"Is it common for children with high-functioning autism to have problems relating to their friends and classmates - and be somewhat of a ‘loner’?"
Although the social criteria for High-Functioning Autism (HFA) and classic autism are somewhat similar, the former disorder involves fewer symptoms and has a different presentation than does the latter.
Kids with HFA are often socially isolated, but are aware of the presence of others, even though their approaches may be inappropriate and odd (e.g., they may engage the listener in one-sided conversation using long-winded, pedantic speech about a favorite and narrow topic).
Although some kids with HFA are often self-described "loners," they often express an interest in making friends. These wishes are often hindered by their strange approaches and insensitivity to the other person's feelings, intentions, and nonliteral and implied communications (e.g., need for privacy, signs of boredom, desire to leave, etc.).
Chronically frustrated by their repeated failures to engage others and make friends, some of these children develop symptoms of depression and/or anxiety, which then can escalate into the desire to simply “stay to oneself.”
Regarding the emotional aspects of social interactions, kids on the autism spectrum may fail to interpret the context of the affective interaction, often demonstrating a sense of insensitivity, formality, or disregard to others’ emotional expressions.
Nonetheless, they may be able to describe correctly, in a cognitive and often formalistic manner, others’ emotions, expected intentions and social conventions, but are unable to act on this awareness in an intuitive and spontaneous manner, thus losing the tempo of the social exchange.
Such poor intuition and lack of spontaneity are often accompanied by a strong reliance on rigid social conventions and formalistic rules of behavior, which is mostly responsible for the impression of social naivete and behavioral rigidity that is so vigorously conveyed by these young people.
While children with classic autism are withdrawn and may seem to be unaware of - and disinterested in – others, children with HFA are often highly interested (sometimes painfully so) to relate to others, but may lack the skills to successfully engage them.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
Paul S said...This is spot on! I have a 19 YO son with HFA and he wants - absolutely desires - to have close friends. Yet people keep him at a distance and sometimes reject him outright because of his "peculiar" behavior.
Unknown said...I have 3 boys with HFA and I didn't see them really make friends until they started attending schools/classes for HFA. Being around others like themselves seemed to make them more comfortable with approaching others. It has also given them a chance to work on social skills they normally would shy away from with guidance from school staff.
dsnyredhead said...This sounds so much like my 14 year old. He also seems to have no ability to understand how his appearance may affect things. He has refused haircuts now for a year and with high school orientation this week, he still refuses. He will be going to a new school (for him) with all new kids, and he refuses to get his hair cut..or shave to make his appearance better. He says "it's my hair!". Ugh. A whole year later. Nothing has changed. He starts 10th grade this week. He did shave a few times early last year. That's it. Now a pretty full beard and long hair. Fortunately, it's a quirky arts type charter so he fits in there. Still no friendships that I know of.
"My husband and I believe that Ryan, our 6-year-old son, may have the milder form of autism. Is it ever too early to get a child diagnosed? How does one go about seeking a diagnosis? And, what are our treatment options?"
If you are noticing some of the early symptoms of High-Functioning Autism (or Asperger's), then it is not too early to seek a diagnosis regardless of the child’s age. Early symptoms usually include problems with social interaction. For example:
a significant lack of empathy
can become very upset if someone touches their things, moves furniture or toys around
demonstrate an extreme aversion or tantrums during transitions
difficulties with social skills
display a very narrow or an unusual range of interests, with elaborate or unusual play-based behaviors
do not notice if a peer or playmate loses interest, or even wanders away
find interpreting social comments, facial expressions, tone of voice, or body language as difficult as trying to interpret a foreign language
find unwritten social rules to be confusing
have difficulty listening to others and understanding their perspective
have excessive or a complete lack of separation anxiety from parents
invade other people's personal space
lack of eye contact or social smiles
lack of social discrimination
limitation in reciprocation or give and take interactions
may act-out elaborate rituals, which appear to be creative play, but are actually scripted activities without the variation or creativity of imaginary play
may appear hyperactive, and pursue movement to an excessive degree
may appear to never be able to "let it go," or tend towards appearing argumentative or "splitting hairs"
may appear very rigid in their point of view
may become extremely upset if their routine or ritual is changed in any way
may demonstrate fixations on things (e.g., Pokémon, television shows, computer games, numbers, dinosaurs, trains, etc.)
