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Anxiety Management in High-Functioning Autism: 25 Tips for Parents

Anxiety can't be measured or observed except through its behavioral manifestation, either verbal or nonverbal (e.g., crying, complaining of a stomachache or headache, crawling under the table, becoming argumentative, etc.).

To manage the anxiety in Aspergers and High-Functioning Autistic (HFA) kids, moms and dads are encouraged to do any – or all – of the following:

1. Avoid over-scheduling. Soccer, karate, baseball, music lessons, play-dates the list of extracurricular activities children can take on is endless. But too many activities can easily lead to stress and anxiety in kids. Just as grownups need some downtime after work and on weekends, kids also need some quiet time alone to decompress.

2. Be flexible and try to maintain a normal routine.

3. Consult a counselor or your pediatrician. If you suspect that a change in the family such as a new sibling, a move, divorce, or a death of a family member is behind your youngster's stress and anxiety, seek advice from an expert such as your youngster's school counselor, your pediatrician, or a child therapist.

4. Create an anxiety hierarchy, and put the events in order from easy to hard.

5. Develop, practice, and rehearse new behaviors prior to exposure to the real anxiety-producing situation.

==> Preventing Meltdowns and Tantrums in HFA Children

6. Don’t dismiss his feelings. Telling your youngster “not to worry about his fears” may only make him feel like he’s doing something wrong by feeling anxious. Let him know that it’s okay to feel bad about something, and encourage him to share his emotions and thoughts.

7. Don’t punish mistakes or lack of progress.

8. Get him/her outside. Exercise can boost mood, so get him moving. Even if it’s just for a walk around the block, fresh air and physical activity may be just what he needs to lift his spirits and give him a new perspective on things.

9. Gradually shift “anxiety control” to your youngster by preparing him for anxiety-producing situations by discussing antecedents, settings, triggers, and actions to take.

10. Help your youngster identify the source of the anxiety if he is old enough to understand this concept.

11. If he is old enough, teach your youngster increasing independence in anticipating and coping with anxiety in a variety of situations.



12. Implement new behaviors in the actual situations where anxiety occurs.

13. Keep your youngster healthy. Make sure he’s eating right and getting enough sleep. Not getting enough rest or eating nutritious meals at regular intervals can contribute to your youngster’s stress. If he feels good, he’ll be better equipped to work through whatever is bothering him.

14. Limit your youngster's exposure to upsetting news or stories. If she sees or hears upsetting images or accounts of natural disasters such as earthquakes or tsunamis or sees disturbing accounts of violence or terrorism on the news, talk to her about what's going on. Reassure her that she and the people she loves are not in danger. Talk about the aide that people who are victims of disasters or violence receive from humanitarian groups, and discuss ways that she may help, such as by working with her school to raise money for the victims.

15. Listen carefully to your youngster. You know how enormously comforting it can be just to have someone listen when something’s bothering you. Do the same thing for your youngster. If he doesn’t feel like talking, let him know you are there for him. Just be by his side and remind him that you love him and support him.

16. Make a list of numerous anxiety-producing situations, from easy ones to those that are more difficult (this is called “anxiety mapping”).

17. Modify expectations during stressful periods.

18. Offer comfort and distraction. Try to do something she enjoys, like playing a favorite game or cuddling in your lap and having you read to her, just as you did when she was younger. When the chips are down, even a 10-year-old will appreciate a good dose of parent TLC.

19. Plan for transitions (e.g., allow extra time in the morning if getting to school is difficult).

20. Prevent anxiety by “external control” (i.e., structuring the environment to make it predictable, consistent, and safe).

==> Discipline for Defiant Asperger's and HFA Teens

21. Use psychological, environmental and psychopharmacological treatments as needed (see below).

22. Recognize and praise small accomplishments.

23. Set a calm example. You can set the tone for how stress and anxiety in kids is handled in your house. It's virtually impossible to block out stress from our lives in today's high-tech, 24-hour-news-cycle world, but you can do something about how you handle your own stress. And the more you are able to keep things calm and peaceful at home, the less likely it is that anxiety in kids will be a problem in your household.

