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Autistic Children and Their Abnormal Reaction to Pain and Discomfort

As parents of kids with high-functioning autism, we may be familiar with the mystery of their unequal reaction to pain and discomfort. A stubbed toe or paper cut may set off a disproportionate pain response (e.g., hysterical crying or screaming). 
 
But, a burst ear drum or broken arm may go seemingly unnoticed. As moms and dads of kids on the spectrum, we may be baffled by this unequal response to pain stimuli. Anecdotal evidence from parents worldwide is full of reports on this topic.

Some of the perplexing behaviors that such children exhibit include: 
  • Crashing into walls and/or people
  • Having an unusually high or low pain threshold
  • Putting inedible things (e.g., rocks, paint) into their mouth
  • Screaming if their face gets wet
  • Throwing tantrums when parents try to get them dressed

These and other abnormal behaviors may reflect sensory processing problems in which the high-functioning autistic child is overwhelmed because of difficulty integrating information from the senses. Sensory processing issues are considered a symptom of the disorder because the majority of kids on the spectrum also have significant sensory problems.



One response to being overwhelmed is to flee. For example, if a high-functioning autistic youngster dashes across the street (oblivious to the danger), it should be a “red flag” that he may be heading away from something distressing (which may not be apparent to the mother or father), or toward an environment or sensation that will calm his system. Many kids on the spectrum gravitate toward the sensations and environments they find calming or stimulating. However, their self-regulation is lacking, so safety takes a back seat to their need to get a calming experience (e.g., jumping in a pond, sometimes resulting in drowning).

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

This fight-or-flight response is why a child with sensory problems will shut down, escape the situation quickly, or become aggressive when in sensory overload. The child is having a neurological panic response to everyday sensations that “typical” kids take for granted.

So, what is behind this perplexing dilemma? The answer has to do with dopamine levels.

“Typical” (i.e., non-autistic) people are physiologically equipped to limit the amount of stimuli entering their brain, thus preventing the brain from becoming overloaded. However, people with autism have a hyper- or hypo-sensitivity to stimuli (i.e., they are either under-stimulated or over-stimulated).

The enzyme “dopamine beta hydroxylase” (DBH) is released from nerve endings during “stimulation” via the five senses (i.e., touch, sight, taste, smell, sound). DBH is essential for cell communication and regulating neurons in the central and peripheral nervous systems. An increase in stimulation results in an increase in the level of this enzyme. Scientific research has shown that people with autism have much higher levels of DBH in their system than found in “ordinary” people. The presence of this enzyme is also linked to certain behaviors (e.g., repetition, agitation, aggression, etc.).

Repetitious activity (e.g., rocking, flapping, pacing, etc.) results in the release of endorphins through the system. Endorphins reduce the sensation of pain and have the ability to block pain. Through the use of repetitious activity, kids on the spectrum have the ability to purposely (but unknowingly) overload their sensory system in order to shut it down completely.

Blocking out all sensation by the production of endorphins may seem like an easy way to cope with sensory over-stimulation; however, in caring for autistic kids, parents need to realize that reaction to ALL sensation becomes limited. Such children may not recognize hunger, tiredness, body temperature (which carries with it the risk of overheating), a full bladder or bowel, pain, etc.

They display agitation through use of repetitious behaviors (e.g., rocking, flapping, pacing, head-banging, staring, screaming, spinning, chanting, humming, etc.). The parents’ job is to recognize these signals of agitation. These repetitive behaviors are used to block out over-stimulation from the environment, certain emotions, and responses to pain. The behaviors also may serve to calm the youngster (if their use is monitored rather than unlimited).

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

For high-functioning autistic kids, the build-up of these endorphins throughout the day also needs to be taken into consideration. This is why those children who have accidents may not show pain or appear to feel it.

All physical exercise causes the release of natural endorphins into the system that can help to protect the youngster without switching off the sensory response. Thus, exercise (e.g., walking, running, swimming, etc.) is extremely beneficial in the youngster's daily routine as a preventative measure. Exercise may be used during periods of agitation to help calm the youngster. In this way, it is used to develop an appropriate social responses (e.g., it is more acceptable to jump on a trampoline rather than on the furniture).

