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Insomnia in Kids with High-Functioning Autism and Asperger's

“What do you suggest for my 4-year-old boy who has a hard time getting to sleep at bedtime, but can’t take melatonin? He has an allergic reaction to that supplement (gives him headaches). And why does it seem that so many high functioning autistic children have trouble going to sleep – even when they are exhausted?”

Researchers don't know for sure why HFA kids have problems with sleep, but they have several theories. Here are the main ones:
  1. Anxiety: Stress or anxiety is a possible condition that could adversely affect sleep. HFA kids tend to test higher than other kids for anxiety.
  2. Low levels of nighttime melatonin: Melatonin normally helps regulate sleep-wake cycles. To make melatonin, the body needs an amino acid called tryptophan, which research has found to be either higher or lower than normal in kids on the spectrum. Typically, melatonin levels rise in response to darkness and dip during the daylight hours. Studies have shown that some kids with HFA don't release melatonin at the correct times of day. Instead, they have high levels of melatonin during the daytime and lower levels at night.
  3. Sensory sensitivities: HFA and Aspergers kids may have trouble falling asleep or awaken in the middle of the night due to an increased sensitivity to outside stimuli (e.g., touch or sound). While most kids continue to sleep soundly while their mother opens the bedroom door or tucks in the covers, the youngster might wake up abruptly.
  4. Ignoring social cues: Most “typical” kids know when it's time to go to sleep at night thanks to the normal cycles of light and dark and their body's circadian rhythms. But they also use social cues (e.g., kids may see their siblings getting ready for bed). These kids may misinterpret or fail to understand these cues.



Sleep problems are some of the most common problems moms and dads face with their children. Most Aspies have sleep difficulties, and many are actually going through their days sleep-deprived. 
 

Here’s how you can help your child with Aspergers (High-Functioning Autism) get to sleep in a reasonable amount of time – even if he can’t take melatonin:

1. An hour before bedtime, avoid all physically stimulating activities (e.g., running, jumping, climbing, etc.).

2. An overnight sleep study may be recommended for your son, especially if he has excessive daytime sleepiness or problems staying asleep. The sleep study will help determine if he has a diagnosable problem (e.g., pure snoring, obstructive sleep apnea, restless legs syndrome, etc.). These disorders may require specific therapy that your son’s doctor will prescribe.

3. Avoid feeding your son big meals close to bedtime, and don't give him anything containing caffeine less than six hours before bedtime.

4. Avoid scary stories or TV shows prior to bedtime.

5. Establish a consistent and relaxing bedtime routine that lasts between 20 and 30 minutes and ends in your son's bedroom. Maintaining a predictable and soothing bedtime routine is critical with Aspergers children. Bathing, brushing teeth, singing lullabies, and reading books are some suggestions for a nightly routine.

6. Feed your son bedtime snacks that contain the amino acid “tryptophan.” Tryptophan helps the body to produce the sleep-inducing chemical serotonin. Tryptophan-containing foods include dairy products, whole grains, poultry, rice, eggs and sunflower seeds.
 

7. Give your son tools to overcome his worries. These can include a flashlight, a spray bottle filled with "monster spray," or a large stuffed animal to "protect" him.

8. Have him get used to falling asleep with a transitional object (e.g., a favorite blanket or stuffed animal).

9. If your son calls for you after you've left his room, wait a few moments before responding. This will remind him that he should be asleep, and it'll give him the chance to soothe himself and even fall back asleep while he is waiting for you.

10. If your son comes out of his room after you've put him to bed, walk him back and gently - but firmly - remind him that it's bedtime.

11. It's better to read a favorite book every night than a new one because it's familiar.

12. Keep the bedroom as quiet as possible for your son. If outside noise is unavoidable, use a sound machine or stereo to block noise.

13. Make sure your son has interesting and varied activities during the day, including physical activity and fresh air.

14. Make sure your son is comfortable. Clothes and blankets should not restrict movement or be too itchy, and the bedroom temperature shouldn't be too warm or too cold.
 

15. Put some thought into finding your son’s ideal bedtime.  In the evening, look for the time when he really is starting to slow down and getting physically tired. That's the time that he should be going to sleep, so get his bedtime routine done and get him into bed before that time. If you wait beyond that time, then your son may get a second wind.  At that point, he will become more difficult to handle and will have a harder time falling asleep.

16. Remove the television from your son's bedroom. Television stimulates the brain, making sleep difficult to achieve.

17. Set up a reward system. Each night your son goes to bed on time and stays there all night, he gets a star. After three stars, give him a prize.

