more than one peer in which the HFA child has to identify, translate, and respond to social and emotional cues and cope with unexpected noise levels – inevitably increases stress to a point where his or her coping mechanisms may collapse.
A “stress assessment” (based on the knowledge of HFA) will help parents and teachers determine what are the natural and distinctive stressors for the child. Subsequently, an effective stress-management program can be designed.
When there are concerns about an HFA youngster’s stress level, a stress assessment can be conducted in order to better understand why the stress is occurring and to determine the most effective interventions to address it.
The assessment process involves:
observing the child’s behavior while he or she is experiencing stress
identifying the context in which the stress-related behavior occurs
documenting actions that precede and follow the behavior
triggers and payoffs for the behavior
parent response
child reactions to the parent response
frequency of the behavior
The goal here is to gain greater clarity about the child’s distinctive stressors and the function of the stress-related behavior so that effective interventions can be put in place to address his or her individual needs.
Components of a stress-management program may include the following:
1. At school, one option for the HFA youngster who becomes stressed on the playground during recess, for example, is to be able to withdraw to the school library, or for the child who is anxious about socializing during lunch break to be able to complete a crossword puzzle or go for a walk in the gym.
2. Help your HFA child understand his routine each day. He wants to know what is going to happen next. He needs to hear it every day – even if he did the same thing yesterday! You might hear your child ask the same questions over and over again. Try not to get frustrated with him if this happens. This is his way of trying to understand or asking you to give him more information. Also, talk to your child if he gets upset about a change. Ask him why he is upset. He needs help putting his feelings into words. Sometimes he just doesn’t like to stop what he is doing, or sometimes he might be worried about what will happen next.
3. “Cue-controlled relaxation” (i.e., a combination of deep breathing and repetition of the word "relax") is also a useful component of a stress-management plan. One technique is for the HFA child to have an object in his or her pocket that symbolizes – or has been conditioned to elicit feelings of – relaxation. For instance, one AS teen was an avid reader of fiction, his favorite book being The Secret Garden. He kept a key in his pocket to metaphorically open the door to the secret garden (an imaginary place where he felt peaceful and content). A few moments touching or looking at the key helped him to contemplate a scene described in the book and to relax and achieve a more positive state of mind. Parents can have a special picture in their wallet (e.g., a photograph of a beach scene) which reminds their child of the solitude and tranquility of such a place.
4. Let your child know if there is going to be a change in her routine. She feels worried inside when she doesn’t know what is going to happen or if she doesn’t know what she needs to do. It really helps when you tell your child about her day when she wakes up in the morning. Also, keep her updated as the day moves forward. Also, it really helps your child do what she needs to do when you can give her a five minute warning before a change happens. Even if she complains and doesn’t like what is going to happen, she can still get ready and do well with your help, if YOU stay calm.
5. Environmental modification can significantly reduce stress. This can include having a safe area for periods of solitude to relax, minimizing distractions and reducing noise levels.
6. If the parent or teacher recognizes that a particular event is a major cause of stress, then it would be wise to consider whether the source of stress could be avoided altogether (e.g., recommending the temporary suspension of homework).
7. Practice new things with your child before she has to do them with others. If she is going to do something new, it helps her get ready and feel good about trying if she can practice with you first. Even if the practice is not exactly the same as what is going to happen, just pretending about something new or simply reading a book about it can help. When the new thing happens, your child will remember about practicing with you and will know what to do.
8. Help your HFA child know what to do when he misses you. Being away from you is hard for him, even when he is doing something fun or is with someone he likes. Sometimes it helps if you tell your child what the two of you will do together when you come back.