may excessively ask the same question over and over
little or no interest in sharing toys and interests
preference towards playing alone or with "things" rather than with friends
tend toward social isolation
tend to be viewed as "lost in their own little world" at times
tend to interact very well with adults, but struggle with appropriately initiating peer interaction
tend toward extreme perfectionism or "having to finish" what they have started
tend toward lining things up, organizing by color, or even repeating lines verbatim
tend to be self-absorbed or aloof
touch or climb people inappropriately
Furthermore, kids with High-Functioning Autism are limited in brain areas that enable them to understand subtle cues. As a result, literal interpretation, misunderstandings, and/or sensory over-stimulation may lead to tantrums, aggressiveness, overreactions, irritability, low-frustration tolerance, anxiety, self-stimulation, depression, or self-injury. In addition, these young people may develop a tendency of distrust towards others due to social failures and negative social experiences over time, which can lead to self-isolation and social phobia. This behavioral reaction can be viewed as "rude" by others, and often kids with this disorder struggle to understand why they are not liked or frequently feel rejected.
Kids with High-Functioning Autism are usually not diagnosed as early as kids with more severe forms of autism, because the symptoms are not as noticeable. Symptoms may not become a problem until the youngster starts school. Your youngster's doctor will look for signs of developmental delays at regular checkups. If your youngster shows any symptoms of High-Functioning Autism, you'll probably be referred to a specialist who treats kids on the autism spectrum (e.g., pediatric neurologist, developmental pediatrician, child psychologist) for a thorough clinical evaluation.
Because Autism varies widely in severity, making a diagnosis can be difficult. There isn't a specific medical test to determine the disorder. Instead, a specialist may do any of the following:
Seek a speech and language assessment
Recommend genetic testing to identify whether your youngster has a genetic disorder (e.g., fragile X syndrome)
Request physical, neurological, or developmental testing
Present structured social and communication interactions to your youngster and score the performance
Establish the history of the youngster's development
Conduct psychological testing
Observe your youngster and ask how his or her behavior, social interactions, and communication skills have developed and changed over time
Interview the parent(s) and others who have frequent contact with the youngster
Give your youngster tests covering developmental level, language, social and behavioral issues, and speech
Involve other specialists in determining a diagnosis
For your youngster to be diagnosed with High-Functioning Autism, he or she must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manual used by mental health providers and by insurance companies to reimburse for treatment.
High-Functioning Autism often includes (a) problems with social interaction (e.g., lack of eye contact, an inability to understand another person's feelings), (b) problems with communication skills (e.g., not speaking, repeating a phrase over and over again), and (c) restricted, repetitive patterns of behavior, interests or activities that cause impairment in social, occupational or other areas of functioning.
To meet Autism criteria, your youngster must have problems across multiple situations with:
Developing, maintaining and understanding relationships (e.g., showing a lack of interest in others, difficulty adjusting behavior to suit various social situations, problems sharing imaginative play, problems in making friends)
Nonverbal communication behaviors used for social interaction (e.g., problems using and understanding body language or gestures, problems making eye contact, lack of facial expressions, difficulty using or understanding nonverbal cues)
Social and emotional give-and-take in social settings (e.g., reduced ability to share experiences or emotions with others, problems initiating or responding to social interactions, inability to engage in normal back-and-forth conversation)
In addition, your youngster must experience at least two of the following:
Extra sensitivity or a lack of sensitivity to sensory input, or an unusual interest in sensory aspects of the environment (e.g., visual fascination to lights or movement, negative response to certain sounds or textures, excessive smelling or touching of objects, apparent indifference to pain or temperature)
Insistence on sameness, rigid routines, or ritualized patterns of verbal or nonverbal behavior (e.g., needing to take the same route to school every day, extreme distress at small changes, expecting activities or verbal responses to always be done the same way)
Interests in objects or topics that are abnormal in intensity, detail or focus (e.g., excessively limited narrow areas of interest, interests that are excessively repetitive, strong attachment to unusual objects or parts of objects)
Odd or repetitive motor movements, use of objects or speech (e.g., mimicking sounds, repeating phrases verbatim without understanding how to use them, lining up toys or flipping objects, body rocking or spinning)
The DSM-5 includes functional levels along the autism spectrum. Children who are generally quite functional and in need of less support are usually given the diagnosis of Level 1 Autism Spectrum Disorder. Hence, the term “high-functioning autism.”