18. Talk to a sleep psychologist about bright-light therapy. Exposing your son to periods of bright light in the morning may help regulate the body's release of melatonin.

19. To prevent sensory distractions during the night, put heavy curtains on your son’s windows to block out the light, install thick carpeting, and make sure the door doesn't creak.

20. Warn your son that bedtime is in five minutes or give him a choice, for example, "Do you want to go to bed now or in five minutes?" …but do this only once.

How To Help Other Family Members Accept Your Child's Diagnosis

"I'm a stay-at-home mom. My husband works out of town and is only home on weekends. My question is how can I get my husband and in-laws to accept our daughter’s diagnosis (high functioning autism)? They claim I am just 'making this up' and that it's really a behavior problem with her – not a 'disorder'."

This is not surprising, and you're not alone. High-Functioning Autism (HFA) and Asperger's (AS) is hard to see if you don’t live with it every day like you do. Also, some family members are simply in denial. Either way, the truth should come out.

Accepting the presence of this high functioning form of autism can lead to the best possible support and treatment available for your daughter. It’s crucial that all family members are on the same page. You could survive handling everything on your own, but life will be much easier for the whole family when everyone is working together to care for your daughter.

Some family members will choose to stand on the outside. You can’t do much about that. Nonetheless, you can equip them with information about autism spectrum disorders so they can make a choice regarding the position they plan to take.

Here are some tips on how to accomplish this:
1. Contact your local Autism support groups. Without family support, it is crucial that you find encouragement elsewhere. Tell your husband about community events or group meetings so he has the opportunity to stay informed.

2. Find books, eBooks, videos, and other media sources that you can share with your family. A great place to start is with one of the resources listed below this post.

3. If you haven’t done so already, involve your daughter in therapy with a professional who works with children on the autism spectrum. Hopefully, your daughter’s therapist will offer parent-training sessions. These sessions allow you to ask questions about your daughter’s program and her progress, while also educating you on her new goals and coaching you on how to meet these goals. Invite your husband and in-laws to attend this parent training. They can ask questions that will help them understand your daughter’s disorder.

4. Network with other parents raising children on the spectrum. Listening to the stories of those parents who are ahead of you in the journey can give you and your husband insight into the disorder. Here are our two Facebook support groups:

5. Maybe your in-laws simply need to hear the truth from a doctor. Official paperwork containing your daughter’s diagnosis is available from your doctor, neurologist, or therapist. You can request copies of any Early Intervention assessments, private therapy evaluations, and school system evaluations. Explain to your in-laws that these individuals are professionals who see autism spectrum disorders every day. You can also mention that the assessments and evaluations rely on much more than your input, removing any possibility that you are “making this up.”

6.Lastly, get the support you need to help yourself and your daughter. Try not to worry about how the other family members are dealing with this. Always encourage their participation, but concentrate on your daughter’s needs.

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

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.


PARENTS' COMMENTS:

Anonymous said…  I think the acknowledgment is there, the trouble is, most people do not know the true difficulties and how it effects everyday life Every day is a struggle and every day brings new challenges. People who are not with your child day in and day out may think it is not a big deal and is easy... it is NOT. Also, that Aspies cannot be disciplined and treated the same as average children to get results.

Anonymous said…  From my personal experience, my son's Aspergers was not as apparent in the home setting in isolation from his peers. Once I saw him at school and noticed the stark difference between him and the other kids and how he did or did not interact with them it was much more obvious. Family members don't always get to see that, so it can be harder to make believers out of them.

Anonymous said…  My sister, who also has a degree in education, babysat my son along with his same aged cousin when they were both 2. She also taught a couple days per week at a Mother's Day Out day care setting. She noticed that my son was very different and often kept him with her because some of the other teachers were less able to handle him. Though my son is good at heart, his bad social judgment often resulted in issues at school each year. It was very frustrating! So when an insightful teacher recommended testing for him in 4th grade, resulting in the diagnosis, we finally had an explanation that made perfect sense to all of us! And I felt better about the future because his teachers could now better understand him instead of writing him off at just "passive aggressive" or simply "difficult." I think if people realize that a diagnosis can yield better understanding and teacher training gives teachers tools for better working with kids, then family can feel better about the child's prognosis and outcome.

* Anonymous said...  Love these articles. A lot of us deal with things similar. This is definitely something that happens with this diagnosis. Even I as the parent of a kiddo that has these tendencies, sometimes would question whether it was just a "behavior problem" or not...whether it was my parenting style or not. If you aren't with the child 24/7, you don't see the whole picture at all. Being education is so important. When one is educated on this particular diagnosis...so much falls into place. 

