In this video, we are going to look at the most important strategies parents of high-functioning autistic children can use to ensure that summer vacation goes smoothly.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
"Our daughter (autistic) is suppose to take 2 meds everyday, but always has a meltdown whenever we try to give them to her. She is so afraid of the side effects that she can’t put her anxiety
aside long enough to take them. Is this common? What can we do? She has to take these two prescriptions according to the doc."
While lack of awareness by parents and their Asperger’s (high-functioning autistic) child of adverse drug reactions can have serious consequences, having a phobia of medications can also have serious harmful effects on the child’s health (e.g., problems with medication compliance, refusal of necessary drug intervention, etc.).
Medication phobia can also present in moms and dads who are concerned about giving medications to their youngster, fearing that the medications will do more harm than good.
Fears of taking medication is prevalent in children who have experienced unpleasant withdrawal effects from psychotropic drugs. Also, medication phobia can be triggered by unpleasant adverse reactions to drugs that are prescribed inappropriately or at excessive doses. Furthermore, due to sensory sensitivities, many children on the autism spectrum have great difficulty with – and a fear of – swallowing pills.
The nature of Asperger’s and high-functioning autism (HFA) introduces significant challenges, particularly when using drug treatments. Building a relationship and gaining the child's trust can be hard to accomplish. Many young people on the autism spectrum feel forced to take medication and commonly recoil from the idea of drug treatment. Some are so frightened of the effects of medications that they can’t put those fears aside long enough to try one.
A real paradox occurs in the area of anxiety. Many, if not most, children on the spectrum experience anxiety. However, the degree of anxiety that makes it appropriate to consider medication for it can also interfere with the child adhering to a prescription. Despite the enormous distress the child’s anxiety symptoms generate, he or she may not be able to put aside worries about the medication. Parents may be the only people the child will allow to counter these fears.
Many of the difficulties associated with anxiety (e.g., behavioral problems) are more distressing to those around the child (e.g., parents, siblings, teachers, etc.) than to the child herself. Children with Asperger’s and HFA commonly lack the ability to perceive the signals of comfort or pleasure of others or, once acquired, to use others' emotions to guide their behaviors. Lacking this ability, these children struggle with the initial fears related to taking medication or entering into other therapy that can help them get along with others. Often they can’t see why they should be required to take a particular drug simply because others are upset. Threatening an unpleasant consequence is usually ineffective. These “special needs” kids are often willing to accept dreadful consequences rather than compromise a rigidly held rule, contain a pressing urge, tackle managing an anxious feeling, or yield control to someone else.
Another hurdle is the limitations children with Asperger’s and HFA have in identifying their own internal mood states and emotions. As a result, parents, teachers and other adults may be unable to gauge whether the child experiences less subjective anxiety, anger, or sadness. The child's emotional “comfort” may not be available to the therapist for rating improvement. To monitor progress, the therapist may have to draw on multiple observations, rely more or less exclusively on the child's somatic experience, and to use highly concrete measures.
An associated obstacle is the deficits children on the autism spectrum have perceiving and understanding other's intentions, wishes, or needs. This blindness to others often contributes to the child’s inability to grasp how his reactions contribute to a bad result. More often, the child believes he is being victimized. The teasing and bullying that the Asperger’s or HFA child often has to endure at school only adds to this. For this child, it may be impossible to tell the difference between (a) the natural consequences associated with his choices and (b) mistreatment by others. Nonetheless, the child is likely to be oblivious to how his actions contribute to a chain of events that end in a meltdown, outburst or aggression – or even to believe that the outcome should be prevented in the future. This blindness also produces a tendency for the child to accuse those around him of causing problems. Faulting others is highly characteristic and is a direct result of the disorder.
Many children with Asperger’s and HFA display profound weaknesses in the ability to observe sequences of events and transactions accurately, and in understanding the “logical” responses of those around them. These kids can be highly concrete. The “big picture” of behaviors and emotions is often lost to an excessive attention to small changes in circumstances or minor details. They often have a flawed sense of proportion (e.g., premeditated, forceful retaliation may be viewed as a justified response to someone else's small gaffe).
In addition, kids on the autism spectrum often are rigid in their behaviors with inflexible routines, dedication to unnecessary rules, or ritualized behaviors. Sometimes these may be no more than a minor irritation to others, but when severe, they can obstruct action and exasperate those around them. Severe rigidity can be highly frustrating to others, and attempts to counter it may produce aggressive reactions from the child. She may perceive that “if only my parents would let me do what I want,” there would be no problems at all.