The high-functioning autistic child may:
have significant speech and language delays, but is able to take part in an inclusive academic program because of his or her age-appropriate academic skills
have anxiety, learning disabilities, and sensory challenges, but has age-appropriate speech and exceptional abilities in music, math, or engineering
have relatively mild speech and social delays, but has sensory issues which make it difficult for him or her to take part in an inclusive academic program
be able to complete daily tasks, do math, read, show affection, use age-appropriate language, and write – but may not be able to pick up on social cues, maintain a conversation, hold eye contact, or engage in imaginative play
As you can see, the possible combinations of strengths and deficits are abundant. In any event, even though high-functioning autistic children may not need help with toileting or basic hygiene, many do need a good deal of support in other settings. For instance, a very bright autistic student with severe sensory sensitivities and anxiety may have a more difficult time in the classroom than a less intelligent “typical” student with less anxiety and fewer sensory sensitivities.
The symptoms of these “special needs” children will fall on a continuum, with some showing mild symptoms, and others having much more severe symptoms. This “spectrum” allows professionals to account for the variations in symptoms and behaviors from child to child.
Treatment—
The goal of treatment is to maximize the youngster's ability to function by (a) reducing the symptoms of High-Functioning Autism and (b) supporting development and learning. Treatment options may include the following:
Behavior and communication therapy: Many programs address the range of social, language and behavioral difficulties associated with High-Functioning Autism. Some programs focus on reducing problem behaviors and teaching new skills, while others focus on teaching kids how to act in social situations and how to communicate better with others. Though kids don't usually outgrow the symptoms of High-Functioning Autism, they can learn to function well.
Educational therapy: Kids with High-Functioning Autism often respond well to highly-structured educational programs. Successful programs often include a team of specialists and a variety of activities to improve behavior, social skills, and communication.
Family therapy: Moms and dads can learn how to play and interact with their “special needs” youngster in ways that manage problem behaviors, promote social interaction skills, and teach daily living skills and communication.
Medication: No medication can improve the core signs of High-Functioning Autism, but certain medications can help control symptoms (e.g., anxiety, depression, behavioral problems, hyperactivity, etc.).
Early identification and intervention are considered key to positive outcomes for kids with High-Functioning Autism. Parents, teachers, school psychologists, mental health professionals, and doctors should work together to become better informed regarding assessment tools, research, and diagnostic criteria, as well as the best interventions to increase appropriate behavior, social skills, personal communication, and peer interaction.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
• Anonymous said… I had a mda multi discipline assessment. through my son's school...he had assessment s and questionnaires, now awaiting diagnoses on the 29 th sept,we have waited no many years for this.my son is nearly 8 next week,he is being assessed for adhd and asbergers, he also has hypermobilty.schools don't normally refer till they are 7-8 years maybe bit younger.good luck x
• Anonymous said… I hope aged 6 isn't too young as my child is 2 1/2 and has just been referred for diagnosis of Aspergers/ASD. I've been warned that as he is so young he might be turned down until he is older. Health professionals such as health visitor and GP are in agreement that my son is definitely somewhere on the spectrum. I'm under the impression we are in for a long wait though. We are in Northern Ireland. Good luck, I hope you get answers.
• Anonymous said… If your in the UK you'll be waiting a long time for a diagnosis as those professionals that perform this task seem to hibernate for 11+ months of the year, or is it reluctance since once diagnosed the council have to fund the schools etc to help them.