* Anonymous said... i am now a single-mom to one ASD son & one non_ASD daughter. I lived out of state for 3 years. I couldnt wait to get back hom with my kiddos (& then husband). But noone welcomed us....not even my own mother (this was before the autism diagnosis). Even after, no one wanted to learn about it...we were just too much inconvience for their lives. I also kicked my husband out for various reasons....but "failure to understand autism" was a big one. It's a lonely life. Me & my 2 kids usually stay home & do the same routine everyday. I try to avoid public...because no one understands, & i dont want my children hurt :o( i'm from a state who fears "different people"...i've always been alternative myself. But, God, if you can at least help your husband "get free" & love you all like you are..that would be awesome for you guys. Who cares what in-laws (or even your own folks think!) let them learn! Or stay away. The world needs to be more open-minded not in "words at church" or "words on social media"
 
•    Anonymous said… I had this a lot with some friends & family and what I did was sent them a link to the National Autistic Societies website and asked them out of Respect to please read it, take it in and that the very fact they are choosing not to Learn more and accept our child for the way he/she is - hurts us more than our child's Diagnosis! Some really made the effort to read more and some didn't bother! This is very common and I have to be honest and say I chose to close the door on those that would not accept my son for who he is! You are not alone! Keep your head up and just always put your child before others
 
•    Anonymous said… Thankfully most people in my life are accepting and understanding, but I have this problem with my sons father... He refuses it completely, and during the long process of getting a diagnosis of Aspergers, he tried to make me stop taking our son to the appointments completely. I would like to say things are getting easier, but since my sons diagnosis, his father and I have actually split up, after 22 years together, and sadly this was one of our major issues that caused it. It's exhausting.. It's all on my shoulders.. I work day after day with my son..And then he goes and spends a weekend with his Dad and comes back to me in turmoil because his Dad refuses to learn how to properly deal with a child with Aspergers. I've tried everything to get him to face reality unsure emoticon I think there are some people who will just never get it..
 
•    Anonymous said… Unfortunately a lot of the symptoms are typical of "normal" kids but when you add them all together they spell Aspergers. I think this website has a concise list that might help those who don't want to read much. My son pretty much had all the symptoms but most of them were fairly mild. Had we not had him in a daycare setting where his caretakers would notice his interactions, we may have just written him off as quirky. Early intervention is the key. He is now seven and was diagnosed between 2 and 3 and it's made a HUGE difference. He has "outgrown" most of his issues but still has social problems to a degree. 
 

*   Anonymous said... My parents and siblings clearly think my kid's diagnosis is bogus (they haven't said in so many words, but keep hinting at it). It used to annoy me, but I actually don't care; they love and appreciate him as he is, quirks and all; so I don't feel the need to shove a diagnosis down their throats. 

Post your comment below...

High-Functioning Autism and Associated (Comorbid) Disorders

“We’re in the process of having our son assessed for high functioning autism. We’ve had numerous problems in the past that have brought us to this point. The doc said he believes our son may have several ‘comorbid’ conditions as well. What other conditions might there be?”

When a youngster has one or more conditions along with the main disorder, it is defined as comorbid and comorbidity. High-Functioning Autism (HFA) – also called Asperger’s (AS) – is listed as an Autism Spectrum Disorder and rarely travels alone. Nearly 100% of the time, the child will have other issues that will need to be addressed.

Here are some of the common comorbid conditions associated with HFA and AS:

1. Attention Deficit Hyperactivity Disorder (ADHD) is a very common comorbid condition of HFA and AS. Here the youngster is unable to concentrate and becomes impulsive to a great degree.

2. Depression and anxiety are the two most common disorders found in a youngster with AS or HFA. Adolescents on the autism spectrum often suffer from depression, which may be caused by (a) being bullied and teased, and (b) coming to the realization that they are different from their “typical” peers. Some of these young people have been known to turn to drugs and alcohol as a way to deal with their plight.

3. Dyspraxia is when a youngster is not able to coordinate or perform certain acts in spite of having the prior plan for it. This disorder is one reason why kids with HFA and AS have always been described as clumsy.

4. Meltdowns are “tantrum-like” behaviors in HFA and AS children. Yelling, hitting, screaming, or a complete shutdown (e.g., covering the face and becoming withdrawn) are common during a meltdown.

5. Obsessive Compulsive Disorder (OCD) is something that is found in most kids on the autism spectrum. The child adheres to strict routines, and she likes to keep every particular object in one particular way – and when changed, she may get very distressed. This is one habit which later on leads to OCD.

