Effective Social Interventions and Supports for Children on the Autism Spectrum

Kids and teens with Asperger’s (AS) and High-Functioning Autism (HFA) often have difficulty understanding social situations, which can cause stress and anxiety. Social situations that seem to be most problematic include:

• Interpreting nonliteral language (e.g., idioms and metaphors)
• Knowing how and when to use turn-taking skills (e.g., focusing on the interests of peers)
• Recognizing that others' intentions do not always match their verbalizations
• Understanding facial expressions and gestures
• Understanding the “hidden curriculum” (i.e., those complex social rules that often are not directly taught)

Even when a youngster with AS or HFA receives effective instruction in social skills, situations will arise that require “interpretation.” Unless interpreted, these situations become a source of stress and do not support future learning. However, with interpretation, perceptions of seemingly random actions can be altered into meaningful interactions. Interpretive strategies include:

1. the Situation-Options-Consequences-Choices-Strategies-Simulation (SOCCSS) strategy
2. the Power Card
3. Social Autopsies
4. Cartooning

Situation-Options-Consequences-Choices-Strategies-Simulation—

One interpretive technique, the Situation, Options, Consequences, Choices, Strategies, Simulation (SOCCSS) strategy, was developed to help AS and HFA kids with social interaction problems put interpersonal relationships into a sequential form. It helps them understand problem situations and lets them see that they have to make choices about a given situation, with each choice having a consequence. The steps of SOCCSS are:

1. Situation: When a social problem arises, the parent or teacher helps the youngster to understand the situation by first identifying:

• who was involved
• what happened
• the date, day, and time of occurrence
• reasons for the present situation

2. Options: The youngster, with the assistance of the parent or teacher, brainstorms several options for behavior. At this point, the parent or teacher accepts all of the child’s responses and does not evaluate them. This step encourages him or her to see more than one perspective and to realize that any one situation presents several behavioral options.

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

3. Consequences: Then the youngster and parent or teacher work together to evaluate each of the options generated. The parent or teacher is a facilitator, helping the youngster to develop consequences for each option rather than dictating them.

4. Choices: The youngster selects the option(s) that will have the most desirable consequences for him or her.

5. Strategy. Next the youngster and parent or teacher develop an action plan to implement the selected option.

6. Simulation: Finally the youngster is given an opportunity to role-play the selected alternative. Simulation may be in the form of:

• writing a plan
• visualization
• talking with a peer
• role play

The SOCCSS strategy offers many benefits to the AS or HFA child. It allows him or her to:

• understand that many options may be available in any given situation
• realize that each option has a naturally occurring consequence
• develop a sense of empowerment by acting on the environment (i.e., these children realize that they have choices, and by selecting one, they can directly determine the consequences of their actions).

The Power Card—

Figure 1 - Click to enlarge

The Power Card is a visual aid that helps AS and HFA kids and teens make sense of social situations, routines, and the meaning of language. The Power Card uses their “special interests” to help them make sense of a specific situation and motivates them to engage in a targeted behavior.

In using this strategy, the parent or teacher develops a brief script written at the youngster's level of comprehension, which details a problem situation or a target behavior and its relationship to the youngster's special interest. Power Cards also provide a solution, relying on the youngster's special interest. This solution then is generalized back to the youngster. A card the size of a business card or trading card containing a picture of the special interest – and a summary of the solution – can be carried with the youngster to promote generalization.

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

The Power Card can be carried in a pocket, purse, or wallet, or it can be velcroed inside a book, notebook, or locker. It also may be placed on the corner of the youngster's desk. Figure 1 provides an example of a Power Card for a 6-year-old female student with HFA who had problems focusing. Her special interest was Dora the Explorer.

Social Autopsies—

Figure 2 - Click to enlarge

This technique was created to help AS and HFA children with severe learning and social problems to develop an understanding of social mistakes. In the traditional sense, an autopsy is the examination and inspection of a dead body to discover the cause of death, determine damage, and prevent recurrence.