Parents should monitor their youngster's production of endorphins, because the presence of excess endorphins causes him or her to lose the ability to respond to any stimulation. This means that the child will miss much of what he or she is supposed to be learning from the environment. Also, parents need to realize that these repetitive behaviors have social consequences for kids with high-functioning autism. 
 
They are a visual reminder that these young people are different from their “typical” peers. Parents should take into account the youngster's socializing skills and ability when monitoring and setting limits on the use of repetitive behaviors (e.g., tell him or her the times and places when repetitive behaviors are acceptable, for controlled periods of time).

Parents do not need to eliminate sensory stimulation in order to protect their youngster. Without stimulation, the world will become meaningless to the child. Instead, parents should attempt to provide their child with a safe sensory environment (e.g., dim lights, softer noises and voices, reduced odors, etc.), thus giving him or her the opportunity to learn and respond appropriately to the environment.


More resources for parents of children and teens on the autism spectrum:
 
By

Fretfulness in Kids on the Autism Spectrum

“My youngest child has high functioning autism and has been officially diagnosed with anxiety disorder. She is clearly a child who reacts to stress with anxiety, constantly fretting about something which then often converts to meltdowns. Anyone else having this issue, and what do you think might help in situations like this?”

The benefit of being a kid is not having a care in the world, yet for many children with ASD or High-Functioning Autism, worry is a reality and something that takes a toll on the joy of childhood. What’s even more alarming is that many moms and dads are completely unaware that their “special needs” child is even feeling this way.

Most children will experience worry at some point. For example, your youngster may have repetitive, exaggerated thoughts such as, “What if I fail English?” …or “What if no one likes me?” He may fear that someone will hurt him or his family, or he may become excessively worried at bedtime, at school, or in social situations. This is O.K. to an extent, because a small amount of apprehension can actually help prepare children to handle tough situations later on in life. 

The difference between normal worry and an Anxiety Disorder is the severity of the worrying. Although feeling fretful is a natural reaction to a stressful or dangerous situation, an AS or HFA youngster may need help if her fretfulness is out of proportion, if it persists, or if it interferes with her life and healthy development.



It's always painful to watch a youngster suffer from stress and worry, but it's especially difficult if you're not sure whether he is worrying “too much” and in need of assistance. So, how do you know if your youngster’s worries are cause for concern? Here are some signs that your child is a chronic worrier:
  • An ASD youngster who is overwhelmed by worries may not realize that those worries are unrealistic or exaggerated, and she may not express them – except by her behavior. For example, if she's fretful that something could happen to her mother or father, she may have trouble separating or falling asleep.
  • The youngster may say negative things, such as “I’m no good” …or “I hate myself” … or “I can’t do this.”
  • The youngster may have excessive concerns or irrational fears, complain of stomachaches, be nervous at school or refuse to go all together, be afraid to go to sleepovers or birthday parties, or have frequent headaches.
  • Kids who have severe angst will try to avoid the things that trigger it. For example, anxiety may be the culprit if the youngster spends a great deal of time in the school nurse's office, refuses to participate in activities other kids enjoy, throws a tantrum before every appointment with the dentist or doctor, or gets sick on Sunday nights due to worrying about going back to school on Monday morning.
  • If the youngster can't stop fretting about germs or getting sick, she may seek constant reassurance or wash her hands obsessively.

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

All kids want to be reassured, and they want to know they will be safe. Some need extra reassurance. If this is the case, routines and traditions can help calm these children. However, many autistic kids will not be calmed by the parent’s answers. It doesn’t matter how many times the parent reassures them or how many times they check on them, they still fret. Kids who have these kinds of worries often struggle in other situations, too. For example, they may not want to meet new peers or go to other’s homes because of their worries (e.g., “What if I need something?” …or “What if I don’t know what to do?”).