6. Oppositional Defiant Disorder (ODD) is a condition in which a youngster displays an ongoing pattern of uncooperative, defiant, hostile, and annoying behavior toward people in authority. The youngster’s behavior often disrupts his normal daily activities within the family and at school.

7. Sensory Processing Disorder (SPD) is common among those that have AS or HFA. In this case, the youngster becomes overly-sensitive to the various sensory stimulations (e.g., forms an intense dislike of loud noises, is easily irritated when dealing with unusual textures, avoids certain foods because they taste bitter, etc.).

8. Tourette’s syndrome is when a youngster exhibits repetitive vocal or motor tics. Most kids diagnosed with Tourette’s also have AS or HFA.


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

____________________

Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.
 
 
PARENTS' COMMENTS:

•    Anonymous said… A friend of mines son is 14 with aspergers. He wants to interact but has so much trouble. We were all introduced to him as a wonderful child who has an interesting view on life. Our group of friends are great. The 14yr old likes to shake everyones had when they arrive and then walks off. We are glad that despite the fact that he knows how different he is he trys to make an effort. I hope that I am blessed to still have this group of friends when my 7yr old is that old.
•    Anonymous said… Good luck to all - its just who they are, and we just have to adapt and continually educate others so they can too. I just keep up my own mantra: "it's all good" and smile broadly at the fact that while he may be socially challenged, my son is smart and has a heart of gold, despite the fact that he doesn't verbalize it.
•    Anonymous said… He must be high functioning. Aspergers is on the high functioning side of autism anyway - but some are higher than others. So, "uncommon"? I would say yes.
•    Anonymous said… I do think the gap gets bigger as they get older. My son really gets along better with either younger children or adults because of this. He used to quote star wars too, btw, lol! Now he is constantly talking about Final Fantasy 7, and most kids don't even have a clue what that is since it is an old playstation game. Thankfully my hubby is a huge gamer and can carry a conversation with him. lol
•    Anonymous said… I will add my vote to that of the other commenters. My son is the same way - playing 'next to' not with, or fully directing the game choices, character choices, rules and all else whenever he does attempt to play 'with' someone - and forbid they don't want to play along by his rules, then we have arguments and meltdowns because he can't tolerate "that's not how you play". His poor sister - she feels like she can't win; its all about him!
•    Anonymous said… My 7 year old is high function Aspergers. He is overly social but has no boundaries. He hugs and has no personal space. We are often told that there is no way he could have Aspergers but they don't realise that this behavour is only one aspect of Him. When he meltdowns over getting dressed or getting in the car I have no doubt. At the end of the day you are his parent and see Him for who he is and everything he does trust yourself.
•    Anonymous said… My aspie is very social in that he loves being around other kids, but he isn't popular. He highly lacks in social skills despite his "socialness". It's like he wants friends but making friends is hard and he doesn't realize whenever someone is being mean.
•    Anonymous said… My son is almost 8 and the "social rules" have gotten a lot more complicated from when he was 5.
•    Anonymous said… My son is is the same as far as boundaries, when he plays with other kids we have to remind him to back up because he will talk (very loudly) into their face instead of to it. @ Jessica, you're absolutely right, what is accepted at 5 won't be at 8. I know my son also won't understand when someone is being mean to him. You guys gave me lots of food for thought and I really appreciate your input :).
•    Anonymous said… My son loves being with other children but just doesn't seem to know how to play WITH them. He orders them around and expects to play all games his own way. Every year seems to get harder as the social gap between the kids getts wider. In his defense he is starting to learn more and more social ideas though doesn't seem to understand why we do them.
•    Anonymous said… Ryan was diagnosed HFA/Asperger's and he is how you guys describe. He loves people, but has no social "skills" -- he can't tell when people don't want to play with him or talk to him. He tries to hug on perfect strangers in stores and such. He is bossy with HOW games are played (everyone has to follow his rules or they can't play anywhere near him). I don't think that this type of social behavior is uncommon at all for Aspies. Many areas of documentation explain this as fairly typical Asperger's behavior... it's one of the determining factors that separates it from other areas on the spectrum. They generally WANT friends, they just don't know HOW to make them, where other auties are more or less oblivious to everyone else around them. What seems to happen as the children get older and the social gap becomes larger and your Aspie son is still quoting comic books and Star Wars characters when all the other boys are chasing girls, they become less social. They learn that the other kids don't want to do the things they want to do, and then they begin to focus less on the social interaction.
•    Anonymous said… This summer we sent them to "social skills camp" for the summer (so they could both learn), where the whole focus was on learning those skills - they are teaching the "how to" very systematically. Rome wasn't built in a day, but after 6 weeks we've seen improvement. 