1. No drug influences the core pragmatic social deficits (e.g., misinterpreting cues, failure to appreciate social cues and nuances, etc.). As a result, there is no one algorithm to follow that targets the primary source of impairment or the greatest source of difficulty for the Asperger’s child.
2. There is an absence of high quality, valid studies of the efficacy of different drugs for specific symptoms in this population. Most of the studies are case reports or small-scale, open, unblinded trials. This requires the clinician to take findings from studies of other disorders in the hope that the results translate to Asperger’s. This presumption is entirely theoretic at this point. Much of the time, a clinician has no way to gauge the child’s response in comparison with others with this disorder. Global functioning may or may not be meaningfully improved.
3. A third obstacle is the absence of treatment and outcome studies of Asperger’s with comorbid conditions. For instance, it may be erroneous to presume that mood dysregulation and the response to mood stabilizers in the context of Asperger’s is identical to bipolar disorder in an otherwise ordinary teenager. Nearly all treatment studies of other childhood disorders exclude children with PDD spectrum disorders. As a result, when an Asperger’s child appears in the clinician's consulting room, unless one has the luxury of a previous relationship and a sense of that child's baseline functioning, one can’t know what the child looks like when the comorbid condition is “resolved.” Most of the core social impairments are likely to remain, although functional gains are possible.
Treatment of Medication Phobia—
Treatments for medication phobia can be approached from several different angles. For example:
Practicing relaxation techniques (e.g., deep breathing, yoga, muscle relaxation, etc.) can help the Asperger’s child deal with the emotional and physical symptoms of medication phobia.
Learning to keep negative thoughts at bay is helpful, because a negative train of thought can initiate the medication phobia.
If choking while taking medicine is the child’s fear, then the physician can give options for liquid or crushed medicines.
Children with medication phobias can learn self-help methods to deal with the worst of the symptoms. Getting informed about the phobia is the first step in overcoming the fear.
Cognitive-behavioral therapy, more commonly known as exposure therapy, may be the best approach for dealing with medication phobia. Using the exposure therapy method slowly exposes the child with his phobia first through the mind in therapy sessions, and then in real life situations. Depending on the severity of the case, therapy can help the child cope with his fear and get his health back on track.
Being afraid of taking medicine - or of suffering adverse reactions - is not uncommon for children on the autism spectrum. However, by utilizing the treatment methods listed above, parents can help their child gain a comfort level such that taking prescribed medication is perceived as a rather harmless endeavor.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
COMMENTS: • Anonymous said… I have a 7 year old who won't take medicine. I hope he can learn over the years ✨🙏🏼✨ • Anonymous said… Mine wouldn't take any meds until he could take a pill (this included antibiotics). He would actually throw up on me if I forced them. I had to be really creative in hiding the meds in foods and drinks. I taught him to swallow pills using mini m&m's when he was 4. Now he takes a daily medication with ease. • Anonymous said… My daughter is 15 and takes meds really well now. She knows if she doesn't take those meds her actions are bad and she has withdrawals. I would talk to a doc and see if anything liquid or other possibilities are available • Anonymous said… Carbonation helps to float the tablet in their mouth. It is how I had to teach one of my kids to swallow a pill. She could not do it with regular water and still cannot. We practiced with Tic Tac's a lot. • Anonymous said… Dispersible tabs here and a capsule emptied into water every single morning. No way he'd ever swallow tablets. And his melatonin drops have to be made up without flavouring...... • Anonymous said… Fascinating reading everybody's comments about swallowing. My son cannot swallow any form of tablet. Puts it on his tongue and then just freezes and panics. Interesting that so many of you have the same issue. Another thing I have learnt today. • Anonymous said… His OT worked with him on swallowing 'pills', mini MM's and regular size cut in half. Now he Can swallow the small gel oval shaped laxatives, but doesn't want to. Currently he is applying DoTerra Oils himself. • Anonymous said… I can't even get my son to take melatonin. I hide it in chocolate milk. He had eye surgery and it took 3 of us to hold him down just to get the woozy meds in to him, which he then spit half of it out and in to the nurse. He was 5 then, he's 8 now. • Anonymous said… I have a 12 year old who won't take medicine. • Anonymous said… Mine doesn't take medication. I think it's only kids with Adhd that are medicated isn't it? Or kids with excessive stimming? • Anonymous