Obsessive-Compulsive Behaviors and Anxiety in Kids on the Autism Spectrum 




How to help the fretful ASD child:

1. Set aside a designated time for your child to fret. This is called “fret time.” If he frets about many things throughout the day, pick a special time for it. Set aside 10 minutes where your youngster can talk about his worries, or he can write his worries on paper and share them with you. Also, try to eliminate all distractions during “fret time.” If your youngster starts to fret at some time other than “fret time,” he can say to himself, “Stop. That is for my fret time.” Then he should do something else to distract himself. As a mother or father, you may need to help your youngster remember to wait for “fret time” by saying something like, “Save that for fret time. We’ll talk about it then. For now, how about playing a video game?”

2. Create a “fret jar.” Have your youngster picture a ‘jar with a lid’ in her mind. This is a “fret jar.” If she starts to fret, she can imagine opening the jar, putting the worrisome thought in the jar, screwing the lid on tightly, and sealing the worry there. Alternatively, you can create a real “fret jar” rather than an imaginary one, and encourage your youngster to write the anxiety-inducing thought on a piece of paper and put it in the jar. Then, she can talk about the worry during “fret time.” You can help with some techniques and ways to deal with the concern at that time.

3. Don’t allow your youngster to avoid everything that worries her. Fretfulness tends to peak at the beginning of a new or scary situation, then eases off. If parents can help their youngster get through the initial stage of high stress, she’s likely to have a positive experience, which will make it easier the next time.

4. Don’t model “excessive caution.” Overly-cautious moms and dads are likely to say things, such as “Be careful on the swing because you might fall and hurt yourself” without realizing that they are increasing the youngster’s fretfulness. It’s better to say confidently, “I’m sure you’ll have fun on the swing. I’m right over here if you need me.”

5. Increased exposure to the stressful situation is an effective strategy for overcoming anxiety.  For example, if your youngster is afraid of cats, start out by showing him pictures of cats, then visit an animal shelter, then go to someone’s house where they have cats, and finally, have your child pet a cat.  The important idea here is to take small steps and gradually expose your youngster to the fear.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism
 
6. Help your youngster put the worry outside of himself. It can help him to think of himself as being separate from the worry. For example, have him picture the worry as a funny looking monster. Help him create the image (e.g., furry with claws, a blob with a big mouth, etc.), and then have him draw a picture of the monster. Next, remind him to visualize the “worry monster” as something that is outside of himself. When your youngster starts to fret, he can picture the monster and can do something about it (e.g., talking back, standing up to it, etc.). Also, have him write down things to say to the “worry monster” (e.g., Get away! I don’t like you! Stop that!). The first few times your youngster does this, the monster will return. When this happens, he should repeat his message in a firm voice (either in is mind or aloud), or he can imagine catching the monster in a net and kicking it out of the house.

7. Help your child to find a distraction when he is in a state of anxiety. Being involved with some activity is key in keeping away worries. The way our minds are, we can’t be relaxed and stressed at the same time. This can be a powerful tool for helping children on the autism spectrum to keep worries away. If your youngster is drawing, reading, or playing a video game, there is little room for the “worry monster” to pester him. Your youngster may not feel like reading a book, for example, but help him understand that being active will help. He may have to force himself to get busy with some activity. As kids realize that staying busy helps keep worries away, it will be easier to want to engage in fun activities. Also, make a list of distracting activities to do (e.g., draw a picture, help dad with yard work, play a game, play music, read, run up and down the stairs, sing a song, take a pet for a walk, etc.), and post the list in a prominent place for all to see.

8. Never try to convince your youngster that her anxiety is unjustified. She’ll just become more convinced otherwise as she tries to prove to you that her worries are real. Instead, help her think about things realistically. For example, if she is worried that you might die, say something like, “Daddy is very healthy. I take good care of myself. I will be living a very long time.”

9. Practice deep breathing with your youngster at bedtime to provide her with a technique to use under stress (e.g., take a deep breath, hold it for a count of three, exhale through the mouth, then repeat). However, bear in mind that it won’t work to introduce deep breathing in the middle of a stressful situation. Your youngster needs to practice so that it becomes a natural response.

10. Don’t chastise your youngster for worrying or resisting something because he’s afraid. He needs your support and reassurance. However, excessive reassurance (e.g., delivering a constant stream of “You’ll be OK” …or “You can do it” …or “There’s nothing to worry about) can make your youngster feel even more fretful. So, don’t offer a bunch of false reassurance.