*    Anonymous said... My 5 year old Aspie has all the tell tale signs of Asperger's syndome, to the point where it seems like everything I've ever read was written with him in mind. Except for one key difference...my son is extremely social. He is very popular among other kids, they almost fight for his attention. They love the fact that he can recite comic books word for word, and remembers the names of even the most obscure Star Wars characters, and because he is a people pleaser he will share anything he has to maintain the friendship. He worries very much about how other kids see him and trys obsessively to fit in. I know all children with Asperger's syndrome are different, but my question is, is this very uncommon in Asperger's? I feel people "don't believe" he is on the spectrum because of his social skills.
 

Please post your comment below… 

Why Teens on the Autism Spectrum Can Suffer from Depression

“I’m concerned that my son is depressed (17 y.o.). Is this something that happens along with high functioning autism? If so, why? How can I know for sure if he is really struggling with depression? He has made some off-handed comments about wanting to kill himself. How seriously do I need to be taking these comments?”

Depression seems to be common among teens and young adults with High-Functioning Autism (HFA) and Asperger’s (AS). Many of the same deficits that produce anxiety often unite to produce depression.

The relationship between serotonin functioning and depression has been explored in detail in this population. There is good evidence that serotonin functions may be impaired in kids and teens on the autism spectrum, which suggests that depression is a common comorbid condition.

In addition to impaired serotonin functioning, (a) deficits in social relationships and (b) poor coping-strategies that allow the teenager to compensate for disappointment and frustration may fuel a vulnerability to depression. (As a side note, there is some genetic evidence suggesting that depression and social-anxiety are more common among first-degree relatives of autistic kids, even when accounting for the subsequent effects of anxiety.)

Because some features of depression and autism spectrum disorders overlap, it is important to track that the changes in mood are a departure from baseline functioning. Therefore, the presence of social withdrawal in a teen with the disorder should not be considered a symptom of depression unless there is an acute decline from his or her baseline level of functioning.

Another important point is that the core symptoms of depression should arise together. Therefore, the simultaneous appearance of symptoms would point to depression (e.g., decreased energy, further withdrawal from interactions, irritability, loss of pleasure in activities, sadness, self-deprecating statements, sleep and appetite changes).

An additional point is that teens who display “affective” (i.e., relating to moods and feelings) and “vocal monotony” (i.e., a droning, unchanging tone) are at higher risk for having their remarks minimized by peers, which often gives the HFA or AS teen the impression that he “doesn’t matter” – which in turn can fuel depression.

Some teens on the autism spectrum can make suicidal statements in a manner that suggests an off-hand remark, without emotional impact. When comments are made this way, parents may underestimate them. The content of such comments may be more crucial than the emotional emphasis with which they are delivered. Thus, comments around “wanting to die” should be taken very seriously.

Medications that are useful for treatment of depression in kids and teens on the spectrum are serotonin reuptake inhibitors, although no medications have been shown to be particularly more beneficial for depressive symptoms in people with the disorder. Therefore, the decision as to which medications to use is determined by side-effect profiles, previous experience, and responses to these medications in other family members.

==> Discipline for Defiant Aspergers & High-Functioning Autistic Teens

Personality Types in ASD Level 1: Fixated, Disruptive, Approach and Avoidant

Fixated Personality--

The fixated personality type can be characterized by a preoccupation with orderliness, perfectionism, and the need to control one’s environment (e.g., to have things in a particular order).

Some of the symptoms of the fixated personality type may include:
  • compulsion to make lists and/or schedules
  • feelings of excessive doubt and caution
  • obsessive need for cleanliness
  • perfectionism (that may sometimes interfere with task-completion)
  • preoccupation with order and organization
  • preoccupation with remembering and paying attention to minute details and facts
  • rigid following of rules and regulations
  • rigidity or inflexibility of beliefs
  • stubbornness
  • unreasonable insistence that others submit to his way of doing things

Some of the specific behavioral manifestations of the fixated personality type among ASD children and teenagers may include:
  • repeatedly checking homework
  • cleaning rituals
  • counting rituals
  • grooming rituals (e.g., hand washing, showering, teeth brushing)
  • hoarding and collecting things
  • ordering or arranging objects
  • repeating rituals (e.g., going in and out of doorways, needing to move through spaces in a special way, rereading, erasing, rewriting)
  • rituals to prevent harming self or others
  • rituals to undo contact with a "contaminated" person or object
  • touching rituals

Parents can look for the following possible signs of the fixated personality type:
  • continual expressions of fear that something terrible will happen
  • dramatic increase in laundry
  • persistent expressions of fear of illness
  • sudden drop in test grades
  • exceptionally long amount of time spent getting ready for bed
  • high, unexplained utility bills
  • holes erased through test papers and homework
  • raw, chapped hands from constant washing
  • reluctance to leave the house
  • requests for family members to repeat strange phrases or keep answering the same question
  • unproductive hours spent doing homework
  • unusually high rate of soap or paper towel usage

Environmental and stress factors can trigger fixated personality traits. These can include ordinary developmental transitions (e.g., starting school) as well as significant losses or changes (e.g., death of a loved one, moving to a different home or city).
 