24. Stay calm when your youngster becomes anxious about a situation or event.

25. Stick to routines. Balance any changes by trying to maintain as much of her regular routine as possible. Try to stick to her regular bedtime and mealtimes, if possible.

Behavioral Manifestations of Anxiety in Kids on the Autism Spectrum:



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

Summary of Anxiety Treatments for Children on the Autism Spectrum—

1. Psychological Treatments:
  • Behavioral Therapies: Focus on using techniques such as guided imagery, relaxation training, progressive desensitization, flooding as means to reduce anxiety responses or eliminate specific phobias.
  • Cognitive-Behavioral Therapy: Addresses underlying “automatic” thoughts and feelings that result from thoughts, as well as specific techniques to reduce or replace maladaptive behavior patterns.
  • Psychotherapy: Centers on resolution of conflicts and stresses, as well as the developmental aspects of an anxiety disorders solely through talk therapy.
2. Environmental Treatments:
  • Reduction of stressors. Identify and remove or reduce stressful tasks or situations at home, school and work.
  • Good sleep habits. Getting adequate, restful sleep improves response to interventions to treat anxiety disorders.
  • Avoidance or minimization of stimulants. No caffeine, minimize use of asthma medications if possible (bronchodilators, theophylline), avoid use of nasal decongestants, some cough medications, and diet pills.
3. Psychopharmacological Treatments (used as a last resort only):
  • Antihistamines: Older medications used for mild to moderate anxiety for many years. These, like the benzodiazepines, work fairly quickly (Atarax, Vistaril).
  • Benzodiazepines: Long-acting are best (Klonopin, Ativan, Valium, Librium, Serax) to quickly reduce the symptoms of an anxiety disorder. However, if used long term the result may be that tolerance develops.
  • Buspirone (BuSpar): A new serotonergic combination agonist/antagonist. Is nonaddicting, but may take 2 to 4 weeks for full effect.
  • Combination Serotonin/Norepinephrine Agents: New medications such as Effexor, Serzone, and Remeron, also with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response.
  • Major Tranquilizers (also called neuroleptics): Medications that act on a variety of neurotransmitter systems (acetylcholine, dopamine, histamine, adrenergic). Most are somewhat sedating, and have been used in situations where anxiety is severe enough to cause disorganization of thoughts and abnormal physical and mental sensations, such as the sense that things around you aren't real (derealization) or that you are disconnected with your body (derealization). Commonly used neuroleptics include: Zyprexa, Risperdal, Seroquel, Mellaril, Thorazine, Stelazine, Moban, Navane, Prolixin, and Haldol.
  • Serotonergic Agents: Newer antidepressants act as antianxiety agents as well, with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response (Luvox, Prozac, Zoloft, Paxil).
  • Tricyclic Antidepressants (TCAs): Older antidepressants with more side effects typically than the serotonergic agents, but also effective. Takes 4 to 6 weeks for full response (Tofranil, Elavil, Pamelor, Sinequan) 

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.

Click here to read the full article…

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

Click here for the full article...

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

Click here to read the full article…

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

Click here to read the full article…

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

Click here to read the full article...

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

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

Click here for the full article...
By

Teaching Interpersonal Relationship Skills to the "Friendless" Child on the Autism Spectrum

One of the most significant problems for children with Asperger’s (AS) and High Functioning Autism (HFA) is difficulty in social interaction. AS and HFA also create problems with "mind reading" (i.e., knowing what another person might be thinking or feeling).

Most young people can observe others and guess (through a combination of tone and body language) what's "really" going on. But without help and training, AS and HFA children can't.

What comes naturally to “typical” kids does not come naturally to kids on the autism spectrum. The lack of interpersonal relationship skills makes it difficult for these boys and girls to make and keep friends – and often leads to social isolation. Now for the good news: Parents can learn to teach interpersonal relationship skills to their “special needs” youngsters.

Indicators That Your Child Needs Social Skills Training 



Here are some concrete ways to give AS and HFA children the tools they need to interact appropriately in social situations:

1. Practice reciprocal interactions. Some kids with AS and HFA have very one-sided conversations. They often talk only about their favorite subject, fail to ask questions to the peer they converse with, and fail to acknowledge interests of the peer. Thus, teach your youngster how to ask questions during a conversation, and practice taking turns while talking. Let your youngster ask a question, answer it, and let him ask another question. Do this exercise regularly to teach him how to have a conversation.