Similarly, a social autopsy is an examination and inspection of a social error to discover the cause of the error, determine the damage, and prevent it from happening again. When a social mistake occurs, the youngster meets with the parent or teacher to discuss it.

Together, in a non-judgmental way, they identify the mistake. Then they discuss who was harmed by the error. The final step of the autopsy is to develop a plan to ensure that the error does not occur again. Figure 2 is an example of a social autopsy worksheet.

Cartooning—

Figure 3 - Click to enlarge

The visual area is a strength for kids on the autism spectrum. Therefore, visual systems often enhance their ability to understand their environment. One type of visual support is cartooning. This strategy has been implemented by speech/language pathologists for many years to enhance their clients’ understanding.

Cartoon figures play an integral role in a number of other intervention techniques (e.g., pragmaticism, mind-reading, and comic strip conversations). Each of these strategies promotes social understanding by using simple figures and other symbols (e.g., conversation and thought bubbles) in a comic strip-like format. This visual representation of a conversation helps AS and HFA kids analyze the social exchange.

Although cartooning has limited scientific verification, some evidence suggests that learners with AS and HFA may be good candidates for social learning based on using a comic format to dissect and interpret social situations and interactions. Figure 3 provides a cartoon depicting a social interchange.

Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> 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

Problems with "Disruption of Routine" in Kids with Asperger’s and HFA

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

Parents' Problem-Solving Skills for Hostile Teens with Autism Spectrum Disorder

“My wife and I are struggling dealing with our angry, increasingly aggressive 14 yr old son with high functioning autism. He's now refusing to hand over his electronics at night and shouting occurs. He is testing the boundaries, of course, but physical confrontation is something we don't know how to cope with.”

Addressing hostility and aggressiveness in teens with Asperger’s (AS) and High-Functioning Autism (HFA) can be a frustrating and demanding process. The challenge for parents and teachers is to address the behavior in a constructive manner, rather than simply reacting to it.

When AS and HFA teens are exhibiting hostile behaviors, it is often a sign that they are not receiving adequate support in mastering their environments, both at home and school. In addition, their aggressiveness does not necessarily reflect willfulness, rather they lack the social skills needed to “fit-in” and to be accepted by others – especially their peers.



What makes AS and HFA teens act-out may lie in the way they process social information, including what aspects of the social environment they pay attention to, and how they interpret what they perceive. These “special needs” teens need help in altering the way they process social information so that they do not view hostility as justified or useful.

The development of an “emotions vocabulary” is an important component in addressing aggressive behaviors so that feelings can be put into words leading to social skills development, identifying feelings, fostering cooperation, emphasis on empathy, discussions of future desires, conflict resolution, and assertive communication.

If the AS or HFA adolescent is acting-out, it is irrational for parents and teachers to assume that he knows more favorable alternatives. If adults are always telling this adolescent what NOT to do, when are they telling him what he SHOULD be doing and helping him to learn how?

Why Teens with Asperger's and HFA Can Be Moody and Depressed--




 ==> Disciplinary Strategies for Asperger's and HFA Teens


Teaching Problem-Solving Skills—

Developmental deficits in cognitive processes are often associated with aggressive behavior, and social development requires mastery of cognitive and behavioral skills for communicating with others, assessing social circumstances, and resolving conflicts without aggressiveness. These skills empower AS and HFA teens to make friends and flourish socially.

Teaching problem-solving skills is useful in addressing hostility and aggressiveness in these adolescents. Below are 6 effective steps to teaching problem-solving skills. Each step requires different approaches to discovering - and linking - the missing skills in social situations.

Step 1: Help the teen to attend to social cues that are often missed or misinterpreted.

Methods: 

• Help the teen identify his own feeling states through self-report and observation.
• Enhance sensitivity to verbal and nonverbal social cues through games and role play, teaching the teen to identify social cues in body language and pitch of voice.
• Have the teen make a video of his own nonverbal cues, and then have him explain his feelings on the basis of cues demonstrated in the video (e.g., hand gestures, facial expressions, voice intonation, and other indicators of social intent).