said… Mine is afraid to swallow the capsules. I break them open over a spoon of yogurt and he eagerky takes them. He says they allow him to stop and think. • Anonymous said… My 16 year old Aspie takes only brufen willingly. No tablets . Antibiotics only yellow one for kids. Thank God she hasn`t needed anything else so far. • Anonymous said… My daughter (8 1/2 yrs old ) refuses to take tablet form she thinks she going to choke and will not let u put it in her mouth so we always get liquid which she takes no problem. • Anonymous said… My daughter is the absolute worse at taking medicine. I am very thankful we do not have daily meds and that she is very healthy. • Anonymous said… My son (7.5 YO) has epilepsy medicine, and he hated the liquid form, but we slowly introduced the pill form instead. It was by a process of putting pill taking in the daily routine, and making sure it was accompanied with a nice drink, i.e. apple juice or milkshake, and occasionally some bribery, i.e. a toy car, a Lego figure, that he now takes it with very little fuss. Routine and patience were rewarded. • Anonymous said… My son hates taking his- luckily we get capsules and can mix it into his breakfast drink. He hates taking it but he told me as long as I don't see you putting it into my drink it's fine. • Anonymous said… My son is afraid of gagging. We have to break open the capsule and he swallows the beads, but occasionally he will gag and throw up all the medicine. That's his Ritalin. He doesn't have an issue with his seizure medicine that is an orally disintegrating tablet. He likes the minty flavor also. • Anonymous said… My son isn't afraid to take his but he doesn't like it. And he will occasionally refuse to take it when he's mad at me, as though he's punishing me. But he's been pretty good about it the last few years. • Anonymous said… My son refuses to take medication- terrified what it might to him • Anonymous said… My two aspie kids will NOT take meds. They are both horrible with meds. We have to hold them down to give them anything • Anonymous said… No afraid to take it but complained because he only liked the circle ones not the oval ones. Something about the circle ones go down better than the oval ones. I had his doctor explain to him that he needed to take them regardless off shape or color and that seemed to work. • Anonymous said… Oh wow!! Our very recently diagnosed 6 year had his tonsils out a fortnight ago. We had medication battles every two hours!! Thankfully he is better today and it's all over. We had no idea that this was common to HFA kids!!! • Anonymous said… Terrified of any and all meds - yes yes yes - so is his dad. • Anonymous said… Will not swallow a pill. Chews his Guanfacine. My friend is a pharmacist and is looking into compounding for him • Anonymous said… Yep! It's a nightly battle. This week the doctor told us to just hide it. • Anonymous said… Yes he is very dubious. Its quite a process. It takes lots if talking. Spoon was best we found, syringe a bit scary. And we just give it in small amounts with sips of water in between until dose taken. • Anonymous said… Yes my son would try really hard to take it. He found it very difficult. When he was about 9 I put $2 on the container which he could have if he got a tablet down. He did it for the first time with food and since then it's been a lot easier • Anonymous said… YES! We have tried EVERYTHING to mix it with. The only thing that sometimes works is offering Pokemon cards (it's his thing right now). We put them in sealed envelopes which he has decorated. Then we make it a big deal "Which one will you choose?" thing. Sometimes we just can't get him to take it. We used to have two of us hold him down but then when he was willing to take it, he would want to "play" that he wouldn't and ask us to hold him down. • Anonymous said… Yes, he refuses all medications. • Anonymous said… Yes, I have struggled the past 3 years for my now 17 year old to take his required Thyroid medication. He claims he has a fear of swallowing and chocking on it. Even if we crush it. Very frustrating. I have tried mixing it in food, but he always knows, he is 17 after all.;-) We have therpists coming twice a week to work with him on this, and he does great for about a month, than he stops taking it again. Trying to figure out what more he fears about this medication, sadly, he can't function without it as he sleeps 24/7 when he doesn't take the meds. And yes, he flat out refuses it. He has learned over the years to just answer "I will take it later on my time" to get us off of his back. And later never happens. • Anonymous said… Yes. My 8 yr old boy was scared to take anxiety meds. Luckily it came in a liquid (and he didn't mind the taste) and I explained that I take meds too. So we take them together. That seemed to get him past it. Please post your comment below…
"After researching the info on this site, my husband and I believe our child is on the autism spectrum. I'm all for going to a doctor to have him diagnosed, but my husband is dead set against it because he thinks our son will be discriminated against once he has 'the label'. SO... my question is does a diagnosis cause more harm than good?"