11. Use social stories, games and puppets to help your youngster learn to relax and manage stress and anxiety.

12. If all else fails, seek support and counsel from a professional who works with children on the autism spectrum.




If you’re concerned that your youngster’s worry is excessive, it’s important to recognize how often he or she experiences distress, how much anxiety it causes, and if it interferes with his or her everyday activities. The crucial issue is not that children worry; rather, it’s the combination that they worry – and it impairs their functioning. By using some of the tips listed above, you can help keep your child’s fretfulness to a minimum.

 
More resources for parents of children and teens on the autism spectrum:
 

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

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Resources for Neurodiverse Couples:

 ==> Cassandra Syndrome Recovery for NT Wives

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Pressed for time? Watch these "less-than-one-minute" videos for on the go.

By

The 6 Most Important Things Parents Can Do for Their Child with Asperger’s or High-Functioning Autism

“We recently got a diagnosis of high-functioning autism for our 6 y.o. son. After researching all the interventions that are recommended, my husband and I are feeling quite overwhelmed. Our son has so much to work on, and we simply don’t know where to begin. Please give us a starting point so we’ll know if we’re on the right path or not. We desperately want our son to be as happy and ‘functional’ as possible.”

Being a parent of a youngster with Asperger’s (AS) or High Functioning Autism (HFA) is both exhausting and rewarding. Whenever you feel confused, apprehensive or worried, know that you are not alone. The good news is this: armed with just a few simple “tools,” your course-of-action can run relatively smoothly.

Although there are many techniques parents will need to employ to successfully raise a child on the autism spectrum, here are the 6 most important ones to consider first:

1. Analyze your AS or HFA youngster’s strengths and weaknesses – and find the right tools to help him or her.

Think about what you know about your youngster before selecting any treatment options. Each youngster on the spectrum is different – there is no “one-size-fits-all” when it comes to interventions. What works wonderfully for one child may backfire drastically for another. Count on the fact that there will be some trial-and-error as you search for the right approach to dealing with your child’s challenges. As you stay the course, there will be clues and indicators of what will work best for YOUR child.

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

Pay close attention to your parental instincts. Just because you heard something worked for someone you know - and their youngster got much better - does NOT mean that the same intervention will work for your child. You will have the most success if you know your youngster’s strengths and weaknesses, and find a combination of techniques that are a good match for him or her.

2. Understand that your youngster will NOT know what to expect in social situations. So, teach him or her what to expect in various situations in a very clear and precise manner.

Imagine how a pajama party might seem to a child who has never been to one (e.g., kids running around laughing and jumping, popcorn all over the place, pillow fights, trying to sleep on the floor rather than in your own bed, and so on). Imagine how it would feel to go to your first day of elementary school when you’re around 30 other kids, you don’t know where the bathroom is, you don’t know how to ask the other kids if you can play with them, you’re not sure how to interact with peers in the unstructured environment of lunch time and recess, and so on.

Kids on the autism spectrum have social skills deficits. Thus, they do best when placed FIRST into social situations that interest them and have plenty of structure. As your child ages, expose him to more social situations, and provide him with information about what to expect and how to behave. For example, if your child is meeting his teacher for the first time, let him know exactly what it involves (e.g., going to the school, walking into the classroom, saying “Hi, my name is Max”, shaking the teacher’s hand, making eye contact, listening to the teacher introduce herself, and answering any questions she may have). Never feel that you are breaking things down too far for your AS or HFA child. The more detailed and concrete your instruction – the better!

3. Find activities that your AS or HFA youngster is highly interested in, and help him cultivate friendships within those activities.

Children on the spectrum have difficulty finding and keeping friends. For instance, Michael (a 6-year-old) is friends with James (also 6 years old). Michael has HFA and does not like to be in large groups of people. Michael likes soccer, but James likes to talk to his friends. Michael often becomes frustrated and is not sure what to say when James is around. Michael doesn’t read social cues, doesn’t know how to get into the conversation, and doesn’t like to talk about what James and his friends are talking about.