2. Rehearse social situations through role-play. If your youngster has difficulty in a specific social situation, practice it beforehand. Kids with AS and HFA must be taught what to say and do in specific situations. Engage in role-play with your youngster to physically act-out the situation. Tell him what he is expected to say or do, and then actually have him act it out with you.

==> Teaching Social Skills and Emotion Management

3. Consider involving your child in a skills-acquisition group. Relationship skills groups offer an opportunity for children with AS and HFA to practice their interpersonal skills with each other and/or “typical” peers on a regular basis.

4. Teachers can play a crucial role in teaching social skills to students on the autism spectrum. These skills need to be learned and understood well enough by the AS or HFA students to generalize them to outside situations beyond the classroom environment. Thus, to promote “skill generalization,” interventions should focus on orchestrating peer-involvement by prompting students to engage and initiate social interactions with classmates.

Teachers can also work with each individual student to practice new skills learned. Involving outside people (e.g., moms and dads, other family members, other classrooms) to promote different interactions can easily support this. Additionally, field trips can help provide natural and safe settings to practice interpersonal relationship skills outside of the classroom. Lastly, intervention sessions should be used to practice skills (e.g., assigning homework tasks) to increase repetition of training and ensure long-lasting learning.

5. Interpersonal relationship skills should not be a set of hard-and-fast rules. You can’t force AS or HFA kids to memorize them the way they would a set of multiplication tables. Different situations call for dynamic thinking. Thus, teach problem-solving and new ways to approach a particular challenge.



6. Parents can teach their youngsters how to recognize the feelings of others. Many kids with AS and HFA have great difficulty understanding how others feel by reading cues. This greatly impacts their social interactions. Therefore, use picture cards, books and magazines to point out facial expressions to your youngster. Teach her what each facial expression is and what it means. Let her practice by telling you what each facial expression is and what it means.

7. The biggest mistake parents can make is to assume that interpersonal relationship skills can be taught once and remembered forever. Social interaction is fluid, with so many variables that it can be daunting even to a “typical” youngster. For those on the spectrum, the training must continue far longer. Challenges get more and more complex as a youngster ages, bringing more things into the picture. So, be sure to go over the skills your child learned in the beginning on a regular basis, adding in more skills that can help her fine-tune her interactions.

8. Make use of “social skills training” materials. There are many tools and interventions available that involve using videos, software or virtual-reality programs to teach complex interpersonal relationship skills (e.g., recognition of emotions in facial expressions and tone of voice).

9. Make use of social stories. Social stories are simple stories written from the youngster's point of view. Each story describes a specific situation, what other people will do or say in that situation, and what your youngster is expected to do or say in that situation. Information on how to write social stories can be found HERE.

10. Locate resources in your area. Drama therapy, for example, is somewhat unusual, but where it's offered, it has the potential to be both fun and educational. Video modeling, video critiques of interactions, group therapy and other approaches may also be available in your area.

Training an AS or HFA youngster in relationship skills may take months – or even years. You may not see any improvement at first – but over time, it will happen. Stay the course, try new training methods, and be there for your youngster as he matures. Positive results will come if you keep at them.

Take into account the many facets of social interaction. Think about your youngster's strengths and weaknesses. Know his abilities as well as his language skills. With plenty of forethought, you can implement a good social skills training program for your child.

==> Teaching Social Skills and Emotion Management
By

How to Improve Your asd Child’s Chances of Finding and Keeping Friends

"My child is so desperate to find just one close friend. It breaks my heart when he tries so hard to make friends but eventually gets rejected. How do you teach friendship skills? How can I help?!"

For most children with ASD [High Functioning Autism], the most important part of a treatment strategy involves the development of communication and social competence.

This emphasis doesn’t reflect a societal pressure for conformity or an attempt to stifle individuality and uniqueness. Rather, it reflects the clinical fact that most children with ASD are not loners by choice, and that there is a tendency (as these young people develop towards adolescence) for despondency, negativism, and depression as a result of the child's increasing awareness of personal inadequacy in social situations and repeated experiences of failure to make and/or maintain relationships.