• Anonymous said… I'm in Qld Australia and my son was diagnosed before turning 3. We are very fortunate as it means we've been able to access the early intervention funding available for under 7s, and I truly believe this has made a huge difference for him.
• Anonymous said… My son was also diagnosed with Aspergers, just before 3 years old. Early intervention is the best thing for these kids and for their parents as well.
• Anonymous said… My son was diagnosed at 6 years old with ADHD, anexity disorder and HFA (aspergers) we talked to our pediatrics and the recommended a psychotherapist who put his through 21/2 mths of testing. I was thrilled it wasn't just thrown togeather and hear ya go. We have opted with meds and therapy which has turned his world around. Still have some rough days. But they are decreasing.
* Anonymous said... I am 60 years old and can't imagine how much better my life would have been if I had been diagnosed as a child. It would surely have saved me a lifetime of difficulties. If you suspect your child of having this disorder and are not able to get a diagnoses for financial reasons, go to the library and get books. Education and understanding how to help your child will benefit them greatly. This would also relieve some of your own frustrations, especially if you are neuro-typical. Please post your comment below…
"I need some ideas on how to handle behavior problems in my students who have autism spectrum disorder. Thanks in advance!"
Managing children with High Functioning Autism (HFA), or Asperger’s, will present you with some unique and distinctive challenges. Not only will these children demand more of your time and patience, many will require specialized instructional techniques in a structured environment that supports and enhances their learning potential. It is important to remember that HFA children are not “disabled” or inept – they simply need differentiated instruction tailored to their unique learning abilities.
Preschool—
Currently, there is no single, uniform presenting picture of HFA in the first 3-4 years of life. The early picture may be difficult to distinguish from typical Autism, suggesting that when evaluating any autistic youngster with apparently normal intelligence, there is a strong possibility that he may eventually have a picture more compatible with an HFA diagnosis. Other kids may have early language delays with rapid "catch-up" between the ages of 3 and 5. Some of these young people – particularly the brightest ones – may have no evidence of early developmental delay (perhaps with the exception of some motor clumsiness). However, in almost all cases, if you look closely at the youngster between the age of about 3 and 5, clues to the diagnosis can be found. In most cases, a comprehensive evaluation at that age can at least point to a diagnosis along the autism spectrum.
Although these young people may seem to relate quite normally within the family setting, problems are often seen when they enter preschool. Problems may include:
aggression
appearing to be "in one's own little world"
difficulty regulating social/emotional responses with anger
difficulty with transitions
excessive anxiety
hyperactivity
odd verbal responses
preference for a set routine
problems sustaining simple conversations
tendency to avoid spontaneous social interactions
tendency to be perseverative or repetitive when conversing
tendency to over-focus on particular objects or subjects
tendency to show very weak skills in interactions
As you can see, this list is much like the early symptom list in classic Autism. However, compared to lower-functioning autistic kids, the youngster with HFA will have less abnormal language and conversational speech, may not be as obviously "different" from other kids, and is more likely to show some social interest in peers as well as grown-ups. Also, certain special skills may be present (e.g., letter or number recognition, rote memorization of various facts, etc.).
Elementary School—
Most young people with HFA will enter kindergarten without having been adequately diagnosed. In many cases, there will have been behavioral concerns (e.g., hyperactivity, inattention, aggression, outbursts, etc.) in the preschool years. Also, there may be concern over "immature" social skills and peer interactions. These children may already be viewed as being somewhat odd or unusual. If these problems are severe, special education may be suggested, but most kids with HFA usually enter a mainstream setting.
Oftentimes, academic progress in the early grades is an area of relative strength. For instance, calculation skills may be strong, and rote reading is usually quite good (although writing skills are often considerably weaker).
Educators may be astounded by the HFA youngster's "obsessive" areas of interest, which often intrude in the classroom setting.