Diagnosis has traditionally been the route by which children with Asperger’s (AS) or High-Functioning Autism (HFA) and their parents have accessed specialist services. But this tradition has grown out of the services for kids on the autism spectrum who were severely disabled by their disorder under all circumstances. The group of children with AS and HFA include those whose social impairment is arguable.
What about the father whose child is diagnosed with AS, and his wife begins to think of her frustrations with her husband during the marriage? Does the husband become socially impaired because he is suspected of having AS? Is a timid father with an eccentric manner who is nevertheless devoted to his wife and youngster socially impaired? Is a loner with a passionate interest in old diesel engines socially impaired?
Checking off the boxes is not sufficient for making a diagnosis. Making a diagnosis has to result in a useful product for the client. There is no hard and fast rule about whether a diagnosis of AS or HFA will be useful. A decision needs to be made in each case, usually following an open discussion about what benefits or costs the client anticipates from a diagnosis. And the situation may change.
An AS or HFA teenager who is facing unemployment because he is acting strangely and whose routines at home are becoming a major source of harassment for his mom and dad, may in a year or two be coping well and happily with another job and be a pleasant (if eccentric) house companion. Although a diagnosis might have been useful on the first occasion, it may be unhelpful on the second.
There are many other conditions in medicine that are dimensional and not categorical, and that may dip in and out of the pathologic range (e.g., hypertension). They require a different kind of management. The family physician must remember that his patient had a raised blood pressure once, and that it needs to be checked from time to time without treating the patient as if he or she has a current disorder.
For psychiatric services dealing with people with AS and HFA, this translates into being able to maintain contact with grown-ups with AS and HFA, perhaps over long periods and without specific treatment; or, alternatively, it translates into enabling people with AS and HFA to access services for themselves and giving them the means to decide when it is in their best interest to do so.
People with AS and HFA may need help particularly during developmental transitions and during crises. Specialist psychiatric help may not be needed at these times, although help from someone who is knowledgeable about autism spectrum disorders and comfortable relating to the affected individuals is important. However, there are some crises that call for specialist psychiatric or psychologic help. These include crises associated with psychiatric comorbidity and forensic problems.
AS and HFA can be misdiagnosed as a number of other disorders, leading to medications that are unnecessary – or that worsen behavior! For example, there is much overlap between AS and NLD. Both have symptoms of precocious reading, verbosity, and clumsiness. But, they differ in that kids with AS have restricted interests, repetitive behaviors, and less-typical social interactions. Diagnostic confusion burdens children and their parents and may cause them to seek useless therapies.
Disorders that must be considered in a differential diagnosis include:
attention-deficit hyperactivity disorder
depression
multiple complex developmental disorder
nonverbal learning disorder (NLD)
obsessive compulsive disorder
other pervasive developmental disorders (e.g., autism, PDD-NOS, childhood disintegrative disorder, Rett disorder)
Diagnosis may be particularly helpful if it results in services provided to the affected child in the area of social skills training. Due to social skills deficits, children with AS and HFA find themselves socially isolated. Reasons for this include, but are not limited to, the following:
Chronically frustrated by their repeated failures to engage others and form friendships, some kids on the autism spectrum develop symptoms of a mood disorder that may require treatment.
Social skills deficits are largely responsible for the impression of social naiveté and behavioral rigidity that is so forcefully conveyed by these children.
The communication style of children with AS and HFA is often characterized by marked verbosity. The youngster may talk incessantly (usually about a favorite subject) often in complete disregard as to whether the listener is interested, engaged, or attempting to interject a comment, or change the subject of conversation. Despite such long-winded monologues, the AS or HFA child may never come to a point or conclusion. Attempts by the listener to elaborate on issues of content or logic, or to shift the interchange to related topics, are often unsuccessful.
Their poor intuition and lack of spontaneous adaptation are accompanied by marked reliance on formalistic rules of behavior and rigid social conventions.