Because Michael enjoys soccer, finding a soccer team or class that he can attend regularly, and then role-playing and coaching him to help with social skills related to those relationships could evolve into people who know Michael and share an interest with him. In the future, those relationships will turn into friendships and into a network of advocates who will share Michael’s interests.

4. Become your child’s advocate.

As a mother or father, you’re the one who has spent the most time with your child, and you may have already figured out what works and what doesn’t (or are coming close to figuring it out). As an expert on your child, you may find yourself being his advocate all the time.

Much of this advocacy happens in the classroom. You’ll need to tell your child’s teacher what techniques work best, what triggers him, and what calms him down. If you find that the school system is just dragging your child along without actually educating him, you’ll need to advocate by talking to the principal, superintendent, or even a lawyer. It may take all of these people to get the school system to take your child’s education seriously.
 


5. Appreciate the benefits of consistency and routines.

Example: Shelley wakes up one morning and eats a bowl of cereal, brushes her teeth, gets dressed, then gets on the bus. The next morning, she wakes up and is surprised to find that she has to take a shower before getting dressed. She becomes agitated and has a meltdown. She starts slapping the wall and knocking stuff off of the counter on to the floor. Now all the kids are late to school – and stressed out!

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

By building in predictability when possible, your AS or HFA child does not have to find other ways to cope (e.g., meltdowns, tantrums, shutdowns, aggression, etc.). Of course, you can’t predict every situation in life, but having a core routine within the family, and preparing your “special needs” child for any upcoming change in routine, will cut down on family stress ten-fold.

In Shelley’s case, maybe she got extremely dirty the night before, but it was too late for her to take a shower. So, you had her get the shower the next morning before school. In this scenario, it would be important to tell her the night before what to expect the next morning. Preferably, you would make a schedule (written or with pictures) so she could visually see what to expect the next day.

Visual schedules are very important when changes in routines are necessary. However, be careful not to over-schedule the routine. Some kids on the spectrum become so dependent on their routines that it can be very upsetting to alter them when “life” happens. Thus, try to build adaptations and variations into your child’s regular routines. This will teach him to cope with the many changes in routines that happen all the time.

6. Take action as soon as possible.

Some therapists have reported working with kids 2 to 3 years old who were diagnosed very early with an autism spectrum disorder that looked like classic Autism (e.g., screaming, banging head into the wall, flapping arms all day with no initiation of communication, etc.) – but with early intervention and treatment, their symptoms fell more in line with high-functioning autism or mild Asperger’s by the time they were 5.

Kids who are already in elementary school and have never had services because the parents thought they were simply late talkers have missed the optimal time for intervention. Thus, the prognosis for improvement is less than ideal.

Parents must catch their child when he is very young and provide treatment. It’s better to help a child who would have been fine either way than to overlook him because you think he will “grow out of it.” Many therapists report working with children who are 5 years old, and the parent knew something was not coming together right for years. Getting help early works. Step through the fear and advocate for the services your youngster needs.

Conclusion–   

The initial period of learning about AS or HFA - and all of the necessary therapies and treatments - can be isolating. You may even feel sad at first, or angry that your life with a child on the spectrum is different than the one you dreamed of and different than the lives of most of those around you. Your ideal world will be very different from the world you actually live in. Still, there are many ways to work towards making your life more of how you want it to be.

As you begin to get more involved in the Autism community, there will be more activity and company of others. This involvement will help your situation feel more “normal” as it provides more chances for typical activity and interaction with others. Over time, life and ideals change, and you will begin to dream new dreams for your real world. 


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

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

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

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism
By

The Severity Levels of Autism


RE: "What's the difference between level 1 autism and high-functioning autism?"

The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) specifies the severity levels of Autism as follows:

Level 1: Requiring Support—

• Social Communication: With supports in place, deficits in social communication cause noticeable impairments. Has difficulties initiating social interactions, and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. [Note: Level 1 autism is most commonly referred to as high-functioning autism.]

• Restricted Interests and Repetitive Behaviors: Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts. Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.

Level 2: Requiring Substantial Support—

• Social Communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with social supports in place; limited initiation of social interactions and reduced or abnormal response to social overtures from others.