Most HFA kids will show some social interest in other classmates, but they are likely to show weak “friend-making” and “friend-keeping” skills. They may show particular interest in one or two peers around them, but the depth of their interactions will be relatively superficial. On rare occasion, however, some HFA kids present as very pleasant and "social," particularly when interacting with grown-ups.
Depending on a range of factors (e.g., anxiety, quality of management at school, quality of parenting at home, hyperactivity/attentional problems, intelligence level, learning problems, temperamental style, etc.), the course through elementary school will vary considerably from youngster to youngster, and overall problems can range from mild and easily managed to severe and intractable.
As the HFA youngster moves into middle school, the most difficult issues continue to be those related to social skills and behavior management. Due to the fact that kids with HFA are frequently managed in mainstream educational settings, and because their specific developmental problems may be more easily overlooked (especially if they are relatively smart), they are often misunderstood at this age by both educators and peers.
In middle school, educators have less opportunity to get to know a youngster well, thus problems with behavior or study habits may be misinterpreted as emotional or motivational problems.
In certain less structured settings (e.g., cafeteria, physical education class, playground, etc.), the HFA youngster may get into escalating conflicts with educators and/or peers who may not be familiar with his developmental style of interacting. This, in turn, can lead to more serious behavioral problems in the HFA child, because stress and anxiety have built-up to the point of “meltdown.”
In middle school, where the tolerance for differences is minimal and the pressures for conformity are maximal, kids with HFA may be teased, bullied, ignored, and misunderstood. Wanting to “fit in,” but unable to, these “special needs” kids may withdraw even more, and their behavior may become increasingly problematic (e.g., school refusal, aggression, non-cooperation, etc.). Also, some degree of anxiety and depression are common complicating factors during this time.
If there are no significant learning disabilities, academic performance can continue strong, particularly in those areas of special interest. However, learning and attentional/organizational difficulties may be present (e.g., there may be ongoing subtle tendencies to misinterpret information, particularly abstract or figurative/idiomatic language).
Fortunately, by high school, peer-tolerance for individual variations and odd behavior often increases to some extent. Also, if the HFA youngster does well academically, it can bring a measure of respect from his peers.
Some HFA kids will fit-in socially as "geeks," a group which they actually resemble in many ways and which may overlap with HFA. The HFA teenager often forms friendships with peers who share his interests through avenues like Star Trek clubs, science fairs, math clubs, and computer clubs.
With a little luck and proper management, many of these “special needs” teens will have developed considerable coping and social skills, as well as a general ability to "fit-in" more comfortably by this age.
Ideas for Behavior-Management in the Classroom—
1. Avoid escalating power struggles. HFA kids often don’t understand rigid displays of authority – and will themselves become more rigid and stubborn if forcefully confronted. Their behavior can then get rapidly out of control, and at that point, it is often better for the educator to back-off and let things cool down. When possible, anticipate such situations and take preventative measures to avoid the confrontation through presentation of choices, negotiation, and diversion of attention elsewhere.
2. Care should be taken to protect the HFA youngster from teasing and bullying – both in and out of the classroom.
3. Classroom routines should be kept as consistent, structured and predictable as possible. Kids with HFA usually don't like surprises. They should be prepared in advance for changes and transitions (e.g., schedule breaks, vacation days, etc.).
4. Direct speech services may not be needed, but the speech and language clinician at school can be useful as a consultant to the other staff regarding ways to address problems in areas such as pragmatic language.
5. Educators can take advantage of the strong academic skills that many HFA kids have in order to help them gain acceptance with their classmates.
6. Educators should take full advantage of the HFA youngster's areas of special interest when teaching. The youngster will learn best when an area of high personal interest is on the agenda. Educators can also use access to the special interests as a reward to the youngster for successful completion of other tasks, adherence to rules, and meeting behavioral expectations.
7. Efforts should be made to help classmates arrive at a better understanding of the HFA youngster in a way that will promote tolerance and acceptance.
8. HFA kids can be fairly rigid about following "rules" quite literally. While clearly expressed rules and guidelines (preferably written down) are helpful, they should be applied with some flexibility. The rules don’t automatically have to be exactly the same for the HFA youngster as for the other kids, because their needs and abilities are different.