There is a lack of contingency in speech that is a result of (a) the one-sided, egocentric conversational style (e.g., unrelenting monologues about the names, codes, and attributes of innumerable TV stations in the country), (b) failure to provide the background for comments and to clearly establish changes in topic, and (c) failure to suppress the vocal output accompanying internal thoughts.
They may be able to describe correctly (in a cognitive and often formalistic fashion) other people's emotions, expected intentions, and social conventions; however, they are unable to act on this knowledge in an intuitive and spontaneous fashion, thus losing the tempo of the interaction.
They may express an interest in friendships, but their wishes are invariably thwarted by their awkward approaches and insensitivity to the other person's feelings, intentions, and nonliteral and implied communications (e.g., signs of boredom, haste to leave, and need for privacy, etc.).
They may react inappropriately to the context of the affective interaction, often conveying a sense of insensitivity, formality, or disregard for the other person's emotional expressions.
They typically approach others, but in an inappropriate or eccentric fashion (e.g., they may engage the listener in one-sided conversation characterized by long-winded, pedantic speech about a favorite, unusual and narrow topic).
Social skills training that would effectively address the issues listed above would suggest that the advantages outweigh any disadvantages of receiving a formal diagnosis.
There are positives and negatives associated with a psychiatric diagnosis – and the diagnostic process generally. Unlike most physical disorders, there is a higher degree of uncertainty attached to a psychiatric diagnosis. The systems of classification that have been developed attempt to reduce this uncertainty, but personal interpretations still play a huge factor. And when a diagnosis is reached, there is the problem of “labeling.”
Labels (i.e., the diagnosis) applied to “special needs” children suggest they are different. To those unfamiliar with autism spectrum disorders, these kids may be viewed as abnormal, making them feel distrustful or anxious? The label itself can result in a self-fulfilling prophecy (i.e., it can result in the child viewing himself as abnormal) and can bias the way parents, teachers, and other adults view the child.
In any event, there are times where a diagnosis is helpful, and there may be times when the child or teen is better off without the “label.” The decision to seek a formal diagnosis is ultimately up to parents.
In the case of an adult, the decision should be his or hers alone. Diagnosis as an adult can be a mixed blessing. Some people decide they are O.K. with being self-diagnosed and decide not to ask for a formal diagnosis. However, for those who DO want a formal diagnosis, there may be a variety of benefits.
It’s never a bad idea for an individual to increase self-awareness in order to capitalize on strengths and work around areas of challenge. Knowing about AS or HFA gives the individual an explanation, not an excuse, for why his or her life has taken the twists and turns that it has. What one does with this information at the age of 20, 30 or 70 may differ, but it is still important information to have in many cases.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
Is it possible that everyone has a touch of Asperger’s (AS), also called High-Functioning Autism (HFA)? Think about it: all the features that characterize AS and HFA can be found in varying degrees in the “normal” population. For example:
A lot of people can engage in tasks (sometimes mundane ones) for hours and hours.
A number of “normal” people have outstandingly good rote memories and even retain eidetic imagery into adult life.
Collecting objects (e.g., stamps, old glass bottles, railway engine numbers, etc.) are socially accepted hobbies.
Everyone differs in their levels of skill in social interaction and in their ability to read nonverbal social cues.
Many individuals are visual, three-dimensional thinkers.
Many people can pay attention to detail – sometimes with painstaking perfection.
Many who are capable and independent as grown-ups have special interests that they pursue with marked enthusiasm.
Most men - and many women - prefer logic over emotion.
Pedantic speech and a tendency to take things literally can also be found in “normal” individuals.
The capacity to withdraw into an inner world of one's own special interests is available in a greater or lesser measure to all human beings.
There is an equally wide distribution in motor skills.
Other “autistic” traits that many “typical” people experience include:
Clumsiness
Don't always recognize faces right away
Have a speech impediment early in life
Eccentric personality
Flat, or blank expression
Highly gifted in one or more areas
Intense focus on one or two subjects
Likes and dislikes can be very rigid
Limited interests
May have difficulty staying in college despite a high level of intelligence
Preoccupied with their own agenda
Repetitive routines or rituals
Sensitivity to the texture of foods
Single-mindedness
Unusual preoccupations
Difficulty understanding others’ feelings
Great difficulty with small-talk and chatter
Has an urge to inform that can result in being blunt or insulting
Lack of empathy at times
Lack of interest in other people
May avoid social gatherings
Preoccupied with their own agenda
Social withdrawal
Can often be distant physically and/or emotionally
It is possible that some people are classified as having AS or HFA because they are at the extreme end of the normal continuum on ALL these features – or one particular aspect may be so marked that it affects the whole of their functioning?