It can be helpful to keep family routines as normal as possible, and for all family members to learn strategies to help the ASD youngster. It is also important to not let the “fixations” be the boss of the house and regular family activities. Giving in to fixations does not make them go away.

“Fixated” Aspies become less fixated at different rates, so try to avoid any day-to-day comparisons and recognize and praise any small improvements. Keep in mind that it's the disorder that is causing the problem, not the child. The more that personal criticism can be avoided, the better.

Treatment for the fixated personality type can involve the following:
  1. Behavior therapy: Discussing with a psychotherapist ways of changing compulsions into healthier, productive behaviors. An effective form of this therapy has been found to be cognitive analytic therapy.
  2. Cognitive behavioral therapy: A systematic approach to changing unwanted thoughts, feelings and behaviors.
  3. Psychopharmacology: A psychiatrist may be able to prescribe medication to facilitate self-management and also enable more productive participation in other therapies.
  4. Psychotherapy: Discussion with a trained counselor or psychotherapist who understands the condition.


 Disruptive Personality--

The disruptive personality is:
  1. a type of cognitive-behavioral style in which the "Aspie's" way of thinking, perceiving situations, and relating to others is sometimes destructive
  2. often comorbid with ADHD and/or ODD
Autistic children and teens with disruptive personality typically have little regard for right and wrong. They may often violate the rights of others, landing in frequent trouble or conflict. They may lie, behave violently, and have drug and alcohol problems. Also, Aspies with disruptive personality may not be able to fulfill responsibilities to family, school, or work.

Disruptive personality traits may include:
  • Aggressive or violent behavior
  • Agitation
  • Impulsive behavior
  • Intimidation of others
  • Irresponsible school-related or work-related behavior
  • Lack of remorse about harming others
  • Persistent lying or deceit
  • Poor or abusive relationships
  • Recurring difficulties with the parents and teachers
  • Repeatedly violating the rights of others
  • Using charm or wit to manipulate others

There may be a link between an early lack of “empathy” (i.e., understanding the perspectives and problems of others) and later onset of a disruptive personality style. These personality problems may be inherited, and identifying them early may help improve long-term outcomes.

Complications and problems associated with the disruptive personality include:
  • Aggression or violence
  • Alcohol or substance abuse
  • Anxiety
  • Depression
  • Reckless behavior
  • Relationship difficulties
  • School and work problems
  • Social isolation
  • Strained relationships
  • Suicidal behavior

Psychotherapy is the main way to treat a child or teen with a disruptive personality style. Types of psychotherapy may include:
  • Psycho-education: This education-based therapy teaches coping strategies and problem-solving skills.
  • Psychodynamic psychotherapy: This approach aims to raise awareness of unconscious thoughts and behaviors and — by bringing them to light — change their negative impact.
  • Cognitive behavioral therapy: This type of therapy helps to uncover unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

Psychotherapy may be provided in individual sessions, in group therapy, or in sessions that include family or even friends. The right type of psychotherapy depends on each person's individual situation. 
 

If you have a child or teen with a disruptive personality style, it's critical that you also get help for yourself. Mental health professionals can help teach you skills to protect yourself from the aggression, violence and anger common to this personality type. They can also recommend strategies for coping.

Parents can help their child with disruptive personality traits in the following ways:
  1. Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
  2. Take a time‑out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time‑out to prevent overreacting.
  3. Pick your battles. Since this particular child has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time‑out in his room for misbehavior, don't add time for arguing. Say "your time will start when you go to your room."
  4. Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
  5. Maintain interests other than your "disruptive" Aspie so that managing your child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) in dealing with your child.
  6. Manage your own stress with exercise and relaxation. Use respite care as needed. 
  7. Come up with a specific parenting-plan to address the behavioral problems associated with a disruptive personality.


Approach Personality--

This type usual occurs in the ASD child who also has ADHD, although this is not always the case.

The two primary characteristics of the “approach personality” are (a) excessive talking about one’s special (or obsessive) interest, and (b) significant violations of other’s personal space.