9. HFA kids with very high-management needs may benefit from assistance from a classroom aide assigned to them.
10. If learning problems are present, resource room or tutoring can be helpful to provide individualized explanation and review.
11. If motor clumsiness is significant, the school Occupational Therapist can provide helpful input.
12. It is often helpful for the educator and parent to work closely together, because the parent is most familiar with what has worked in the past for the HFA youngster.
13. It is very helpful if the HFA youngster can be given opportunities to help other kids at times.
14. Keep teaching fairly concrete. Avoid language that may be misunderstood by the HFA youngster (e.g., sarcasm, confusing figurative speech, idioms, etc.) Try to simplify more abstract language and concepts.
15. Know that the HFA student usually shows a surprising sensitivity to the personality of the educator. He can be taught, but only by those who give him true understanding and affection. The educator’s underlying emotional attitude influences (involuntarily and unconsciously) the mood and behavior of this “special needs” youngster.
16. Most kids with HFA respond well to the use of visuals (e.g., schedules, charts, lists, pictures, etc.).
17. Put as many details as possible into an Individual Educational Plan so that progress can be monitored and carried over from year to year. It can sometimes be helpful to enlist the aid of outside consultants familiar with the management of young people on the autism spectrum (e.g., psychologists, psychiatrists, etc.).
18. Realize that the HFA youngster has an inherent developmental disorder which causes her to behave and respond in a different way compared to other students. Oftentimes, behaviors in the HFA student are interpreted as "manipulative" or some other term that misses the point that she responds differently to environmental stimuli. Thus, school staff must carefully individualize their approach for this “special needs” child. It will likely be counterproductive to treat her just the same as her peers.
19. The school counselor or social worker can provide direct social skills training, as well as general emotional support.
20. The use of a "buddy system" can be very useful since HFA kids relate best 1-1. Careful selection of a peer-buddy for the HFA youngster can be a tool to help build social skills, encourage friendships, and reduce stigmatization.
21. There will be specific situations where medication can occasionally be useful. Educators should be alert to the potential for mood problems (e.g., anxiety or depression), significant compulsive symptoms or ritualistic behaviors, and problems with inattention. Occasionally, medication may be needed to address more severe behavior problems that have not responded to non-medical, behavioral interventions.
22. Try to insure that school staff outside of the classroom (e.g., physical education teacher, bus driver, school nurse, cafeteria monitor, librarian, etc.) are (a) familiar with the HFA youngster's style and needs and (b) have been given adequate training in management approaches. Those less structured settings where the routines and expectations are less clear tend to be difficult for the HFA youngster.
23. Try to promote appropriate social interactions and help the youngster “fit-in” better. Formal, didactic social-skills training can take place both in the classroom and in more individualized settings. Approaches that have been most successful utilize direct modeling and role playing at a concrete level. By rehearsing and practicing how to handle various social situations, the HFA youngster can learn to generalize the skills to naturalistic settings.
It is inevitable that you will have the opportunity of working with children on the autism spectrum in your classroom. You may need to make accommodations for some and modifications for others. Providing for the needs of these young people will certainly be one of your greatest challenges as a teacher. Consider the tips and strategies listed above to make behavior-management and the learning process run as smoothly as possible.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
“Is it common for children on the high functioning end of autism to hate touch and avoid being hugged, held, etc.? My grandson will rarely show affection.”
Although it can happen, it is rare for kids with Level 1 Autism (High-Functioning Autism) to "refuse" to be touched at all times - in all situations. However, it is fairly common for these kids to have tactile sensory issues, which may make them avoid certain types of physical contact with others on occasion.
BUT... this really has nothing at all to do with the inability - or lack of desire - to show or receive affection. Autistic kids are the most loving and affectionate people I know! So please don't make the mistake of taking your grandson’s lack of interest in physical contact as a personal insult.