• Restricted Interests and Repetitive Behaviors: RRB’s and/or preoccupations or fixated interests appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress or frustration is apparent when RRB’s are interrupted; difficult to redirect from fixated interest.

Level 3: Requiring Very Substantial Support—

• Social Communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning; very limited initiation of social interactions and minimal response to social overtures from others.

• Restricted Interests and Repetitive Behaviors: Preoccupations, fixated rituals and/or repetitive behaviors markedly interfere with functioning in all spheres. Marked distress when rituals or routines are interrupted; very difficult to redirect from fixated interest or returns to it quickly.



So as you can see, Level 1 would be considered high-functioning Autism. Disability will be common among children with Level 3 Autism and non-existent in Level 1 (where children currently diagnosed with Aspergers will be reclassified).

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

The new method for diagnosing Autism replaces the five prior diagnoses: Asperger Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder, and Autistic Disorder. If a child has a pre-existing diagnosis of any of these disorders, he or she is automatically considered to have an Autism diagnosis. 

Children who are being newly diagnosed (or re-evaluated) and do not fit into the new criteria for Autism may receive a new diagnosis called Social Communication Disorder. This appears to be an extremely mild version of Autism (the child does not have sensory issues or repetitive behaviors) and is similar in many ways to the old PDD-NOS. 

The DSM-5 defines Autism as a single “spectrum disorder,” with a set of criteria describing symptoms in the areas of social communication, behavior, flexibility, and sensory sensitivity. If a child has symptoms in these areas, he or she will probably be diagnosed as “on the spectrum.” When a physician diagnoses a youngster with Autism, it's important to know the severity of the disorder. If the physician does give his/her opinion on the severity, it’s with the disclaimer that it’s only an opinion, not a medical diagnosis. Whether the opinion is that it's severe, or that it's mild, it has no bearing on the actual diagnosis. A youngster with Autism deemed as mild is just as autistic as one believed to be severe. The medical diagnosis for both is exactly the same.

Autistic kids have issues with social interactions, behavioral issues, restricted interests, self-stimulatory activities and sensory issues. So severity in each of these categories needs to be determined to assess severity as a whole. While the severity of Autism is not a diagnosis, physicians who specialize in Autism can tell where a youngster is in relation to the other kids they have treated. The same youngster will get different opinions of severity from different people. Since determining a “Level” is subjective and not a technical diagnosis, there is no right or wrong answer.

The severity of Autism changes not only day to day, but also situation to situation. For example, autistic kids may exhibit significant social deficits when trying to play with their peers on the playground -- but in the classroom, they may blend in perfectly with their peers. Autism severity is simply a place to start. It’s something to use to help the youngster make progress by getting more services and to help describe the youngster to therapists, teachers, etc. It’s just a snapshot, not something that reflects the future or the youngster in all situations.

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

Promoting Social Competence in Children with Asperger's and HFA

"My child (high functioning autistic) is currently struggling to have good relationships with his peers? He is mostly disliked because he is frequently aggressive and disruptive."

One of the traits of young people on the autism spectrum is social unresponsiveness (social avoidance behavior). Social unresponsiveness is fear of, or withdrawal from, people or social situations. This becomes a problem when it interferes with relationships with peers, in social situations, or other aspects of a youngster’s life. 

Symptoms of social unresponsiveness may appear as part of the child’s overall personality or as a situation-specific response to a particular stressor. Many kids with Asperger’s (AS) and High-Functioning Autism (HFA) are especially susceptible to self-consciousness in social situations that make them feel exposed or psychologically unprotected.

Social unresponsiveness can also develop as an ongoing reaction to repeated failure, mistreatment, or rejection by peers. Some AS and HFA children may show good peer-group adjustment and ability to interact socially, but they may display communication apprehension when asked to perform in public, answer academic questions, or engage in an activity that they know will be evaluated. Other types of social unresponsiveness may result from specific experiences or environmental factors.

In a manner of speaking, the opposite of social unresponsiveness is social competence. Social competence refers to a child’s ability to get along with others. A youngster’s social competence is affected by how well he communicates with peers, teachers and other adults. A youngster’s view of himself in relation to his family, friends and the wider world also affects his social competence.