Excessive Talking About Special Interests—

Excessive talking in the Aspie can present a number of problems. No one particularly likes to be referred to as a "motor-mouth," but they can be exactly that. While some people have much to say of value, excessive talkers usually do not. They talk either because they can't help it due to “mind-blindness” (i.e., they are unaware that the listener is both bored and annoyed with the one-sided conversation), or because they simply love to tell others about their favorite hobby/activity out of a huge sense of passion about that particular hobby/activity.

Aspies who talk excessively can sometimes get along well with one another, probably because neither is paying much attention to what the other is saying. For those with normal speaking habits however, excessive talking often borders on being socially unacceptable. We are brought up to be attentive to what others are saying, to speak mainly when spoken to, while at the same time hoping that when we do talk, we sound intelligent and say the right things in as few words as possible.
 

Excessive talking in the Aspie often translates into an inability to understand or follow instructions. The very act of learning can be seriously impeded, and the chattering Aspie may be unable to concentrate on those things where concentration is vital to success.

Those Aspies who persist in excessive talking about their obsessive interest are more apt to be victims of another type of disorder, the Obsessive-Compulsive Personality Disorder (OCPD). Not all of those with OCPD are excessive talkers – it is just one of the symptoms. You can usually spot those with OCPD, because they tend to be preoccupied with perfectionism and orderliness, pay excessive attention to detail, and are most comfortable in an environment where there are rules to follow, schedules to meet, and an organizational structure in which they know their place.

The drive for perfectionism often results in such individuals being unable to complete certain assigned tasks, or being unable to follow rules which don't conform to their own strict standards. Some OCPD Aspies are extremely introverted (living in their own carefully regulated and orderly world) while others can be quite extroverted (these are the attention seekers, the ones who violate your personal space, and who often over-dramatize any and every situation). It is from among this group that excessive talking is apt to be one of the more noticeable symptoms.

Tips for the excessive (obsessive) talker:

1. Appreciate what others have to say. Listening to other person’s viewpoint allows you to permit him or her to express an opinion.

2. Be a good listener. People like to be listened to.

3. Be more conscious of your behavior patterns. Acknowledge that you speak too much and behave accordingly.

4. Do not talk for the sake of talking. Restraint is good.

5. One can take up courses in being a good conversationalist.

6. Seek professional help if excessive talking is a compulsive behavior. Often people speak due to some psychological disorder or problem. A person with a nervous disposition will speak more.

7. One need not express everything on one’s mind. Certain things you must keep to yourself.

8. One should always have something important to contribute. Whatever you say should have an impact on others. They should want to listen to you. Conversation should be interesting.

9. One should avoid being pushy or aggressive while conversing. Try to convey things in fewer words. Be brief in what you say.

10. Think before you speak. It may be difficult if you are nervous. But it is better to be aware of what you are saying. You need not regret later.

11. Try not interrupting another person’s conversation as far as possible.

12. Try to allow the other person to say something. It may be difficult, but one needs to practice self-control. A good conversation is a two-way process. All of those taking part in the conversation have much to contribute. Each person must get a chance to say something.

Violating Personal Space—

Interpersonal space refers to the psychological "bubble" that exists psychologically when one person stands too close to another. There are four different zones of interpersonal space:

1. Intimate distance: ranges from touching to about 18 inches (46 cm) apart, reserve for lovers, children, close family members and friends, and pets.

2. Personal distance: begins about an arm's length away starting around 18 inches (46 cm) from the person and ending about 4 feet (122 cm) away. This space is used in conversations with friends, to chat with associates, and in group discussions.

3. Social distance: ranges from 4 to 8 feet (1.2 m - 2.4 m) away from the person and is reserved for strangers, newly formed groups, and new acquaintances.

4. Public distance: includes anything more than 8 feet (2.4 m) away, and is used for speeches, lectures, and theater. Public distance is essentially that range reserved for larger audiences.

Aspies with approach personality traits tend to be mostly in the “intimate distant” mode (i.e., they will stand within arm’s reach – even with strangers). It goes without saying that most people are taken aback by such behavior.

The absence of strong emotional responses to personal space violation is, again, the result of the Aspie’s “mind-blindness” (i.e., an inability to develop an awareness of what is in the mind of the other person). If you, as a neurotypical, did an experiment in which you purposely stood excessively close to a stranger to read his/her reaction, you would readily notice a pained expression on the other person’s face, sending you a very clear non-verbal message that he/she is alarmed. The mind-blind Aspie with approach personality traits does not receive this non-verbal cue – even though the cue was indeed sent.

