“My son wakes in a terrible, nasty mood. He goes to bed happy, laughing and loving. Nothing that I do can deter him from ruining his day and the day of those around him. I have tried everything to help him turn the day around - from being extra cheerful, music, ignoring, consequences, taking away privileges, talking about it, timeouts, etc... Although I do everything that I can to make sure that he gets adequate sleep (9pm-7am) he has been diagnosed with frequent night wakings. The doctors will not do anything about it. He was diagnosed with ADHD, age 5. However, I realized at age 7 that it was something much more complex than that. Finally, this past winter, he was diagnosed with mild-to-moderate ASD. We have provided countless hours of traditional and non-traditional therapy yet he still struggles a good portion of the time. His father passed away January '14 so that does not help matters -- and he has entered precocious puberty (being treated). Would you please be willing to give me suggestions to help get him off that path as quickly as possible so that everyone can go on about their day?”
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I think the harder you try to fix this, the worse you may be making it. Sometimes you just have to let a child be angry and upset. Kids need to vent, too.
Let's try this: Stop trying to change it. I'm sure your efforts to "cheer him up" annoy him even further. Give him permission to be moody. You can even say something like this first thing in the morning: "Good morning, this is the time you have a mood, so go ahead and get started." [reverse psychology]
But first, tell him tonight, while he is in a good mood, that you are giving him permission to have a mood in the morning. Then remind him in the morning using the line I just mentioned. In addition, while he is disgruntled in the morning, you can say things like, "I know honey – it's hard to get up and get going in the morning, isn't it?" In this way, you aren't punishing, ignoring or cajoling -- rather you are validating his feelings. Try it!
Having said that, here are some common reasons for “night wakings” and tips for dealing with them:
1. Children may be awakened during the night due to an urge to urinate, thus your son should avoid drinking fluids before bedtime. Some kids may have urinary tract problems that awaken them even when their bladders aren’t full. If your son has frequent night wakings, try to find out if bathroom trips are contributing to the problem.
2. Children who suffer from heartburn may experience frequent night wakings. Heartburn is associated with sleep-disordered breathing, and can be dangerous in some cases. If you think your son may suffer from heartburn, consult your doctor for treatment options. Meanwhile, avoid acidic and hard-to-digest foods before bedtime.
3. Children who suffer from headaches are more likely to suffer from frequent night wakings. It’s not clear if headaches cause sleep problems, or sleep problems are causing the headaches. Either way, it’s a good idea to have your youngster’s headaches checked by a doctor.
4. Night terrors are distressing, disruptive, and cause night wakings. But night terrors differ from nightmares. A youngster may move (even sleep walk) during a night terror, which puts him at risk of hurting himself. Have you ever noticed your son sleep walking?
5. Nightmares are associated with REM sleep, and they are more likely to occur after a youngster has been sleeping for several hours. When a youngster wakes up immediately after a nightmare, he is likely to remember it. Triggers for nightmares include anxiety and medications that interfere with REM sleep. Children who awaken from nightmares need to be reassured that their dreams are not real. Also, check to see if any of your son’s medications are contributing to sleep problems.
6. Worried, frightened children have more sleep problems. Research suggests that ignoring a youngster’s fears may lead to nightmares and emotional problems. Thus, it’s important to take an active role in teaching your son to overcome his fears.
7. When children are overtired, their sleep may become more restless – and they suffer more frequent night wakings. If your son is overtired, he needs more sleep. An earlier bedtime may help.
8. Children often learn to associate falling asleep with certain forms of comforting stimulation (e.g., parental soothing, a particular sleep environment, etc.). These sleep aids may be very effective, but if your child becomes dependent on them, he fails to learn how to fall asleep on his own. Thus, if your son is used to falling asleep in your presence, but wakes up alone, he may not be able to settle himself back to sleep. If you want your son to develop self-soothing skills, you may want to consider sleep training.
9. “Sleep disordered breathing” includes interrupted breathing (i.e., sleep apnea), loud breathing, snoring, and troubled breathing during sleep. Sleep disordered breathing can restrict the oxygen supply to a youngster’s brain and cause serious health problems. It is also associated with attention problems, daytime sleepiness, frequent night wakings, hyperactivity, nighttime crying, and poor sleep quality. If you suspect your son suffers from sleep-disordered breathing, consult your doctor.
10. Kids who have experienced traumatic events are likely to suffer from night wakings and other sleep disturbances (and you did say his father passed away recently --- BIG FACTOR THERE!). Even everyday stressors disturb sleep. Children experiencing family stress suffer more night wakings and get less sleep overall. These sleep problems are associated with elevated stress hormone levels. Check to see if your son is experiencing an inordinate amount of stress for some (perhaps hidden) reason. Grief counseling may be in order as well.
Morning moodiness is associated with the "sleep inertia" phase, which is a transitional period of fatigue that usually lasts between 5 and 20 minutes after a child first wakes, though it can go on for a longer time in some cases. The process of waking up is slow – it’s not like a light switch. Feeling excessively grouchy in the morning is not enjoyable, but does not necessarily indicate having had a poor night of sleep.
Why some kids are able to cheerfully connect their sleep inertia phase with the rest of their day is much more specific and individualized. Moodiness might be associated with not getting enough rest and being tired, but it might also be symptomatic of having a bad attitude about the day. For some children though, chronic morning moodiness is simply a symptom of an over-scheduled life, with too little sleep, and not enough things that bring them joy on a day-to-day basis.
Resources for parents of children and teens on the autism spectrum:
"My son, 17 y.o. with HFA, is no longer interested in trying to relate to his peers or do anything social. He says 'nobody' likes him. I would describe him as a recluse at this point. Is this something I should be concerned about, or just let him do his thing, which appears to me to be a very lonely way to live.?"
Peer-group rejection occurs when a person is deliberately excluded from social relationships among his or her age group. Unfortunately, this phenomenon is common for teens with Asperger’s (AS) and High-Functioning Autism (HFA).
Research dealing with the implications of peer-group rejection on later development suggest that AS and HFA teens experiencing continuous rejection often experience a decline in their self-image, a state of despair, behavioral difficulties, loneliness and seclusion – and in some cases, serious emotional disturbances.
AS and HFA teens who experience peer-group rejection often choose to isolate themselves, which makes a bad problem worse. Here are some of the common reasons for isolation:
A depressed adolescent loses interest in everyday activities and drops out of social groups at school. Depression is a Catch-22. It can cause isolation, but may also come from a lack of social interaction. For example, Michael (diagnosed with Asperger’s) was depressed when his attempts to fit-in with the boys in his class always backfired. They were sports-minded, but Jack was more artistic. He was mocked by his male peers for his “weird” artwork and eventually stopped trying to win their friendship. Over a period of weeks, he became depressed and began to isolate.
An adolescent who feels rejected may spend too much time on social networking sites and lose touch with peers. He or she may replace genuine social interaction with chat rooms and conversations with strangers. Adolescents who interact online lose out on genuine social interaction. For example, Craig (diagnosed with High-Functioning Autism) was a computer geek who spent hours chatting online. After months of this, his social skills were under-developed and his understanding of face-to-face interaction was damaged by hours upon hours of Internet use.
Moodiness and erratic behavior can drive an AS or HFA adolescent away from his peers.
Shyness can be a cause of social isolation.
Many young people on the autism spectrum have one particular “special interest,” and may engage in – and talk about – that interest to the exclusion of all other social activities and conversations. For example, Josh was diagnosed with Asperger’s at age 8. He had a particular interest in trains and train schedules, but his classmates found his incessant talk about them boring. They eventually left him out of social activities, which made him feel socially clumsy and unwanted – and resulted in isolation.
Some AS and HFA adolescents may be ostracized by their peers because they either excel academically or underachieve. Fitting-in is important to teens, but those who stand out are often pushed to the fringes of social groups.
Though most want to be accepted by their peers, AS and HFA teens tend to be very hurt and frustrated by their lack of social competency. Their inability to “connect" to others is made worse by the negative feedback that they receive from their painful social interactions (e.g., bullying, teasing, rejection, etc.). The worse they perform socially, the more negative feedback they get from their friends and classmates, so the worse they feel and perform. Due to this consistent negative social feedback, many of these “special needs” teens feel depressed, anxious and angry, which just compounds their social difficulties by further paralyzing them in social situations. In addition, although negative behaviors often lead to peer-group rejection, the reverse is also sometimes true (i.e., being ostracized can bring out the worst in AS and HFA teens, which leads to even more ridicule and rejection).
The AS or HFA teen can be rejected on an individual basis, or by an entire peer-group. In addition, rejection can be either “active” (e.g., bullying, teasing, ridiculing, etc.) or “passive” (e.g., being ignored, getting the silent treatment, etc.). Some level of rejection is an inevitable part of life for all teens. However, it can become a serious problem when it is prolonged or consistent, when the relationship is important, or when the teen is highly sensitive to being rejected. Furthermore, the experience of peer-group rejection often leads to a number of adverse psychological consequences (e.g., aggression, anxiety, depression, feelings of insecurity, heightened sensitivity to future rejection, school refusal, loneliness, low self-esteem, and even suicidal ideation).
Research reveals that most teens who are rejected by their peers display one or more of the following behavioral patterns:
high rates of aggressive or disruptive behavior
high rates of inattentive, immature, or impulsive behavior
high rates of social anxiety
increased preference for solitary activities (e.g., playing video games)
low rates of prosocial behavior (e.g., engaging in meaningful conversation, sharing, etc.)
One of the strongest effects of sustained peer-group rejection is “global impairment” (i.e., impairment across several domains, including behavior, emotions, social relationships, and involvement in activities). Studies suggest that long-term peer-group rejection is consistently associated with problems in (a) relationships (e.g., peers, siblings, and adults other than parents), (b) emotions (e.g., feeling unhappy or sad, not having fun, feeling nervous or afraid), (c) behavior at home, and (d) low involvement in activities (e.g., sports and hobbies).
Additional research on peer-group rejection reveals the following:
“Active rejection” (e.g., bullying, teasing, ridiculing, etc.) is more stable, more harmful, and more likely to persist after the teen transfers to another school.
An analysis of 15 school shootings between 1995 and 2001 found that peer-group rejection was present in all but two of the cases (87%). The documented rejection experiences included both acute and chronic rejection, and frequently took the form of ostracism and bullying. The researchers assert that although it is likely that the rejection experiences contributed to the school shootings, other factors were also present (e.g., depression, poor impulse control, etc.).
Peer-group rejection, once established, tends to be stable over time, and thus difficult for the AS or HFA teen to overcome.
Rejected teens are likely to have lower self-esteem, and to be at greater risk for “internalizing” problems (e.g., depression).
Some rejected teens display “externalizing” behavior and show aggression (acting-out) rather than depression (acting-in).
Teens with developmental disabilities are more likely to be rejected, and this rejection may lead to a negative developmental cycle that worsens with time (i.e., their emotional growth becomes stunted).
Rejected teens are more likely to be bullied.
Peer-group rejection is believed to be less damaging for teens with at least one close friend.
For the AS or HFA teen who has poor social skills or struggles to build friendships, the idea of interaction with peers is extremely unappealing. Many of these young people can’t think of anything they would hate more than being “forced” to be outgoing. Who can blame them? Nobody enjoys doing things they “suck” at.
The bottom line is this: AS and HFA teens have a “developmental disability,” which simply means that their emotional age is much younger than their chronological age. So, for example, your 16-year-old AS or HFA son is emotionally more like a 12-year-old – yet he is thrown in with a bunch of 16-year-old classmates. Thus, the odds are high that he has already had numerous uncomfortable peer-encounters at school. You can see why the critically important skill (i.e., the ability to engage in age-appropriate social interaction) needed in the teenage years may be the one thing that the AS or HFA teen associates with failure.
Here are several crucial steps that parents and teachers can take to help the AS or HFA teen to deal with rejection:
1. With or without an autism spectrum disorder, most teens become less willing to take a parent’s word or advice. Thus, parents need to hook-up their “special needs” teenagers with other trustworthy adults. If you want your teen to learn or try to do something, arrange for the suggestion or information to come from a trusted adult other than you, the parent. For example, handpick your teen’s guidance counselor, or look for other good mentors (e.g., uncle, scout or youth group leader, psychologist, social worker, peer mentor, “Big Brother,” social skills group leader, weight room coach, martial arts teacher, etc.).
2. Special interests may change, but whatever the current one is, it remains an important aspect of motivation, pleasure, relaxation, and reassurance for the “special needs” teen. So, as long as it isn't creating additional problems, allow your teen to engage in his special interest.
3. Side-by-side conversations (e.g., while walking or driving in the car) about the “issues of the day” may be more comfortable for your teen than talking face-to-face.
4. Seek out activity-based, practical social skills groups designed especially for AS and HFA teens. Participating in such a group, being accepted by group leaders and peers, is probably the most powerful way to allay a teen’s potential despair at not fitting-in socially and not having any friends.
5. Schedule regular monthly educational team meetings to monitor your teen’s progress, to ensure that the IEP is being faithfully carried out, and to modify it if necessary. Because AS and HFA teens can be so volatile or fragile, and because so many important things must be accomplished in 4 short years of high school, these meetings are crucial.
6. Remember that teens on the spectrum are relatively immature (socially and emotionally) compared to “typical” teens of the same chronological age. Imagine sending a 10-year-old girl off to high school (even if she is chronologically 15), or putting a 13-year-old boy behind the wheel of car (even if he has a chronological age of 18), or sending a 16-year-old off to college or the Navy. We need to adjust our expectations for teens on the autism spectrum – and make sure they still have appropriate supports.
7. Look for volunteer activities or part time jobs at the high school or in the community. Be persistent in asking the school to provide help in the areas of career assessment, job readiness skills, and internships or volunteer opportunities.
8. Look for opportunities for a sheltered, successful overnight stay away from home with no parent (e.g., long weekend visits to relatives, a week or two of a carefully chosen sleep-away camp, taking a course on a college campus, etc.).
9. If you have not talked to your teen about autism spectrum disorders, you or someone else should do so, to the extent that your teen is ready to hear it. It’s difficult for AS and HFA teens, because they so much want to be “normal” and successful. A diagnosis can seem threatening – or even totally unacceptable. In truth, however, the adults with AS and HFA who do best are those who know themselves well – both their own strengths, which point them toward finding their niche in the world, and their own blind spots where they need to learn new skills or seek out specific kinds of help.
10. Have realistic, modest goals for what your teen or the family can accomplish in a given time period. You may need to postpone some plans for career goals, trips, culture or recreation.
11. Go with the flow of your teen’s nature. Simplify schedules and routines, streamline possessions and furnishings. If, for example, your teen only likes plain T-shirts without collars or buttons, buy them. If she likes familiar foods or has a favorite restaurant, indulge her.
12. Even for a previously well-adjusted teen, multiple stressors during the teenage years may bring on anxiety and depression. Stressors include increased academic/abstract thinking and social demands at school, peer pressure, increased social awareness, and fears of the future. Highly anxious teens who do not get professional help may be at risk for school failure, acting-out, alcohol and substance abuse, and even suicide attempts. Seek the assistance of a child and adolescent psychiatrist who specializes in autism spectrum disorders.
13. Build and use any support networks you can (e.g., extended family, close friends, church/synagogue groups, empathetic school staff, etc.). If you don’t have a good network, consider individual or family therapy for some support during a stormy, demanding life passage.
14. Boys on the autism spectrum may need to spend increased amounts of time with their fathers, and/or other male role models as they undertake to become men. If dad has taken a back seat, let him know his son really needs his attention now. If you are a single mother, look especially hard for male mentors at your son’s school or in the wider community.
15. Although most teens with AS and HFA are more docile and child-like, be prepared to tolerate/ignore considerable distancing, surliness, or acting out, knowing that it won’t last forever. At the same time, set some firm limits, and keep a close eye on your teen’s welfare.
16. Teens with AS and HFA are less prepared than “typical” teens for the new challenges of sexuality and romance. Some are oblivious, while others want a girl or boy friend, but are clueless about how to form and maintain a relationship. Boys especially may be at risk for accusations of harassment, and girls especially at risk for becoming victims. Teach appropriate rules, or see that another adult does. Look for supervised activities in which boys and girls can socialize safely together, supervised by a staff person who knows about autism spectrum disorders and can coach appropriate social skills.
17. Teens on the spectrum need to learn when to ask for help, from whom, and how. It’s very helpful to have someone such as a trusted guidance counselor whose door is always open, and who can coach your teen in problem solving.
Adolescent culture is social by nature. Teens tend to move around in groups of people their own age. Thus, an adolescent who is isolated, either by chance or choice, is at a distinct disadvantage – and is often treated as an outcast. The effects of rejection and isolation on an AS or HFA adolescent can be long-lasting and create problems that moms and dads need to address. By using the steps listed above, parents can help their “special needs” teen (a) overcome the negative effects of peer-group rejection, (b) learn critical social skills, and (c) gain the self-confidence needed thrive as an adult.
Resources for parents of children and teens on the autism spectrum:
• Anonymous said... I have a twenty year old who was excluded and teased when he was 15. The wound still exist. In college he still does not want friends and only interacts with video game faceless friends. I gave him therapy, support and love. The heart never forgets this pain. I believe this bulling by the next door neighbor boy is something he got over at some level. His social life consist of video gaming. Gaming just feels easier and safer to socially interact with others. Without games he would be alone? • Anonymous said... I have a very lonely, sad 16 yr old • Anonymous said... I understand. My son is 15 and i put him in a charter school. He did a shadow tour and told me he wanted to ho there. The school has been very supportive and he's met a few friends. Of course, they had tp approach him. • Anonymous said... It's heartbreaking seeing my 14 year old son with no friends...even worse was the constant bullying • Anonymous said... The same with my 12 year old • Anonymous said... Try finding other small groups or hobby clubs of people with the same interest as your child, a place where they feel they can fit in and belong and have confidence because it is an area of expertise. Through the common shared interest, they can find a social outlet. Check into gaming stores, sometimes they have meetings for those interested in certain games: video games, card games, comic books, etc. • Anonymous said... very true • Anonymous said… Great advice, tina...gaming clubs, etc. • Anonymous said... I am leery of the gaming stores... When I was in NYC we paid a visit to the Nintendo store and what really concerned me was the zombie nature of several grown men around a large white table playing Nintendo games well into the night. I am all for being social, but these men were not being social with each other. It was very off putting and I strongly believe would aid in furthering my son's avoidance behavior. I honestly left concerned... • Anonymous said... My son is 17. He has never had what most would call a friend. He has had peers who supported him and allowed him to safely socialize with them which he prefers to act however he wants and talk about whatever he wants while his peers tolerate him but .. that isn't real and I don't know how to help. He graduates from high school this year and .. what happens next? He doesn't have the maturity to study/participate in college and his math deficit and desire to build machines, tanks, firetruscks, sirens, etc doesn't lend itself to any jobs so .. just kinda lost. • Anonymous said... This breaks my heart. • Anonymous said... we have a 16 year old with similar theme!
• Anonymous said… My aspie 17 year old seems to be completely oblivious to how much he gets left out. He will follow people around, talking at them, and even continue talking after they turn around and ignore him. He goes to a private school with a higher number of ADHD and special needs kids, and we worship at a mega church. Both places have plenty of nice people who will listen (or pretend to listen) to his non-stop monologues about machinery. The church people especially try to befriend him, but he wants an audience for his monologues, not conversations, so they don't really know how to connect. They tell me what a neat kid he is, though. So, while he still ends up with no one who wants to invite him to hang out on weekends, he feels like he's incredibly popular and well liked since someone among the hundreds in the room will always be willing to hear his unending list of machinery factoids. It's when he's home that he's unhappy, because there is just so much we can handle hearing before we tell him to hush and try to teach him social skills. He gets angry and lashes out, simply because I tell him to try to listen to his siblings or participate in what the family is doing. So it's not being left out that bothers him - it's not being able to treat people as his audience and he's not treated like the star he knows himself to be that really ticks him off. • Anonymous said… Just to pick up on the gaming group comment. I can see how it would not be interactive. However, when my son was 13 - 15 he would go to CARD game tournaments (you don't have to take part in the actual tournament) It would lift my heart to see loads of like minded kids chatting and laughing in a way he never did with any other people. Sadly he grew out of the card game phase but I believe it taught him he will not always be lonely.
Many parents of kids with Asperger’s and High-Functioning Autism have discovered that some of their youngster’s behaviors make no obvious sense and do not serve any clear purpose. But when these kids engage in “odd” or confusing behavior, they are also sending the parent hidden clues about things that are important to them. Thus, it’s the parent’s job is to break the code so she can interpret the clues.
By becoming more like a “detective,” you can begin to notice coded messages you didn’t see before, and as a result, find more effective ways to help your “special needs” youngster.
Early intervention is key to optimal outcomes for children with AS and HFA. There's little doubt that young people on the spectrum who undergo therapy at an early age, be it behavioral or developmental, do better than kids who don't. And there's 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 child to “fit-in” with his peer-group. While early intervention is extremely important, intervention at any age can be helpful.