The argument could be made that the difference between someone with AS/HFA and the “typical” individual who has a complex inner world is that the latter DOES take part appropriately in two-way social interaction, while the former does NOT. Also, the typical person, however elaborate his inner world, is influenced by his social experiences, whereas the person with AS/HFA seems cut off from the effects of outside contacts.
So, now a new question arises: Is it possible that AS and HFA are simply reflections of object-oriented individuals (i.e., those who have a preference for ideas, tasks and objects) versus people-oriented individuals (i.e., those who prefer social interaction over all else)? If so, does this preference make for a “disorder”?
Also, if we should view AS/HFA as a disorder, whose problem is it? Is it a problem for the person with the disorder, or for the people who have dealings with the affected person? If “normal” people have difficulty with AS/HFA individuals, but AS/HFA individuals are O.K. with themselves, then it would seem that the “typicals” own the disorder.
What if we stopped viewing AS and HFA as abnormal? Many individuals on the autism spectrum embrace their condition. Rather than seeking a “cure,” they seek respect for “neurodiversity.” They want to show that autism does NOT mean “limited,” rather it is simply a different way of thinking and viewing the world. Individuals with differently wired brains have always existed – some of them geniuses because of their autistic traits, not despite them.
Neurodiversity is the idea that neurological differences (e.g., AS, HFA, ADHD) are the result of natural variation in the human genome (i.e., an organism’s complete set of DNA). This represents a new way of looking at disorders that were traditionally characterized as medically or psychologically abnormal.
Neurodiversity is a viewpoint that is not universally accepted, although it is increasingly supported by science. This science proposes that disorders like AS and HFA have a stable prevalence in human society as far back as we can measure. We are realizing that developmental disorders emerge through a combination of genetic predisposition and environmental interaction – not the result of injury or disease.
Talk of “cure” feels like an attack on the very being of many AS and HFA individuals. Some hate that word for the same reason other groups dislike talk of “curing gayness.” Thus, shouldn’t the accommodation of neurological differences be a similarly charged civil rights issue? If their diversity is part of their true nature, shouldn’t they have the right to be accepted and supported “as is?”
Neurodiverse individuals have contributed many great things to human society. If those contributions were truly influenced by neurological differences, then an attempt to “cure” such differences would seem to be extremely damaging to humanity.
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Anonymous said… This is an excellent article! In my experience the window of 'neurotypical' is getting narrower and narrower. I have to chuckle when I hear all the labeling and categorizing of people these days - aren't 'labeling' and 'categorizing' hallmarks of Aspergers and HFA? What does that say about our society? People with Aspergers and HFA don't need to be cured. Neurotypicals need to be less rigid in their thinking regarding the wonderful range and diversity of the human brain:)
Anonymous said…I know I may be biased, partly due to the fact that I am Autistic. Yet I see many things on that list that apply to me and I don't see some of them as being entirely positive. Autism is generally identified as a multitude of these factors acting as either deficits or the brain's attempt at compensating for these deficits. If one is low functioning the factors contributing towards their Autism may almost be crippling. I am high functioning and I was torn to pieces before even attempting this post, yet I ferl strongly enough to attempt to advocate for those of us who tend to live with society's expectation that we should be the second coming of "Rain Man". Yet even as I undertake a course at Uni for Disability Studies, and don't see the academic value of this article, I do see where it is coming from. I do however, have to ask a question, can't these factors existing in almost everyone, be simply accredited to Human Diversity? Why must we glorify Autism and state (dangerously), that everyone has a degree of Autism in them? Because that in my perspective, sensationalises the stereotype that we all possess superhuman abilities. Sorry for the spiel, I do respect the article, but it is an important idea to raise.
"Do some teens with ASD make awkward advances to the opposite sex, which are viewed as harassment? Our 17 y.o. was recently called down to the Dean's office for 'making inappropriate advances' to a girl he has a crush on!"
Perhaps the most obvious trait of Asperger’s (AS) and High Functioning Autism (HFA) is impairment of two-way social interaction. This is not due primarily to a desire to withdraw from social contact. Rather, the problem arises from a lack of ability to understand and use the rules governing social behavior.