How well a youngster gets along with others may be the single best childhood predictor of how well she will function later in life. Kids who are unable to sustain close relationships with peers, who are generally disliked, who are aggressive and disruptive, who can’t establish a place for themselves in the peer-culture, and who do not have a basic level of social competence by the age of 6 usually have trouble with relationships when they become adults. The long-range risks for a youngster who can’t interact well with peers may also include poor mental health, low academic achievement and other school difficulties, and poor employment history.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
Conversely, a youngster is more likely to have stronger relationships, better mental health, and more success in school if she has many chances to strengthen her social competence by playing, talking, collaborating with others, and working out disagreements. The youngster doesn’t necessarily have to be a "social butterfly." Quality matters more than quantity when it comes to friendships. Kids who have at least one close friend tend to increase their positive feelings about themselves.

The checklist below was created to help parents and teachers check to see whether a youngster’s social competence is developing satisfactorily. Many of the traits included in the checklist indicate adequate social growth if they are “usually” true of the youngster. If a youngster seems to have most of the traits in the checklist, then he is not likely to need special help to outgrow occasional difficulties. Conversely, a youngster who shows few of the traits on the list will benefit from strategies to help build social competence.

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The youngster:
  • Asserts own rights and needs appropriately
  • Displays the capacity for humor
  • Does not draw inappropriate attention to self
  • Does not seem to be acutely lonely
  • Enters ongoing discussion on a topic
  • Expects a positive response when approaching others
  • Expresses frustrations and anger effectively, without escalating disagreements or harming others
  • Expresses wishes and preferences clearly
  • Gains access to ongoing groups at play 
  • Gives reasons for actions and positions
  • Has “give-and-take” exchanges of information or feedback with others 
  • Has positive relationships with one or two friends
  • Interacts nonverbally with other kids (e.g., smiles, waves, nods, etc.)
  • Is able to maintain friendships even after disagreements
  • Is accepted versus rejected by other kids
  • Is invited by other kids to join them in play
  • Is named by other kids as someone they are friends with or like to play with
  • Is not easily intimidated by bullies
  • Is not excessively dependent on parents or teachers
  • Is usually in a positive mood
  • Is usually respected rather than feared by other kids 
  • Makes relevant contributions to ongoing activities
  • Negotiates and compromises with others 
  • Shows appropriate response to new people (as opposed to extreme fearfulness or indiscriminate approach)
  • Shows interest in others 
  • Shows the capacity to empathize
  • Shows an interest in keeping friends and misses them if they are absent
  • Takes turns fairly easily
  • Usually copes with rebuffs or other disappointments adequately

Though each component contributes to the other, there is a necessary initial sequence to the elements of learning social competence for children: (1) the ability to enter play successfully, which (2) creates feelings of being accepted by others, which (3) leads to friendships and to caring about others, which (4) makes the youngster more willing to consider the perspective of others instead of just his own. When these components are in place, the youngster is usually open to assistance with social skills and behaves in a fairly socially acceptable manner.

Parents and teachers should think about a youngster’s motivation for prosocial behaviors (e.g., sharing, compromising, taking turns, etc.). Some young people simply don’t care if they hurt others or make them upset. These are usually the kids who feel rejected by peers – and who reject peers in return. If a youngster has little empathy, then parents and teachers are going to have little luck with lessons about “getting along.”

A basic component for learning social competence is having friends, which for most kids, means having playmates. In order to have playmates, young people must be able to successfully enter into play with their peers, which may be the most basic part of developing social competence. The process of playing with others not only provides motivation for learning social skills, it also provides superb practice. Play provides many opportunities for conflict resolution and negotiation, which help kids to be empathic (i.e., to consider the needs and feelings of others). Considering the needs and feelings of others is called “perspective-taking,” which is also “basic” to developing social competence.

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

Why Asperger's/HFA is Largely a Disorder of Social Skills 



 Below are suggestions for AS and HFA kids who are socially unresponsive, and how parents and teachers can promote the development of social competence:

1. Any time your AS or HFA youngster exhibits socially appropriate behavior, praise her and let her know you are proud of her.  Also, be sure to state exactly why you are proud (e.g., “Julie, you did a great job saying ‘hello’ to Mrs. Johnson.  That’s you being friendly.”).