The typical limitations of insight and self-reflection experienced by children with ASD often preclude spontaneous self-adjustment to social and interpersonal demands. The practice of communication and social skills doesn’t imply the eventual acquisition of communicative or social spontaneity and naturalness; however; it does better prepare the child to cope with social and interpersonal expectations, thus enhancing their attractiveness as conversational partners or as potential friends.

The following are suggestions intended to foster relevant skills in this crucial area:

1. The child with ASD should be taught to monitor her or his own speech style in terms of:
  • adjusting depending on proximity to the listener
  • background noise
  • context and social situation
  • naturalness
  • number of people
  • rhythm
  • volume

2. The child should be helped to recognize and use a range of different means to disagree, discuss, interact, mediate, negotiate, and persuade through verbal means. In terms of formal properties of language, the child may benefit from help in thinking about idiomatic language that can only be understood in its own right, and practice in identifying them in both text and conversation.

It’s also important to help the child to develop the ability to anticipate multiple outcomes, to explain motivation, to make inferences, and to predict in order to increase the flexibility with which he or she thinks about - and uses language with - other people.

==> Teaching Social Skills and Emotion Management

3. The effort to develop the child's skills with peers in terms of managing social situations should be a priority. This should include:
  • ending topics appropriately
  • feeling comfortable with a range of topics that are typically discussed by same-age peers
  • shifting topics
  • the ability to expand and elaborate on a range of different topics initiated by others
  • topic management

4. Explicit verbal instructions on how to interpret other people's social behavior should be taught and exercised in a rote fashion. Facial and hand gestures, gaze, non-literal communications (e.g., sarcasm, metaphor, humor, figurative language and irony), the meaning of eye contact, tone of voice, and various inflections should all be taught in a fashion not unlike the teaching of a foreign language (i.e., all elements should be made verbally explicit and repeatedly drilled).



5. The same principles as described in #4 should guide the training of the child's expressive skills:
  • Self-monitoring techniques (e.g., practicing in front of a mirror, listening to the recorded speech, watching a video recorded behavior, etc.) should all be incorporated in this program.
  • Social situations contrived in the therapeutic setting that usually require reliance on visual-receptive and other nonverbal skills for interpretation should be used. Also, strategies for deciphering the most salient nonverbal dimensions inherent in these situations should be offered.
  • Encounters with unfamiliar people (e.g., making acquaintances) should be rehearsed until the child is made aware of the impact of her or his behavior on other people's reactions to her or him. 
  • Concrete situations should be exercised in a therapeutic setting and gradually implemented in naturally occurring situations.

As a final note, all those in close contact with the ASD child should be made aware of the program so that consistency, monitoring and contingent reinforcement are maximized.


Simple Ways To Teach Social Skills to Your Child 



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


 COMMENTS:

•    Anonymous said... I have a 16 yr old son with aspergers. He has really come out of his shell this year. I attribute it a lot to the fact that we have talked alot about the positive aspects of aspergers, showing him all the greatly successful people with aspergers and we also got him a book for teens written by a women who has it. If you ever want to talk I'd be happy to share with you what has worked for us
•    Anonymous said... My son has aspergers and I have had such a hard time finding a therapist who has made a connection with him to help in any real way if you have any suggestions would love input.
•    Anonymous said... My son is almost 13 & we could use it here too!!!
•    Anonymous said... Our son has recently been diagnosed with HFA and this is exactly the sort of training he needs but have no idea where to turn to get him it. We try at home but it's difficult as he feels it more as a criticism of his current lack of skills rather than we're trying to help. I'm sure professional help would be so much better. As I say, I just don't know where to turn to access such support?
•    Anonymous said... would love to hear what's worked for your family! I have 14yr old boy in denial so can't mention it without him getting very defensive. He shows all the traits mentioned in the post! I have bought an ebook for teenage AS and I'm waiting for the next melt down. I will then open the bedroom door, throw it in, and take cover!!

Please post your comment below…
By

Behavior-Management Techniques for Children with High-Functioning Autism

"How can parents tell the difference between deliberate, defiant and manipulative behaviors - as opposed to symptoms of autism (high functioning in this case)."