9. Traditional relaxation techniques using activities to encourage muscle relaxation and breathing exercises can be taught to children with HFA as a “counter-conditioning procedure,” but parents and teachers must also consider the circumstances in which the child is particularly prone to stress. Counter-conditioning is the conditioning of an unwanted behavior or response to a stimulus (e.g., nervousness) into a wanted behavior or response (e.g., calmness) by the association of positive actions with the stimulus. For instance, when conditioning a child who has a “startle response” to loud noises, the parent would create a positive response by massaging or hugging the child when he or she reacts anxiously or nervously to a loud noise. Thus, this will associate the positive response with the loud noise.
10. Some stress is “good” stress, and some stress is “bad” stress. Not all stress is bad. Learning to do new things can be stressful for your child, but you can help her take a break if she needs to, or you can help her feel good about trying.
Resources for parents of children and teens on the autism spectrum:
More articles for parents of children and teens on the autism spectrum:
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.
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.
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.
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." Click here to read the full article…
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. Click here to read the full article...
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.
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.
Many students with Asperger’s (AS) and High-Functioning Autism (HFA) are unable to generalize the skills that they learn. For instance, the teacher may inform the student how to respectfully address a teacher. Normally this skill would then be generalized to any adult in a position of authority. However, a student with AS or HFA is likely to only apply the skill to the individual initially used as the target of respect in the learning process. The student will probably not apply this behavior to a principal, dean, or police officer.
The inability to generalize can also pose a problem in classroom assignments. For example, giving the direction to open a math book to a certain page does not communicate to additionally begin solving the problems. Thus, teachers should verbally give all the steps necessary to complete an assignment rather than assuming the AS or HFA student will know what comes next.
There are additional techniques that have been used in assisting “special needs” students to learn to generalize. Modes of instruction such as "scope and sequence" can be useful in equipping these students with the skills that assist in social and academic learning as well as generalization. Scope and sequence training involves teaching the student about the basics prior to expecting the generalized rules to be learned. For example, it would be best to (1) teach the student that “the tone of a person's voice sends a message” BEFORE (2) teaching the student he should “use a tone that is respectful to others.” Due to the difficulty AS and HFA students have with generalization, failing to teach the basics will further enhance their inability to generalize.
The IDEA Act is clear in its declaration that students must be placed in the least restrictive environment possible in an effort to provide them with the best education possible. This can only be achieved by means of evaluation by teachers as to the effectiveness of their chosen teaching strategies and a willingness on the part of teachers to continue to learn new techniques of instruction. Every AS and HFA youngster needs to (a) be evaluated, (b) have a plan established addressing areas of weakness, and most importantly (c) have a teacher that believes in the student and expects her to reach appropriate grade level requirements.
It is important that the teacher understands what AS and HFA is – and how it hinders students. Without a clear understanding of this disorder, actions that are clearly a part of the syndrome can be confused with behavioral issues and dealt with inappropriately.
"My child (with HFA) does obsess about certain things, but how can I tell if he has full-blown obsessive compulsive disorder?"
Obsessive compulsive disorder (OCD) is described as a condition characterized by recurring, obsessive thoughts and compulsive actions. Obsessive thoughts are ideas, pictures of thoughts or impulses that repeatedly enter the mind, while compulsive actions and rituals are behaviors that are repeated over and over again.
The obsessions seen in kids with Asperger’s (AS) and High-Functioning Autism (HFA) differ from the youngster with obsessive compulsive disorder. The youngster with AS or HFA does not have the ability to put things into perspective. Although terminology implies that certain behaviors in AS and HFA are similar to those seen in obsessive compulsive disorder, these behaviors fail to meet the definition of either obsessions or compulsions.
They are not invasive, undesired or annoying, which is a prerequisite for a diagnosis of obsessive compulsive disorder. The reason for this is that children with severe autism are unable to contemplate or talk about their own mental states. However, obsessive compulsive disorder does appear to coincide with AS and HFA.
Szatmari et al (1989) studied a group of 24 kids. He discovered that 8% of the kids with AS and 10% of the kids with HFA were diagnosed with obsessive compulsive disorder. This compared to 5% of the control group of kids without autism, but with social problems. Thomsen el at (1994) found that in the kids he studied, obsessive compulsive disorder continued into adulthood.