Step 2: Help the teen to assign meaning to social cues. This step is necessary because hostile teens commonly interpret neutral interactions as threatening – and then respond defensively. Unlike “typical” teenagers, AS and HFA teens do not intuitively know how to exhibit socially acceptable behavior, and the level of their required assistance depends on the social supports they have previously encountered.

Methods: 

• With the help of videotapes of social encounters, the teen should be taught to identify the sources of the problems and the feelings of participants with emphasis on correctly identifying friendly and neutral – as well as hostile – intent on the part of others.
• The teen should learn to identify and classify social cues by friendly, neutral, and hostile categories of intent. The teen can practice by assuming the roles of his peers in disputes.

Step 3: Help the teen to define goals that enhance social relationships with an awareness of the consequences of behavior.

Methods: 

• Brainstorming example: The teen is rewarded for having ideas about goals for various situations. Goals can be rated as to whether they are likely to enhance or damage interpersonal relationships with peers.
• The teen should be given opportunities to practice identifying and fitting pro-social goals to various situations.

 ==> Disciplinary Strategies for Asperger's and HFA Teens

Step 4: Help the teen to develop ideas about how to respond to each social circumstance he encounters. This step is necessary because compared with “typical” teens, AS and HFA teens identify fewer alternatives and seem unaware of the various options that may be open to them when confronted by a social problem. These “special needs” teens need help identifying their options and possible outcomes (this is why constantly telling them what they are doing wrong does not increase the likelihood of improved future performance).

Methods: 

• Help the teen to develop skills to control arousal and to generate behavioral responses in which anger and use of force are only two of many response possibilities.
• Help to increase the teen’s skill in identifying alternatives to the use of force to solve social problems.

Step 5: Help the teen to assess likely outcomes of potential responses and to select a response that can be initiated given the limitations of the situation. Compared to non-hostile teens, hostile ones tend to evaluate pro-social responses less favorably. Thus, they are not behaving a certain way to purposely hurt those around them, rather they are simply making decisions based on social skills deficits.

Methods: 

• Evaluation of each alternative: The teen should be given opportunities to discuss likely gains and losses associated with each identified alternative in specific social situations.
• Like goals, gains may be described as short and long term, material and social, or affective and concrete.
• In addition to benefits, look at costs (i.e., negative outcomes) of each alternative.

Step 6: Help the teen to implement a response. This step is where a teen with hostile tendencies joins a group, negotiates deals, offers and/or receives positive feedback, and bargains for the exchange of social opportunities by implementing a strategy from previous steps. Practicing this step will be intimidating and challenging for the AS or HFA teen. Any attempts – successful or not – should be praised and reviewed to identify areas of strength as well as need for improvement.

The development of problem-solving skills includes the AS or HFA teen as a contributor in planning and execution. Thus, be sure to include his input in all the steps listed above. The methods described are something you are doing WITH the teen, rather than TO him. Addressing hostility in these “special needs” young people demands an understanding of their perspective. Any approach to correcting hostility that does not include the teen himself is not going to have long-term benefits.

Behind every behavioral problem is a skill deficit – and a need to acquire that skill. Identifying with whom, over what, where and when behavioral problems occur will highlight specific circumstances so that appropriate problem-solving skills can be taught. Including the teen in the plan to address his aggression and hostility is allowing him to be assertive in a positive way; it gives him a sense of control that is often craved when he is lacking a skill and acting-out aggressively.

 

Resources for parents of children and teens on the autism spectrum:
 

==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder

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

==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book

==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism

 

Understanding Meltdowns in Children with Level 1 Autism

"I'd like to figure out what causes my child's meltdowns. She's autistic (level 1) and is getting more out-of-control lately. My suspicion is that she is dreading going back to school (starts 5th grade). We had several bad experiences last year, and she may be thinking that it's going to be more of the same this year - IDK."