Children with Asperger’s and High Functioning Autism (HFA) often exhibit different forms of challenging behavior. It is imperative that these behaviors are not seen as willful or malicious; more accurately, they should be viewed as connected to the child’s disorder and treated as such by means of insightful, therapeutic and educational strategies, rather than by inconsistent punishment or other disciplinary measures that imply the assumption of deliberate misbehavior.

Parents and teachers need to recognize the difficulties that the youngster with HFA brings to each situation as a result of his or her neurologically-based disorder. Among the common traits of this “special needs” child include the following:
  • A need for predictability and routine
  • A tendency to respond based on association and memory, which leads the youngster to repeat familiar behaviors even when they produce consistently negative results
  • An overly reactive sensory system that makes ordinary noise, smell or touch irritating or intolerable
  • Considerable difficulty organizing himself to do something productive in undirected play activities, in stimulating public situations, or when waiting
  • Emotional responses that are apt to be extreme and are often based on immediate events, leading to rapid changes (e.g., from laughing to screaming)
  • Lack of embarrassment or concern about other people's impressions of them
  • Limited ability to recognize another person's perspective or opinion or to empathize with others
  • Poor recognition of public versus private behavior
  • Problems shifting attention
  • Problems transitioning from one activity to another
  • Recovery from emotional upset is often immediate once the problem is removed, but for some kids on the spectrum, irritability and secondary upsets can continue for hours
  • Significant difficulties with understanding language, especially in group situations
     
Note: These traits are not the result of poor parenting or teaching. Also, they are not deliberate, willful or manipulative behaviors. They are simply common traits of kids with HFA.

==> Discipline for Defiant Asperger's and HFA Teens

Symptoms of Asperger's and High-Functioning Autism that Cause Behavioral Problems



Specific problem-solving strategies can be taught for handling the requirements of frequently occurring, problematic situations (e.g., involving novelty, intense social demands, frustration, etc.). Training is usually necessary for recognizing situations as problematic and for selecting the best available learned strategy to use in such situations.

The following steps will help parents and teachers implement behavioral management techniques for children and teens on the higher end of the autism spectrum:

Step #1: Prepare a list of frequent and challenging behaviors (e.g., perseverations, obsessions, interrupting, or any other disruptive behaviors). When listing these behaviors, it is important that they are specified in a hierarchy of priorities so that both parent and child can concentrate on a small number of truly troublesome behaviors.

Step #2: Create some specific interventions that help with the challenging behaviors whenever the behaviors arise. Here are just a few examples of appropriate interventions:



• Instructional intervention is used with a child who already wants to change his behavior, but simply doesn't know how. This is one of the easier behavior intervention strategies, because you simply need to tell the child what to do and how to do it. Once he has this information, he can change his behavior on his own.

• Positive reinforcement is a good behavior intervention technique, because it doesn't even recognize the negative behavior. To positively reinforce a child, you just tell her that she is doing a great job or otherwise reward her whenever she does the right thing. This creates a situation where she associates the right thing with a good outcome and has no such association with the wrong thing. This helps to positively change behavior without having to punish, yell or otherwise negatively reinforce behaviors.

• Negative reinforcement is the opposite of positive reinforcement. Rather than positively reinforce the correct behaviors, negative reinforcement reinforces the incorrect behaviors. This is good for more serious issues (e.g., if the youngster consistently climbs on the counter next to a pot of boiling water, you need to negatively reinforce that behavior immediately, because the consequences of knocking over the pot are so dire). Examples of negative reinforcement include stern words, loss of privileges and other forms of discipline.

• Supportive intervention is when the child needs help reinforcing a behavior. She may know it theoretically, but she may not always apply it as it is not yet internalized. So, supportive intervention is when the child is gently guided through positive and negative feedback. It is different from other forms of behavior intervention, because it has a specific spot in the behavior management cycle – specifically, after the behavior has been learned, but before it is consistently applied.

Step #3: Make sure that the interventions listed above are discussed with the HFA child in an explicit, rule-governed fashion so that clear expectations are set and consistency across adults, settings and situations is maintained.

Step #4: Help the child to make choices. Do not assume that he makes informed decisions based on his own set of elaborate likes and dislikes. Rather he should be helped to consider alternatives of action or choices, as well as their consequences (e.g., rewards and unhappiness) and associated emotions. The need for such an artificial set of guidelines is a result of the HFA child’s typical poor intuition and knowledge of self.
 