One of the most pervasive myths that surround Level 1 Autism is that a youngster who has it will never show affection and can’t accept getting affection from anyone. There have been hundreds of stories of parents taking their youngster to a psychologist and the doctor telling the parents something like, "Your youngster can’t possibly have an Autism Spectrum Disorder because he gives you a hug now and then."
While this assessment is incorrect, studies have shown that Level 1 Autistic kids do process sensory touch differently than a "typical" youngster, and that this is where the myth that kids on the spectrum don’t like to be touched comes from.
Level 1 Autism and the way it affects kids really runs the gamut from light to severe. An excellent point to remember when dealing with an autistic child is that everyone is different and will react to almost everything differently.
Here are some tips for showing your grandson affection:
1. For a few Autistic kids, a simple, random hug can be sensory overload. They can become agitated, upset and even violent if they are touched without prior warning. You will probably need to have a trial and error approach when it comes to hugging and touching your grandson. Some methods may be responded to in a positive way, other ways won’t be. You just have to try and see.
2. If you think your grandson needs a hug, instead of rushing into his personal space and just taking one, speak to him, bend down to his level and open your arms. Smile and let him know that he is loved and see what the response is. If he doesn't come running in for a hug, don’t be offended. It may just not have been the right time.
3. If your grandson is too sensitive to hugs or touches to show affection, you can try positive reinforcement in addition to hand singles. Things like a simple thumbs up accompanied by a smile and some positive comments can let him know he is loved and what he did was good. You can also offer him a chance to hug during these situations - and he might just take you up on it.
4. Make sure everyone is on the same page. If you are starting to make progress on getting your grandson to be more affectionate, you don’t need his sibling, another family member, or a teacher who doesn’t know or understand his boundaries messing up all of your hard work. If you’ve begun to implement an affection program with him, make sure everyone who would possibly try to hug or touch him knows the rules.
Consistency and repetition are crucial to kids on the autism spectrum, and this applies to a situation like this as well. Trying to figure out a puzzling condition like high-functioning autism and Asperger’s can be a lifelong challenge. For many parents and grandparents, the affection issue may be the biggest. But with patience and learning to go by the youngster’s cues and not your own, you will be able to connect with your grandson in a deep and meaningful way.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
Early intervention is key to optimal outcomes for kids on the autism spectrum. There's little doubt that young people with Asperger’s (AS) and High-Functioning Autism (HFA) who undergo therapy at an early age, be it behavioral or developmental, do better than kids who don't. And there's certainly no good reason for parents to wait to provide such therapy.
Even a little progress is far better than none, especially when that progress comes in the form of new social skills that allow the special needs youngster to “fit-in” with his or her peer-group. While early intervention is extremely important, intervention at any age can be helpful.
Even if your youngster has not been diagnosed with AS or HFA, he may be eligible for early intervention treatment services. The Individuals with Disabilities Education Act states that kids under the age of 3 who are at risk of having developmental delays may be eligible for services. In the U.S., these services are offered through an early intervention system in each State. Through this system, parents can ask for an evaluation. Also, treatment for particular symptoms (e.g., speech therapy for language delays) often does not need to wait for a formal diagnosis.
The first five years of life are crucial to a child’s development and growth. To intervene before age five can help the AS or HFA youngster learn new social and communication skills at a time when she is most able to grasp them. In addition, she can unlearn problematic behaviors before they become deep-rooted. Kids on the autism spectrum who are younger are usually easier to teach because they have less time to develop unwanted behaviors before they become habit. For example:
Speech therapy works best with younger kids. Correcting errors in speech early on can be easier than waiting years later after the youngster has already become used to certain mouth movements and pronunciations.
It is easier to implement new dietary interventions with a younger boy or girl before long-term food preferences are entrenched. A preschool child, while having some food preferences of course, can often be convinced to change her diet with repeated introductions to new foods. This is essential since many therapeutic interventions address possible food allergies (e.g., gluten, casein).
It is much easier to teach a 4-year-old not to tantrum as compared to a 7-year-old.