These rules are complex, unwritten and unstated, constantly changing, and affect choice of clothing, eye contact, gesture, movement, posture, proximity to others, speech, and many other aspects of behavior.
The degree of skill in this area varies among “typical” people, but those with AS and HFA are outside the normal range, for example:
Many are over-sensitive to criticism and suspicious of others.
Some have a history of rather bizarre antisocial acts (perhaps because of their lack of empathy).
Their social behavior is peculiar and naive.
They do not have the intuitive knowledge of how to adapt their approaches and responses to “fit in” with the needs and personalities of others.
They may be aware of their difficulties – and even strive to overcome them – but in inappropriate ways.
Relations with the opposite sex provide a good example of the more general social ineptitude in AS and HFA. One 26-year-old male with AS observed that most of his peers had girlfriends and eventually married and had kids. He wished to be “normal” in this respect, but had no idea how to indicate his interest and attract a partner in a socially acceptable way. He asked some of his friends for a list of rules for talking to females, and tried to find “the secret” in various books. He had a strong sex drive, and on one occasion approached and kissed a female he had a crush on. As a consequence, he found himself in trouble with the police, and later tried to solve the problem by becoming solitary and withdrawn.
Possibly because of the absence of a reference group, sexual interests among individuals with AS and HFA may be unusual, for example:
AS and HFA males may become addicted to adult internet sites, and a few have attracted police attention by downloading pictures of kids.
Fetishes are not uncommon and may occasionally lead to forensic problems, as with the person with AS who liked to impersonate doctors and ask women intimate questions about reproduction.
Many young people with AS and HFA manage to suppress their sexuality.
Teens with AS and HFA may relate better to younger kids than they do to their peer group, and may occasionally make inappropriate sexual approaches to them. Older teens – and even some grown-ups – may idealize childhood, and may be sexually attracted to kids for that reason.
Young people with AS and HFA may rarely get into trouble indecently exposing themselves, but this may turn out to be something that someone else (often a girl) put them up to.
Stalking is the area in which the sex life of young people on the autism spectrum gives most cause for concern. “Crushes” are common in the teenage years, and young men with AS and HFA often develop them. Although “typical” teens are aware that their feelings are not going to be reciprocated by the opposite sex, this may not be obvious to the teenager with AS or HFA who may become inappropriately attached.
There is usually an initial phase during which the object of the attraction (the female) feels a bit flattered, a bit alarmed, or very caring toward the AS or HFA male who has become fixated on her. However, there may be phone calls, inappropriate notes, or statements made to others that lead the female who is the object of adoration to decide that “enough is enough.”
There is usually a confrontation that is often clumsily handled because the object of adoration is frequently someone like a teacher or nurse who has a duty of care for the AS or HFA male. The problems begin if this rejection is not accepted. The object of adoration may become an object of hatred and may be targeted with abusive calls or letters by the AS or HFA male. The female’s friends may be the victims of jealous attacks, or the female may be followed.
How can parents and teachers help? Start by providing a few straightforward relationship tips. For example:
Ask the girl how she's doing or what she's reading instead of commenting on her body parts.
Be aware of the girl’s personal space.
If she ignores you, drops eye contact, or walks away, back off.
It’s not rude of you to approach a girl, but understand that she is not being rude if she doesn't want to keep talking to you, especially if you initiated conversation while she was running an errand, waiting for the bus, or on her computer at a coffee shop.
Look at her face instead of her chest.
Males are socialized to think that females don't really say what they mean. Wrong! Take her words at face value.
Not all greetings are out of bounds. There is the matter of context. For example, early-morning dog-walkers may offer courteous "good mornings" as they pass each other on the sidewalk. However, commenting on a woman's form as she walks past is not acceptable.
Talk “to” the girl, not “at” her.
Know that there can be a fine line between flirtation and harassment.
Above all, treat her with respect.
Most AS and HFA males will want a girlfriend, but may feel shy or intimidated when approaching the opposite sex. They may feel "different" from others. Although most “typical” teens place emphasis on being and looking "cool," teens with AS and HFA may find it frustrating and emotionally draining to try to “fit in.”
They may be immature for their age and be naive and too trusting, which can lead to social skills deficits (especially in the world of dating), teasing and bullying. All of these difficulties can cause these young people to become withdrawn, socially isolated, depressed and anxious.