2. Don’t speak FOR your youngster. When someone approaches her (e.g., asks her name or comments on her pretty dress), it may be tempting to speak for her.  By speaking for your youngster, it lets her off the hook because she doesn’t have to respond. Also, it sends the message that her voice isn’t necessary, which can reinforce social unresponsiveness.  So, let you child speak for herself as often as possible.

3. Find information on the internet, in books and magazines, etc. on ways to be prosocial and make friends. Share this information with your child. In addition, social stories about “making and keeping friends” are especially helpful when attempting to promote prosocial behavior in AS and HFA children (click here for an example).

4. For the AS or HFA youngster who is socially unresponsive, it may take her a while just to muster up the courage to attempt to join a play group. Let her go at her own pace with your support and encouragement.  Pushing a youngster to join in play may lead to humiliation and resentment towards you.

5. Help the youngster develop confidence that she will be accepted by her peer-group. A youngster who approaches playmates with confidence is more likely to gain entry to play. On the other hand, the hesitant child is more likely to experience peer-rejection. Peer-rejection starts a cycle of ineffective behaviors that lead to even more rejection. Parents and teachers can make a difference with careful confidence-building strategies.
 
 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

6. Parents and teachers can help kids on the autism spectrum become socially competent by encouraging friendships. Friendships are crucial for a variety of reasons: (a) friendships offer the best opportunities for developing the interpersonal understandings needed for socialized behavior; (b) kids are more likely to be successful when initiating contact with friends, thus increasing their confidence; (c) kids care more about the feelings of friends than about those of others, thus encouraging them to practice perspective-taking; and (d) kids’ play is more sophisticated and mature when they are playing with friends, which improves their competence.

7. Teach your youngster positive self-talk.  Have her list the things she can do, what she is good at, and friends and family that care about her.  Have her practice saying all of this to herself.  Keep the list posted in a prominent place. In this way, she is reminded of all her good qualities.

8. The AS or HFA youngster will have a much easier time being outgoing in social situations if his parents model good social behavior.  For instance, when you are out with your youngster, make an effort to be especially friendly and outgoing to people. This will let your youngster see that it is safe to relate to others (i.e., family members, friends, acquaintances, and even strangers).

9. Well-meaning parents and teachers often insist that “no child be left out,” but this eliminates a teachable moment that may actually make things worse for the AS or HFA youngster in the long-term. There is usually a reason for a youngster being rejected by the play group, and it is the adult’s job to assess the situation and figure out why. Usually there is a missing skill that the child needs to develop. So, parents and teachers should try to identify what needs to be learned – and then teach it. Insisting that a particular youngster be allowed to play just covers up the problem, teaches no social skills or understanding, and makes the other kids more resentful of the “special needs” youngster forced upon them. Consider how you would feel if you were in a meaningful conversation with your best friend, and an uninvited acquaintance jumps in and disrupts the conversation. It’s reasonable at times for kids to ask not to be disrupted by others.

10. Young people on the autism spectrum must be helped to avoid advances that disrupt the ongoing play among his peers. Too often, the AS or HFA youngster will barge into a play situation like an Army tank and be totally surprised and disappointed when the other kids get angry. In these cases, it would be helpful to teach the child a “beginning strategy” that does not interrupt. For example: (a) doing a similar activity near the play group; (b) observing what the desired playmates are doing, which provides information that the youngster can use by offering a way to contribute or fit into the existing play (the youngster who joins a group with a contribution to ongoing play is most likely to be accepted); or (c) simply playing alongside potential playmates.

Play is a common form of interaction between - and among - all kids. Young boys and girls do not construct their own understanding of a concept in isolation – but in the course of interaction with peers. Some of the social skills developed through play are (a) the ability to work towards a common goal, (b) cooperating with peers, and (c) initiating a conversation. By using the strategies listed above, parents and teachers can help the AS or HFA child to move past social unresponsiveness – and on to social competency.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

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