 ==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

Additional behavior management strategies that are critical to the success of the HFA child include the following:

• Stick to a routine: This is necessary for both the youngster and the parent. A youngster with HFA thrives on routine. Being able to anticipate what comes next is soothing and satisfying. Routine lessens anxiety, and a less anxious youngster has fewer outbursts. Adhering to a schedule is a necessary behavior management tool. If the youngster is complacent with her schedule, it eliminates some behavior issues. Behavior management for kids on the autism spectrum is about anticipating what will cause unwanted behavior and eradicating those situations. Because of insufficient social skills, the youngster often has to memorize the rules of situational norms (e.g., eating in a restaurant, waiting in line, sharing with friends, etc.). Routine-based behavioral management techniques focus on the prevention of the negative behaviors that accompany an unstructured or weak routine.

• Encourage the child’s special interest: The HFA youngster will often have a very specific interest and obsess about it. Some moms and dads are apprehensive about encouraging this peculiar behavior, but it is actually a helpful coping technique. The youngster’s special interest can be used to encourage positive behavior (e.g., “If you share with your friend, we will go to the library and check out another book about dinosaurs”). However, don’t use the special interest as a disciplinary tool. Taking away the youngster’s “go-to coping skill” is denying him a form of self-imposed therapy.

• Issue rewards for positive behavior immediately: Kids on the autism spectrum are often unable to relate cause and effect, especially if a lot of time exists between the two. Thus, reinforcements should be given immediately. The youngster can’t relate a reward received at the end of the day to a behavior exhibited earlier in the afternoon. Also, rewards should be chosen carefully, and moms and dads need to follow through with the incentive (e.g., if stickers or other tokens are being used to encourage successful behavior, be sure that these rewards are readily available at all times – and in all settings).

• Use visual schedules: Kids on the autism spectrum crave structure, and visual schedules are helpful in creating order, clear choices and expectations. A visual schedule is a series of pictures that lists the day’s activities and choices (e.g., a morning schedule posted on the bathroom mirror can have pictures depicting the youngster brushing her teeth, washing her face, and getting dressed …or at breakfast, there may be a visual schedule showing meal options). Depending on the needs of the youngster, the schedule can illustrate more detail.


By

Dyspraxia in Kids on the Autism Spectrum

“My son with high functioning autism is nearly 5 years old and the problem is his clumsiness. I was always clumsy as a kid, which was blamed on my left-handedness, but his is extreme. Today he has dropped two drinks and spilt milk down himself. He is also left handed, but he is grown up for his age, seems very intelligent, and has no other health worries. Is this part of having AS …is it just a phase for his age …or could there be a neurological problem?”

Most children with Asperger’s (AS) and High-Functioning Autism (HFA) have a history of delayed acquisition of motor skills (e.g., hand writing, pedaling a bike, tying shoe laces, catching a ball, opening jars, climbing monkey-bars, etc.), which is called “motor clumsiness.” These young people are often visibly awkward, exhibiting rigid gait patterns, odd posture, poor manipulative skills, and significant deficits in visual-motor coordination. Although this presentation contrasts with the pattern of motor development in autistic kids (for whom the area of motor skills is often a relative strength), it is similar in some respects to what is observed in older people with autism.



Dyspraxia is a disorder that affects motor skill development. AS and HFA children with Dyspraxia have trouble planning and completing fine motor tasks. This can vary from simple motor tasks (e.g., waving goodbye) to more complex tasks (e.g., brushing teeth). Dyspraxia is a lifelong disorder, and its severity and symptoms can vary from child to child. Also, it can affect individuals differently at different stages of life. Dyspraxia can affect many basic functions required for daily living, and is often broken down into the following categories: 
  • Constructional Dyspraxia (i.e., establishing spatial relationships, being able to accurately position or move objects from one place to another)
  • Ideational Dyspraxia (i.e., multi-step tasks such as brushing teeth, making a bed, putting clothes on in order, buttoning and buckling)
  • Ideomotor Dyspraxia (i.e., completing single-step motor tasks like combing hair and waving goodbye)
  • Oromotor Dyspraxia (i.e., coordinating the muscle movements needed to pronounce words)

Dyspraxia often exists along with learning disabilities (e.g., dyslexia, dyscalculia, ADHD, and other conditions that impact learning). Weaknesses in comprehension, information processing and listening can contribute to the difficulties experienced by children with Dyspraxia. These young people may also have low self-esteem, depression and other emotional and behavioral issues.