Level 1 Autism, or high-functioning autism, is a neurological condition. The brain is wired differently, making this disorder a lifelong condition. It affects communication, social interaction and sensory issues.

Level 1 Autism is often referred to as the "invisible disorder" because of the internal struggles these kids have without outwardly demonstrating any real noticeable symptoms. Thus, difficultly assessing someone with Level 1 Autism is even more impacted.

Kids with high-functioning autism and Asperger's struggle with a problem and internalize their feelings until their emotions boil over, leading to a complete meltdown. These outbursts are not a typical temper tantrum. For children with Level 1 Autism (and for their parents), these episodes are much worse.

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

Many Level 1 Autistic kids may appear under-receptive or over-receptive to sensory stimulation and therefore may be suspected of having vision or hearing problems. Therefore, it's not unusual for parents or teachers to recommend hearing and vision tests. Some kids may avoid gentle physical contact such as hugs, yet they react positively to rough-and-tumble games. Some Level 1 Autism kids have a high pain tolerance, yet they may not like to walk barefoot in grass.

There are nine different types of temperaments in Level 1 Autistic children:

1. Distractible temperament predisposes the child to pay more attention to his or her surroundings than to the parent.
2. High intensity level temperament moves the child to yell, scream, or hit hard when feeling threatened.
3. Hyperactive temperament predisposes the child to respond with fine- or gross-motor activity.
4. Initial withdrawal temperament is found when children get clingy, shy, and unresponsive in new situations and around unfamiliar people.
5. Irregular temperament moves the child to escape the source of stress by needing to eat, drink, sleep, or use the bathroom at irregular times when he or she does not really have the need.
6. Low sensory threshold temperament is evident when the child complains about tight clothes and people staring and refuses to be touched by others.
7. Negative mood temperament is found when children appear lethargic, sad, and lack the energy to perform a task.
8. Negative persistent temperament is seen when the child seems stuck in his or her whining and complaining.
9. Poor adaptability temperament shows itself when children resist, shut down, and become passive-aggressive when asked to change activities.

Some meltdowns are worse than others, but all leave both parent and kid exhausted. 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 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 full force.

Meltdowns are overwhelming emotions and quite common in Level 1 Autistic kids. They can be caused by anything from a very minor incident to something more traumatic. They last until the kid is either completely exhausted, or he gains control of his emotions, which is not easy for him to do.

If your child suffers from Autism, expect her to experience both minor and major meltdowns over incidents that are part of daily life. She may have a major meltdown over a very small incident, or may experience a minor meltdown over something that is major. There is no way of telling how she is going to react about certain situations. However, there are some ways to help your daughter learn to control her emotions.

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

Autistic children don’t really have the knowledge to decipher when their actions are inappropriate. When your daughter is calm and relaxed, talk to her about her meltdowns if she is of an age where she can reason and learn to work with you. This will probably not be until the kid is seven or eight years old. Then, tell her that sometimes she does things that are not appropriate. Have her talk to you about a sign you can give her to let her know when this happens.

All you can do is be patient with your daughter while she is having a meltdown, though they are emotionally exhausting for you as well as he. Never punish her for experiencing a meltdown. Overwhelming emotions are part of the Autism traits, but if you work with your daughter, she will eventually learn to control them somewhat.

Level 1 Autistic kids don’t like surprises and some don’t like to be touched. Never rush to your daughter and give her a hug. If you want to hug her, tell her exactly what you are going to do. A surprise hug can send her into an even worse meltdown than she is already experiencing.

These young people like to be left alone to cope with emotions. If your daughter says something like, “I just want to be left alone,” respect her wishes for at least a while. You can always go back in ten minutes and ask if you can help. Do not be hurt if she refuses.

Work with your daughter as she grows older to help her learn to cope with daily life. Remember, she sees the world much differently than we do and needs help deciphering exactly how we see the world. While working with her on this, she will give you clues as to how she sees the world and a firmer bond will be established.

Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> 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

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:
 

==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder

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

==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book

==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism