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The Best Treatment for Teenagers on the Autism Spectrum

“My husband is ashamed and embarrassed that our oldest son has autism (high functioning) and is not what he calls normal. If my husband knew that I was typing this, he would become very irate and the yelling would start between the two of us as he does not like it when I try and seek help. James is 15 and in the years gone by He has called him a retard to his face, he even used to hit him across the back of the head. James does not seem to get along with our 13-year-old and often hurts himself as well as our other son. Because of this, I try not to leave the two of them home alone. The other evening, I went to visit my parents for two hours leaving them with their dad. Apparently, the boys started into each other and instead of separating them and talking with them, he told the oldest with the problem. ‘I wish you would just beat the shit out of him and teach him a lesson’. When I found out about this, I became very irate and tried to explain to Michael [husband] that he just gave James permission to beat up his brother. He does not really understand right from wrong at times. 
 
So now I wait for the day they fight and he says, ‘dad said I could’ without realizing the damage he could cause or the consequences. My husband refuses to seek help, says he reads up about what is going on but I find that hard to believe otherwise he would know better how to deal with issues. Is there anything you can suggest in the way for treatment for James? I can’t change his dad but maybe I can get James some help for his disorder. I am starting to think that my feelings do not matter and I need to put my children first and remove Michael from my home so that our eldest will have a home that understands him. Even our 13 year old understands him better than his own dad. ppls help!”

 
RE: "Is there anything you can suggest in the way for treatment for James?"

 The best treatment for high-functioning autistic (HFA) children and teens is definitely “social skills training” (SST). Social skills training is a form of behavior therapy used by therapists to help these young people who have difficulties relating to other people.

A major goal of social skills training is teaching the youngster (who may or may not have emotional problems) about the verbal and nonverbal behaviors involved in social interactions. There are many teens and preteens on the autism spectrum who have never been taught such interpersonal skills as making "small talk" in social settings, the importance of good eye contact during a conversation, etc. In addition, many of these individuals have not learned to "read" the many subtle cues contained in social interactions (e.g., how to tell when someone wants to change the topic of conversation or shift to another activity). 
 

Social skills training helps these young people to learn to interpret these and other social signals so that they can determine how to act appropriately in the company of others in a variety of different situations. Social skills training assumes that when individuals improve their social skills or change selected behaviors, they will raise their self-esteem and increase the likelihood that others will respond favorably to them. The child or teen learns to change his social behavior patterns by practicing selected behaviors in individual or group therapy sessions.

Another goal of social skills training is improving the child’s ability to function in everyday social situations. Social skills training can help these children and teens to work on specific issues that interfere with their school or daily lives.

Techniques in social skills training—

Therapists who use social skills training begin by breaking down complex social behaviors into smaller portions.

Next, they arrange these smaller parts in order of difficulty, and gradually introduce them to the clients. For example, a therapist who is helping an HFA teen learn to feel more comfortable at parties might make a list of specific behaviors that belong to the complex behavior called "acting appropriately at a party" (e.g., introducing oneself to others, making conversation with several people at the party rather than just one other guest, keeping one's conversation pleasant and interesting, thanking the host or hostess before leaving, etc). The teenager would then work on one specific behavior at a time, rather than trying to learn them all at once.

Such specific techniques as instruction, modeling, role-playing, shaping, feedback, and reinforcement of positive interactions may be used in social skills training. For example, instruction may be used to convey the differences among assertive, passive, and aggressive styles of communication. The technique of monitoring may be used to ask clients to increase their eye contact during a conversation. In role-playing exercises, group members have the opportunity to offer feedback to one another about their performances in simulated situations. For example, two members of the group may role-play a situation in which a customer is trying to return a defective purchase to a store. The others can then give feedback about the "customer's" assertiveness or the "clerk's" responses.

Some of the goals for social skills group training are helping autistic kids and teens to:
  • read the body language of others
  • play and have fun
  • learn to cope with mistakes
  • learn strategies for developing peer relationships
  • learn peer group problem-solving
  • become aware of their emotions

Kids on the spectrum are pliable to treatment because they tend to be compliant. Although their ritualistic behavior and rigidity may create obstacles to treatment, most of these kids are able to learn the nuances of feelings, body language and behavior to assist them in their everyday functioning.

Content of social skills training—

Social skills training may be used to teach "special needs" children and teens specific sets of social competencies. A common focus of social skills training programs is communication skills. A program designed to improve the teen’s skills in this area might include helping him with nonverbal and assertive communication and with making conversation. It might also include conversational skills that are needed in different specific situations, for example job interviews, informal parties, and dating. The skills might be divided further into such subjects as beginning, holding, and ending conversations, or expressing feelings in appropriate ways. 
 

Another common focus of social skills training programs involves improving a client’s ability to perceive and act on social cues. Many of these teenagers have problems communicating with others because they fail to notice or do not understand other people's cues, whether verbal or nonverbal. For example, some of them become unpopular with their peers because they force their way into small play groups, when a youngster who has learned to read social signals would know that the kids in the small group do not want someone else to join them, at least not at that moment. Learning to understand another person's spoken or unspoken messages is as important as learning conversational skills. A social skills program may include skills related to the perceptual processing of the conversation of others.

Scheduling—

Social skills training may be given as an individual or as a group treatment once or twice a week or more often depending upon the severity of a client’s disorder and the level of his social skills. Generally speaking, kids on the spectrum appear to gain more from social skills training in a peer group setting than in individual therapy. Social skill training groups usually consist of approximately 10 clients, a therapist, and a co-therapist.

Culture and gender issues—

Social skills training programs may be modified somewhat to allow for cultural and gender differences. For example, eye contact is a frequently targeted behavior to be taught during social skills training. In some cultures, however, downcast eyes are a sign of respect rather than an indication of social anxiety or shyness. In addition, girls or women in some cultures may be considered immodest if they look at others, particularly adult males, too directly. These modifications can usually be made without changing the basic format of the social skills training program.

Generalization or transfer of skills—

Current trends in social skills training are aimed at developing training programs that meet the demands of specific roles or situations. This need developed from studies that found that social skills acquired in one setting or situation are not easily generalized or transferred to another setting or situation. To assist clients in using their new skills in real-life situations, therapists use role-playing, teaching, modeling, and practice.

Preparation—

Preparation for social skills training requires tact on the therapist's part, as HFA clients (especially older teens and young adults) may be discouraged or upset by being told that they need help with their social skills. One possible approach is through reading. The social skills therapist may recommend some self-help books on social skills in preparation for the treatment. Second, the therapist can ease the client’s self-consciousness or embarrassment by explaining that no one has perfect social skills. An additional consideration before starting treatment is the possibility of interference from medication side effects. The therapist will usually ask the client for a list of all medications that he takes regularly.

One of the most critical tasks in preparation for social skills training is the selection of suitable target behaviors. It is often more helpful for the therapist to ask the client to identify behaviors that he would like to change, rather than pointing to problem areas that the therapist has identified. The treatment should consider the client’s particular needs and interests. Whereas social skills training for some clients may include learning assertiveness on the job, training for others may include learning strategies for dating. Therapists can prepare clients for homework by explaining that the homework is the practice of new skills in other settings, and that it is as relevant as the therapy session itself. 
 

Aftercare—

Some studies strongly suggest the need for follow-up support after an initial course of social skills training. One study showed that follow-up support doubled the rate of employment for a group of older Aspergers and HFA adolescents, compared to a group that had no follow-up.

Normal results—

Outcome studies indicate that social skills training has moderate short-term effects, but limited long-term effects. Social skills training programs that include social perspective-taking may have greater long-term effects than traditional social skills training programs based on cognitive-behavioral models. In general, social skills training tends to generalize or transfer to similar contexts rather than to contexts that are not similar to the training. Social skills training programs for HFA children and teens should include programming for generalization, so that these clients can transfer their newly acquired skills more effectively to real-life settings. One approach to improving generalization is to situate the training exercises within the client’s school, work, living, or social environment.

The benefits of social skills training programs include flexibility. The treatment can take place either as individual or group therapy, and new trainers can learn the techniques of social skills training fairly quickly. An additional advantage of social skills training is that it focuses on teaching skills that can be learned rather than emphasizing the internal or biological determinants of social adequacy.

Future research should explore (a) the integration of social skills training with the needs of families from different cultural backgrounds, (b) the relationship between social skills training and different categories of mental disorders, (c) the transfer of skills from therapeutic contexts to daily life, and (d) improving the youngster's long-term gains from social skills training.

NOTE: Having said all of the above, while proper treatment for your autistic son is important, it sounds like you have bigger fish to fry (i.e., dealing with an abusive husband). If possible, try to educate him about the disorder so that he can understand your HFA son better - and hopefully show more compassion.
 
 



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Virtual Reality and Learning Social Skills: Help for Kids on the Autism Spectrum

It’s no secret that Autism is on the rise, but what's being done about it? Researchers have invested a lot of time and money to figure out ways to reach kids with Autism Spectrum Disorders, and a few have come up with an approach called "Virtual Reality."

Virtual reality is a realistic simulation of an environment by a computer system. It’s technology taking you to a scene that feels and looks real, and for some kids with Aspergers and high functioning autism (HFA), it can be a safe way to learn to interact with others.

Virtual reality allows these "special needs" kids to practice all-important reciprocal social interaction skills in a safe environment. Virtual characters are more predictable than real peers, and sometimes more patient, and so young people on the autism spectrum may find it easier to engage in the kinds of interactions that we ultimately hope they will have in the real world with their real friends.

The “virtual reality” concept involves using computer technology to create a simulated, three-dimensional world that the child can manipulate and explore while feeling as if he were in that world. Scientists, theorists and engineers have designed dozens of devices and applications to achieve this goal. Opinions differ on what exactly constitutes a true virtual reality experience, but in general it should include:
  • The ability to track the user's motions, particularly his head and eye movements, and correspondingly adjust the images on the user's display to reflect the change in perspective
  • Three-dimensional images that appear to be life-sized from the perspective of the user

In a “virtual reality” environment, the user experiences “immersion” (i.e., the feeling of being inside and a part of that world). The child is also able to interact with his environment in meaningful ways. The combination of a sense of “immersion” and “interactivity” is called “telepresence,” which is the extent to which one feels present in the mediated environment, rather than in the immediate physical environment (i.e., an effective virtual reality experience causes you to become unaware of your real surroundings and focus on your existence inside the virtual environment).

The “Virtual Reality” project started over ten years ago with a study designed to determine whether virtual reality could help Aspergers and HFA kids learn the beginning skills of street crossing. These kids were placed in a virtual world and practiced correctly observing and responding to the virtual world situations. The results indicated that they could - and did - accept learning in a virtual world.

Here’s how it works: There are two modes of interaction in virtual learning systems. In one, the youngster interacts directly with a virtual peer. In another, the virtual peer is controlled by the youngster. In the future, it is hoped that virtual reality can go even further in helping kids with an autism spectrum disorder. Virtual peers of this sort can help to assess the exact nature of the social deficits that may be experienced by these kids, which in turn may allow us to design better and more targeted interventions.

A playmate named Sam, a talking dog named Buddy, and an Israeli street leading to a toy store all have starring roles in a new generation of virtual reality games designed to teach basic safety and social skills to kids diagnosed with Aspergers and HFA.

Skills that are often taken for granted can be torturously difficult or school-aged kids on the spectrum (e.g., classroom manners, navigating the social norms of group playtime, etc.), but with a virtual reality learning experience, “practicing” for multiple real-life situations that occur in the real-world is finally possible.

Here are our top 5 picks for virtual reality headsets:



Pansonite Vr Headset with Remote Controller[New Version], 3D Glasses Virtual Reality Headset for VR Games & 3D Movies, Eye Care System for iPhone and Android Smartphones



Oculus Go Standalone Virtual Reality Headset - 32GB




VR Headset for iPhone & Android Phone - Universal Virtual Reality Goggles Ver2.0 - Play Your Best Mobile Games 360 Movies With Soft & Comfortable New 3D VR Glasses | + Adjustable Eye Protection System




VR Headset - Virtual Reality Goggles by VR WEAR 3D VR Glasses for iPhone 6/7/8/Plus/X & S6/S7/S8/S9/Plus/Note and Other Android Smartphones with 4.5-6.5" Screens + 2 Stickers



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Is My Autistic Child "High-Functioning"?

Question

We have a 12 yr old son who is not in our primary care, as he lives with his mother and we see him only every other weekend. He was diagnosed with very mild autism, and is very high functioning, i.e. he is not on an EAP getting B's and C's, and although a bit socially challenged does OK with his peers.
Unfortunately he is not being challenged to become more independent, and it would appear as if his mother is trying to hold him back, i.e. he is forced to be in daycare after school with 5 - 10 yr olds, and desperately wants the chance to spread his wings and try an hour after school on his own (with a safety plan, and he has taken and passed the babysitters course). Are there any suggestions on how we go about determining if he can be challenged with more responsibility, i.e. is there a checklist of demonstrated behaviours etc?


Answer

The following lists can help parents, teachers and other caretakers to determine if the child is truly on the high-functioning end of the autism spectrum. Note: It is not expected that any high-functioning child will show all the traits listed in any section.

General intellectual ability—

• asks many questions of a provocative nature
• displays a great curiosity about objects, situations or events
• displays a willingness to accept complexity
• has a high energy level
• has a liking for structure, order and consistency
• has a power of abstraction, conceptualization and synthesis
• has a power of concentration, an intense attention that excludes all else
• has a wide range of interests
• has an interest in cause-effect relations
• has avid interest in science or literature
• has the capacity to look into things and be puzzled
• has the capacity to use knowledge and information other than to memories
• is a good guesser
• is an avid reader
• is an entrepreneur - readily makes money on various projects or activities
• is creative in new ideas, seeing associations, pursuing innovations
• is friendly and outgoing
• is independent
• is involved with many exploratory type activities
• is perceptually open to his or her environment
• is persistent
• is resourceful - solving problems by ingenious methods
• is secure emotionally
• is venturesome, wanting to do new things
• learns rapidly, easily and efficiently
• makes good grades in most subjects
• needs little outside control - applies self discipline
• provides very alert, rapid answers to questions
• retains and uses information which has been heard or read
• reveals originality in oral and written expression
• shows superior judgment in evaluating things
• tends to dominate peers or situations
• uses a large number of words easily and accurately
• uses a lot of commonsense

 
Specific academic aptitude—

• has a long attention span in areas of interest
• is able to extend learning from these key areas to various situations somewhat unrelated in orientation
• is able to judge own and others' relative abilities in key areas of interest
• is able to show broad perspective on one or more subject areas
• learns rapidly, easily and with less repetition in one or a few specific areas (probably not all subject areas)
• likes or loves one or a few areas of knowledge
• likes to study some subjects more than others
• seeks assistance of others beyond his or age peers in extending knowledge in areas of interest
• shows similar characteristics to general intellectual ability but concentrated around one or a few fields
• spends time voluntarily beyond ordinary assignments on projects of interest to him or her

Creative thinking and production—

• acts spontaneously, intuitively
• always trying to adapt or improve things
• asks provocative questions, challenges parents, teachers, written and other authorities
• can show intense concentration on a task
• can show unusual degrees of originality, concentration and persistent hard work on projects that capture their interest and imagination
• displays energy, sometimes disruptively
• doesn't accept authoritarian pronouncements without own judgment
• doesn't mind being different
• has a keen sense of humor, seeing humor in situations others don't
• is bored with memorization and recitation
• is considered, and perhaps resented, by some peers as "crazy"
• is flexible in thinking patterns
• is fluent in producing and elaborating on ideas
• is intellectually playful, interested in fantasy, imagination
• is uninhibited in expression, sometimes radical
• juggles or redefines elements of a problem or task
• makes unusual associations between remote ideas
• produces unexpected, sometimes "silly" responses
• provides multiple solutions or responses to problems
• readily guesses and makes hypotheses
• retains own ideas in a discussion or collaboration
• senses inconsistencies and discontinuities
• senses when problems exist
• tolerates ambiguity and uncertainty

 
Leadership—

• can adopt non-leadership roles within a group
• can articulate ideas clearly
• can coordinate the work of several individuals
• can establish the mood of a group
• can give directions clearly and effectively
• can listen to others empathetically
• can stimulate and arouse others
• exercises authority reliably and responsibly
• interacts with others easily showing social skills
• is looked to by others when something must be decided
• is often asked for ideas and suggestions
• organizes others
• recognizes and can articulate the goals of a group
• recognizes skills and abilities possessed by others
• supports others in a group when appropriate
• understands how people feel and how groups function

Psychomotor ability—

• demonstrates endurance, stamina and persistence in physical activities
• demonstrates prowess in physical activities common amongst age peers
• has a suitable body build
• is able to understand the intellectual aspects of psychomotor activities
• is athletic
• is coordinated, balanced and confident in physical activities
• is energetic
• is inventive in constructing or modifying games
• is rhythmic
• likes to play physically

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

Music:

• discriminates musical and other sounds well
• enjoys dance and dramatic activities with musical elements
• enjoys musical activities and demonstrates musical feeling
• has good sense of rhythm
• is well-coordinated
• makes up original tunes
• responds readily to rhythm, melody and harmony
• shows tonal memory
• understands musical relationships
• uses music to express feeling or experience

Dramatics:

• brings a dramatic situation to a climax with a well-timed ending when telling a story
• communicates feelings by means of facial expressions, gestures and bodily movements
• demonstrates ability to dramatize feelings and experiences
• demonstrates interest and enjoyment in dramatic activities
• demonstrates understanding of conflict when acting out a dramatic event
• enjoys evoking emotional responses from listeners
• readily shifts into role of another character, animal or object
• uses voice to reflect changes in mood

Art:

• draws a variety of objects
• is interested in other people's art, both appreciating it and criticizing it
• is willing to try out new materials and experiences
• likes to model three dimensionally with clay, soap carving, etc.
• pursues art in spare time
• puts depth into drawing, showing planning and good proportion
• shows originality in modes of undertaking art
• treats art seriously and enjoys it
• uses art to express feelings and experiences

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

==> Videos for Parents of Children and Teens with ASD
 
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Helping Your Older ASD Teen to Find Work

Question

How can I get my 19-year-old son [with high functioning autism] to stop playing video games long enough to go find a job? I try to tell him that he needs to be working at least part-time at this age – but he’s not interested. (*sigh*)

Answer

Looking for a job is difficult for any teenager new to the job market, especially when high unemployment allows extreme selectivity among job applicants. But with ASD or high-functioning autism, the difficulty level goes up yet another notch. Chances are strong that your child will face this challenge.

How can you make your home a supportive place for job hunting? Here are some ideas:

1. Be a good listener. Let him express his feelings of frustration, anger, and nervousness about seeking employment.

2. Be aware of community resources. Know the applicable civil rights laws. Consider government programs such as vocational rehabilitation and job service. If you know of other parents whose children are job hunting, you may want to form a support group for yourselves and/or your children.

3. Grooming is important. Teens with autism are often unaware of stains on their clothing, sloppy hair, or dirt on their hands. It helps if someone looks them over before an interview.

4. Help him to organize himself. Many – if not most – HFA teens do not know how to look for work. There are many books about job-hunting, each with a slightly different approach. Together, you might decide on a plan of action. Or help might be needed with the fine points of planning and scheduling. You could remind him of necessary follow-up telephone calls or letters. 
 

5. Help with writing if necessary. Teens on the spectrum tend not to have the best hand-writing skills. It might be helpful if the parent types or hand-writes job applications since sloppy handwriting and misspellings tend to disturb employers. If the employer uses online job kiosks (a new barrier for people with reading and writing difficulty), you may have to sit with him and key in the words of the application. Also, help with transportation, if necessary.

6. Insist your child actively look for work. Do not let him spend extensive time playing games, watching TV, reading, etc. If necessary, tell him that looking for work is a full-time job, which he must do in order to earn your financial support. Help him by not overloading him with chores during working hours on the weekdays when employers are in. Help him overcome his failures, but do not accept lack of effort.

7. Use your social network to help your child find work. Talk to your friends, co-workers, and other parents of autistic children. Tell them about your child. Stress your child’s positive qualities and describe him as a capable worker. Don’t spend a lot of time describing his disorder. Ask him to follow up any leads that you discover.

8. Social skills are important to job success. Help your child to understand the point of view of co-workers and to adjust to the many hidden rules of the organization.

9. As he looks for employment, emphasize his actions and behavior, rather than the results. If he is actively seeking work, he deserves your respect and praise, even if he does not succeed in finding work. For example, praise your child if he does a good job of describing his qualifications at an interview, even if he is not selected for the opening.

10. Finding a job is only half the battle. Your child will have to work hard in order to keep that job. Be sure your child gets a complete job description and check for problem areas. If your child might have difficulty with any task because of his disorder, he may want to consider trading that task with a co-worker in return for a task that he can do.

Autistic teens work in every conceivable job – salesperson, optometrist, pilot, doctor, psychologist, computer programmer, janitor, and waiter. Pay attention to your child’s abilities. Teach him to feel pride in his achievements. And support him as he hunts for a job. With your help and your clear belief that your child can succeed, he can “make it.” 

Good luck!


Resources for parents of children and teens on the autism spectrum:
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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

Click here for the full article...

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

Click here to read the full article…

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

Click here to read the full article…

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

Click here to read the full article...

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

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

Click here for the full article...
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Avoiding Negative Reinforcement: Tips for Parents of Kids on the Autism Spectrum

Negative reinforcement requires the youngster to work for the removal of an in-place, unpleasant consequence. The child's goal is to get rid of something that is unpleasant rather than to earn something that is desirable. In a negative reinforcement model, instead of working to earn a positive consequence, the youngster works to distance herself from an aversive consequence. 

Click here for the full article...

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