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

AS and HFA kids with Dyspraxia may experience several difficulties.

Younger kids have problems with:
  • Being sensitive to touch (e.g., being irritated by clothing on skin, hair brushing, nail-cutting, or teeth-brushing)
  • Bumping into things
  • Establishing left- or right- handedness
  • Learning to walk, jump, hop, skip and throw or catch a ball
  • Moving the eyes—instead, moving the whole head
  • Pronouncing words and being understood

School-aged kids have problems with:
  • Doing activities that require fine motor skills (e.g., holding a pencil, buttoning, cutting with scissors)
  • Making social connections due to speech challenges
  • Phobias and obsessive behavior
  • Playing sports, riding a bike and other activities requiring coordination
  • Poor pencil grip and letter formation and slow handwriting
  • Sensing direction
  • Speaking at a normal rate or in way that can be easily understood

Teens have problems with:
  • Clumsiness
  • Cooking or other household chores
  • Driving
  • Over- or under- sensitivity to light, touch, space, taste, or smells
  • Personal grooming and other self-help activities
  • Speech control (i.e., volume, pitch, articulation)
  • Writing and typing

Early identification and intervention can greatly help an AS or HFA child with Dyspraxia. Depending on the severity of the disorder, therapy from occupational, speech and physical therapists can improve the child's ability to function and succeed independently. The following therapies most commonly help these young people:
  • Speech and language therapy: The speech and language therapist will first carry out an assessment of the youngster's speech, and then help him communicate more effectively.
  • Perceptual motor training: This involves improving the youngster's language, visual, movement, and auditory skills. A series of tasks, which gradually becoming more advanced, are set. The goal is to challenge the youngster so that she improves, but not so much that it becomes frustrating or stressful.
  • Occupational therapy: An occupational therapist will first observe how the youngster manages with everyday functions both at home and at school. The therapist will then help the youngster develop skills specific to activities which may be troublesome.
  • Active play: Experts say that “active play” (i.e., any play that involves physical activity), which can be outdoors or inside the home, gets the motor activity going in AS and HFA kids. Play is a way these young people learn about the environment and about themselves (particularly for those aged 3 to 5). Active play is where the youngster's physical and emotional learning, the development of language, special awareness, the development of what his senses are, all come together. The more these kids are involved in active play, the better they will become at interacting with others successfully.
  • Equine therapy: A team researchers evaluated the effects of equine therapy (i.e., therapeutic horse-riding) on a group of 40 kids aged 6 to 15 years with Dyspraxia. These young people participated in six horse-riding sessions lasting 30 minutes each, as well as two 30-minute audiovisual screening sessions. The researchers found that riding therapy stimulated and improved the child’s cognition, mood and gait parameters. The data also pointed to the potential value of an audiovisual approach to equine therapy.
Problems with Handwriting in Children with Asperger's and High-Functioning Autism:
 

AS and HFA children with Dyspraxia need help practicing simple tasks. Beginning at an early age, it is vital that moms and dads offer patience, encouragement, help and support. These young people often benefit from step-by-step progress into more complex activities. You can start with easy physical activities that develop coordination, and then move on to the more complicated tasks.

Here are just a few ideas that will help you make daily life easier for your AS or HFA youngster:
  • Avoid tight neck holes
  • Baggy t-shirts and shorts are easy and comfortable
  • Buy trousers with an elasticated waist to save dealing with buttons and zips
  • Don't fill cups too full
  • Keep keys and purses on a long chain which clips to clothing
  • Keep to a daily routine
  • Lay out clothing layer by layer, underwear on top
  • Post-it notes stuck at eye-level on doors are useful reminders
  • Shirt collars one size larger are easier to fasten
  • Sit down to eat
  • Transparent purses and pencil cases are good for being able to see contents easily
  • Trousers with a pleat at the front make identifying the 'right way around' easier
  • Use a damp towel under plates to stop them moving
  • Use a flexible straw when drinking to prevent spills