Tips for the personal space violator:

1. Understand that (a) people have certain expectations about verbal and nonverbal communication behavior from other people, and (b) violations of these expectations cause arousal and distraction in them.

2. Only stand or sit within arm’s reach of close family members and romantic partners.

3. With your friends, stand or sit no closer than arm’s length.

4. With all others, stay at least 4 feet away.

5. Pay attention to the facial expressions of those you stand or sit close to. Are they grimacing, for example? If so, then you may be too close.

6. Pay attention to whether or not the other person moves away, creating addition distance between the two of you. Does he/she seem to be taking steps backwards during the conversation? If so, you may be too close.

7. If you are uncertain, ask the other person “Am I violating your personal space?” Most people will respect that question and answer honestly.

Some of the behaviors exhibited in the “approach personality” have a good side to them when these behaviors can be correctly channeled. There are many activities in which paying greater than normal attention to detail can be a definite plus, and those with a short attention span often find a place in activities demanding creativity and thinking outside the box. As far as excessive talking is concerned, it is best that it be treated with counseling (usually in the form of “social skills training”), although there are occasional openings for stand up comics and radio talk show hosts. As far as personal space violations are concerned, it is best to reserve close proximity for those who enjoy being close to you (e.g., your mother, girlfriend, cat, etc.).
 

Avoidant personality is characterized by a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. This type of autistic child is often described as being extremely shy, inhibited in new situations, and fearful of disapproval and social rejection. Avoidant personality becomes a major component of an Aspie’s overall character and a central theme in how he relates to others.

Aspies with avoidant personality tend to do some of the following:
  • Views self as socially inept, personally unappealing, or inferior to others
  • Stays quiet or hides in the background in order to escape notice
  • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
  • Is unwilling to get involved with people unless certain of being liked
  • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
  • Is preoccupied with being criticized or rejected in social situations
  • Is inhibited in new interpersonal situations because of feelings of inadequacy
  • Drinks before social situations in order to soothe nerves
  • Avoids social situations to a degree that limits activities or disrupts life
  • Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection

The following situations are often stressful for Aspies with avoidant personality:

• Attending parties or other social gatherings
• Being called on in class
• Being teased or criticized
• Being the center of attention
• Being watched while doing something
• Eating or drinking in public
• Going on a date
• Making phone calls
• Making small talk
• Meeting new people
• Performing on stage
• Public speaking
• Speaking up in a meeting
• Taking exams
• Talking with “important” people or authority figures
• Using public bathrooms

Emotional symptoms of avoidant personality include:
  • Excessive self-consciousness and anxiety in everyday social situations
  • Extreme fear of being watched or judged by others, especially people you don’t know
  • Fear that others will notice that you’re nervous
  • Fear that you’ll act in ways that that will embarrass or humiliate yourself
  • Intense worry for days, weeks, or even months before an upcoming social situation

Physical symptoms of avoidant personality include:

• Feeling dizzy or faint
• Racing heart or tightness in chest
• Red face, or blushing
• Shortness of breath
• Sweating or hot flashes
• Trembling or shaking (including shaky voice)
• Upset stomach, nausea (i.e. butterflies)

For kids and teens with avoidant personality, evaluating for the presence of psychiatric disorders, particularly major depression, substance abuse, and other anxiety disorders, is extremely important. Because “social anxiety tendencies” are often found in other family members, a family psychiatric history is beneficial. 
 

Help for Children with Avoidant Personality—

1. Avoid or limit caffeine. Coffee, tea, caffeinated soda, energy drinks, and chocolate act as stimulants that increase anxiety symptoms.

2. Challenge negative, unhelpful thoughts that trigger and fuel social anxiety, replacing them with more balanced views.

3. Drink only in moderation. You may be tempted to drink before a party or other social situation in order to calm your nerves, but alcohol actually increases your anxiety in the long run.

4. Face the social situations you fear in a gradual, systematic way, rather than avoiding them.

5. Get adequate sleep. When you’re sleep deprived, you’re more vulnerable to anxiety. Being well rested will help you stay calm in social situations.

6. Learn how to control the physical symptoms of social anxiety through relaxation techniques and breathing exercises.

7. Quit smoking. Nicotine is a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety.

8. Take a social skills class or an assertiveness training class. These classes are often offered at local adult education centers or community colleges.

9. Volunteer doing something you enjoy, such as walking dogs in a shelter, or stuffing envelopes for a campaign — anything that will give you an activity to focus on while you are also engaging with a small number of like-minded people.

10. Work on your communication skills. Good relationships depend on clear, emotionally-intelligent communication. If you find that you have trouble connecting to others, learning the basic skills of emotional intelligence can help.


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

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