AS and HFA kids with obsessive compulsive disorder:
become preoccupied with whether something could be harmful, dangerous, wrong, or dirty
experience a need for symmetry, order and precision
experience intrusive sounds or thoughts
feel like they must perform the task or dwell on the thought
feel strong urges to do certain things repeatedly (i.e., rituals or compulsions) in order to banish the scary thoughts or ward off something dreaded
have a difficult time explaining a reason for their rituals
have a fear of contamination
have a fear of illness or harm coming to oneself or relatives
have a strong belief in lucky and unlucky numbers
have an "overactive alarm system"
have upsetting or scary thoughts or images that pop into their minds that are hard to shake
may have preoccupation with body wastes
may have religious obsessions
may have sexual or aggressive thoughts
realize that they really don't have to repeat the behaviors, but the anxiety can be so great that they feel that repetition is "required" to neutralize uncomfortable emotions
try to relieve anxiety via the use of obsessions and compulsions
want to feel absolutely certain that something bad won't happen
worry about losing things, sometimes feeling the need to collect these items, even though the items may seem useless to others
worry about things not being "in order" or "just right"
Compulsions that are most common include:
cleaning rituals
counting rituals
grooming rituals
hoarding and collecting things of no apparent value
ordering or arranging objects
repeatedly checking homework
repeating rituals (e.g., going in and out of doorways, needing to move through spaces in a special way, rereading, erasing, rewriting, etc.)
rituals to prevent harming self or others
rituals to undo contact with a "contaminated" person or object
touching rituals
Moms and dads can look for the following possible signs of obsessive compulsive disorder in their AS or HFA child:
a continual fear that something terrible will happen to someone
a dramatic increase in laundry
a persistent fear of illness
a sudden drop in test grades
an exceptionally long amount of time spent getting ready for bed
constant checks of the health of family members
high, unexplained utility bills
holes erased through test papers and homework
raw, chapped hands from constant washing
reluctance to leave the house
requests for family members to repeat strange phrases or keep answering the same question
If your AS or HFA youngster shows signs of obsessive compulsive disorder, talk to your physician. In screening for obsessive compulsive disorder, the physician will ask your youngster about obsessions and compulsions in language that he or she will understand, for example:
Are there things you have to do before you go to bed?
Do things have to be "just so"?
Do you collect things that others might throw away (e.g., hair, fingernail clippings, dead batteries, etc.)?
Do you count to a certain number or do things a certain number of times?
Do you have to check things over and over again?
Do you have to wash your hands a lot?
Do you have worries, thoughts, images, feelings, or ideas that bother you?
Treatment—
The most successful treatments for AS and HFA children with obsessive compulsive disorder are cognitive-behavioral therapy (CBT) and medication. CBT helps these “special needs” children learn to change thoughts and feelings by first changing behavior. The therapy involves gradually exposing children to their fears, with the agreement that they will not perform rituals in order to help them recognize that their anxiety will eventually decrease and that no disastrous outcome will occur.
Just talking about the rituals and fears have not been shown to help obsessive compulsive disorder, and may actually make it worse by reinforcing the fears and prompting extra rituals. Thus, for CBT to be successful, it must be combined with “response prevention,” in which the youngster's rituals or avoidance behaviors are blocked (e.g., a youngster who fears dirt must not only stay in contact with the dirty object, but also must not be allowed to wash repeatedly).
Many children can do well with CBT alone, while others will need therapy and medication. Selective serotonin reuptake inhibitors (SSRIs) often can reduce the impulse to perform rituals. Once a youngster is in treatment, it's important for moms and dads to participate, to learn more about obsessive compulsive disorder, and to modify expectations and be supportive.
AS and HFA kids with obsessive compulsive disorder get better at different rates, so parents should try to avoid any day-to-day comparisons and recognize and praise any small improvements. Also, try to keep family routines as normal as possible.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