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

Here are a few activities designed to help your AS or HFA child practice and develop “fine” motor skills:
  • Artwork like drawing, painting, pasting, and cutting are wonderful motor skill exercises.
  • Cut out animal shapes, then punch holes around the edges and have your youngster thread yarn. 
  • Cutting skills should be practiced (e.g., cutting forward on a line and moving the paper with the guiding or non-cutting hand). 
  • Even scribbling will encourage handwriting later.
  • Fill an egg carton with little snacks (e.g., goldfish crackers, Hershey Kisses). 
  • Help your child develop the ability to color within the lines. 
  • Help her develop the ability to copy lines, circles and crosses, and trace diamonds or triangles. Help develop a tripod grasp or a mature pencil grip, taking the pencil between thumb and index finger and resting on the middle finger. 
  • Jigsaw puzzles and light brite help greatly with fine motor skills.
  • Legos! As far as simple fine motor skills activities go, they are very popular!
  • More advanced skills such as adept use of silverware or tying shoelaces should be practiced. 
  • Peel stickers off of a cookie sheet and stick them onto paper.
  • Picking up and laying down pennies is a great exercise.
  • Picking up and sorting beads with clothespins is a good challenge.
  • Play “Scatterpillar Scramble” (a game you can buy at Target or Walmart).
  • Play dough provides four different types of motor skill fundamentals: cutting, rolling, squeezing and stamping.
  • Practice skills such as tying shoes, fastening buttons, zipping and snapping clothing. 
  • Put thin dowels into Styrofoam and put beads on them! 
  • Stringing beads, or even better - cereal with holes is another wonderful exercise.
  • Tape paper under a coffee table or other low surface and have your child lay on his back and draw on the paper.
  • Teach increasingly sophisticated finger motor tasks like playing video games, completing puzzles, playing instruments, and typing on a computer keyboard.
  • Tongs are fun to grab pompoms and sort into different color bowls.
  • Try tearing strips of paper from old phone books (the paper is thin and generally tears in a straight line).
  • Using short pieces of chubby crayon encourages a natural grasp.
  • Using simple hand movements while listening to songs helps kids build fine motor skills.
  • Water play using eye droppers and colored water to explore with is fun.
  • Writing and drawing on vertical surfaces strengthens core and arm muscles as well as fingers.

Here are a few activities designed to help your AS or HFA child practice and develop “gross” motor skills:
  • Balancing (e.g., on a low beam or plank at the playground, or a homemade balance beam)
  • Building and navigating obstacle courses indoors (e.g., with furniture, pillows, boxes, blankets, etc.) or outdoors (e.g., with rocks, logs, playground equipment, etc.
  • Cooking (includes pouring, shaking, sprinkling, kneading, tearing, cutting with butter knife, etc.)
  • Dancing (e.g., freestyle or through songs with movements)
  • Finger plays (e.g., songs like "The Itsy Bitsy Spider")
  • Large-scale arts and crafts activities
  • Manipulative toys like blocks, puzzles, or dolls with clothes to take on and off
  • Marching, jogging, skipping, and hopping, or musical instruments to form a parade
  • Playing pretend (e.g., the child uses her body to become a waddling duck, stiff-legged robot, galloping horse, or a soaring plane) 
  • Playing tag or other classic backyard games (e.g., Follow the Leader, Red Light/Green Light, Tails, Simon Says, Duck Duck Goose, Musical Chairs, etc.)
  • Pulling or pushing wagons, large trucks, doll strollers, or shopping carts
  • Puppet shows
  • Riding tricycles, scooters, and other ride-on toys
  • Sand play
  • Sidewalk chalk or any art project
  • Swimming and other water play 
  • Swinging, sliding, and climbing at a playground or indoor play space
  • Throwing, catching, and rolling large lightweight soft balls

From the first days of life, kids begin using their bodies to learn about the world around them. Motor experiences are the basis for all intellectual functioning for approximately the first 2 years of life. As young people continue to mature, their reliance on physical interactions with people and objects remains strong. Motor skills are an essential component of development for all children.


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