There are many different types of therapies available (e.g., vitamin therapy, sensory integration therapy, physical therapy, occupational therapy, speech therapy, music therapy, facilitated communication, discrete trial training, auditory training, anti-yeast therapy, etc.). The different types of therapies can generally be broken down into four categories:
Medication
Dietary Interventions
Complementary and Alternative Medicine
Behavior and Communication Interventions
Medication— While there are no medications that can “cure” AS or HFA, or even treat the main symptoms, there are medications that can help most children with related symptoms (e.g., hyperactivity, inability to focus, anxiety, depression, seizures, etc.). (Click here for more information.)
Dietary Interventions— Many biomedical interventions call for changes in the child’s diet (e.g., removing certain types of foods, using vitamin or mineral supplements, etc.). Dietary therapies are based on the idea that the lack of certain supplements and/or food allergies cause (or worsen) symptoms of AS and HFA. (Click here for more information.)
Complementary and Alternative Therapies— To relieve the symptoms of AS and HFA, some moms and dads use therapies that are outside of what is typically recommended by their doctor (e.g., special diets, treatment to remove heavy metals like lead from the body, biologicals, deep pressure, etc.). (Click here for more information.)
Behavior and Communication Interventions— Behavior and communication methods that help kids with AS and HFA are those that provide structure, direction, and organization for the youngster in addition to family participation. A notable treatment method for these special needs children is called Applied Behavior Analysis (ABA). ABA has become widely accepted among mental health professionals and is used in many schools and treatment facilities. ABA discourages negative behaviors and encourages positive behaviors in order to improve a variety of skills. There are different types of ABA (click here for more information), for example:
Verbal Behavior Intervention (VBI) is a type of ABA that focuses on teaching verbal skills.
Pivotal Response Training (PRT) aims to increase the AS or HFA youngster’s motivation to learn, monitor her own behavior, and initiate communication with others.
Early Intensive Behavioral Intervention (EIBI) is a type of ABA for younger kids on the autism spectrum (below the age of 5).
Discrete Trial Training (DTT) is a type of therapy that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts, and positive reinforcement is used to reward correct answers and behaviors while incorrect answers are ignored.
Additional Therapies— Other therapies that can be part of a complete treatment program for a youngster with AS or HFA include the following:
The Picture Exchange Communication System (PECS) uses picture symbols to teach communication skills. The child is taught to use picture symbols to ask and answer questions and have a conversation.
TEACCH uses visual cues to teach certain skills (e.g., picture cards can help teach a youngster how to get dressed by breaking information down into small steps).
Speech therapy helps to improve the child’s communication skills.
Sensory integration therapy helps the child deal with sensory information. The therapy aids the AS or HFA youngster who is troubled by certain tastes, smells, sounds, or does not like to be touched.
Occupational therapy teaches skills that help the AS or HFA adult live as independently as possible.
FLOORTIME focuses on emotional and relational development (e.g., feelings, relationships with parents/teachers/peers). It also focuses on how the youngster deals with sensory overload.
What about moms and dads whose kids on the spectrum weren’t identified soon enough for early intervention?
Many kids with AS and HFA are indeed “high-functioning” enough that they are not identified until they enter elementary school. It is only as they get older and their classmates surpass them socially and behaviorally that problems become noticeable. Not every youngster shows signs of autism before the age of 6, or the signs are so few and far between that they are missed. The higher-functioning youngster can compensate for his deficits, and peers may just pass him off as being odd or “quirky.” The entire pattern of behavior has to be evaluated, and unless the youngster is having issues that significantly disrupt his daily functioning at home or school, no “red flags” pop up.
Parents should not blame themselves in this case. Simply begin the process of seeking help when you discover the need for it. Later intervention is certainly better than no intervention. Rather than dwelling on what wasn’t done or what you “should have noticed,” focus on what can be done now. With the right intervention, older kids with AS and HFA (since they are high-functioning) can catch up rather quickly in most cases.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
Although the social criteria for High-Functioning Autism (HFA) and classic autism are somewhat similar, the former disorder involves fewer symptoms and has a different presentation than does the latter.
