Avoiding Social Interaction: The Dilemma for Teens on the Autism Spectrum

Teens with High-Functioning Autism (HFA) and Asperger’s (AS) have difficulty with the basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments with others, as well as a lack of social or emotional reciprocity.

The reason this is such a problematic issue is because we, as humans, are social creatures by nature. Social interaction is a “requirement” within our species.

The sad truth is that teens on the autism spectrum desire acceptance and want to “fit-in” with their peer group, but are often ostracized, mocked and bullied. In the adolescent world where EVERYONE feels insecure, the teenager who appears “different” or “odd” is voted off the island.

Many of the traits associated with HFA and AS tend to exacerbate peer-rejection. For example, the “special needs” teen:

• faces similar academic problems as students with ADD due to his distractibility and difficulty organizing materials
• finds friendship and all its nuances of reciprocity to be exhausting
• has poor social skills (e.g., lack of eye contact during conversation, body language that conveys a lack of interest)
• is not privy to street knowledge of sex and dating behaviors that other adolescents pick up naturally
• is stiff and rule-oriented and acts like a little adult (a deadly trait in any teen popularity contest) 
• may be naive when it comes to puberty and sexuality
• may remain stuck in grammar school clothes and hobbies instead of moving into adolescent concerns (e.g., dating, clubs)
• often experiences depression that results from chronic social tension 
• often has poor motor coordination, which leaves him out of high school sports (typically an essential area of male-bonding and friendship in the teenage years)
• often neglects his hygiene 
• tends to attract bullies, but is less likely to report bullying than his peers
• tends to be more immature than his peers
• typically does not care about adolescent fads and clothing styles (concerns that obsess everyone else in his peer group)

The hormonal changes of adolescence - coupled with the problems outlined above - usually means that an HFA or AS adolescent becomes emotionally overwhelmed on almost a daily basis. Childish temper tantrums may reappear, and it is not uncommon for the teen to experience "meltdowns" at home after another day filled with harassment, rejection, bullying, and pressure to conform.

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

Parents of teens on the autism spectrum can usually tell whether or not their son or daughter is experiencing some form of social rejection by observing his or her behavior and attitude. HFA and AS adolescents who feel disliked by others and who have experienced some form of emotional abuse:

• are disengaged from friends and classmates
• are frequently ill (e.g., stomach aches, headaches, colds, etc.) 
• are impulsive
• are less able to calm themselves
• are socially anxious
• become avoidant or aggressive when dealing with negative emotions
• behave in ways that cause them to get into conflicts at school
• exhibit emotions too intense for a situation
• experience a significant degree of anger and frustration
• have a preference for isolation at home and school
• have difficulty controlling their attention span
• have difficulty decreasing negative emotions
• have difficulty understanding emotional experiences
• may refuse to go to school
• may skip classes
• often seem genuinely depressed
• tend to have poor academic performance

All teenagers are required to use increasingly sophisticated social skills and to interpret ever more subtle social nuances as they progress through high school. For that reason, young people diagnosed with HFA or AS often find themselves more and more in conflict with prevailing social norms as they move through adolescence. Due to the fact that social encounters are seldom reinforcing (i.e., rewarding) for young people on the autism spectrum, they often avoid social interaction all together. Over time, they may develop negative attitudes about themselves, which makes it even more difficult to continue attempts at social interaction. As a result, the cycle continues – they retreat even deeper into their own little world.

Spending a lot of time in voluntary isolation creates a host of problems in-and-of itself. For example, teens who isolate may become depressed due to the lack of social contact. A depressed adolescent often 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.

Furthermore, an adolescent who isolates may spend too much time playing video games and on social networking sites, thus losing touch with family, friends and his peer group. He may replace genuine social interaction with chat rooms and conversations with strangers. Adolescents who interact online lose out on genuine social interaction, which stunts their emotional growth even further.

When HFA and AS teens begin to act-out their frustrations (e.g., with verbal or physical aggression), it is usually a sign that they are not receiving adequate support in mastering their environments, both at home and school. In addition, their acting-out does not necessarily reflect willfulness, rather they lack the social skills needed to avoid be targeted as the “odd ball.”

After years of social failures, many young people on the spectrum literally give up. They simply stop trying to make friends and adopt an avoidant personality style (even though they may not have the formal diagnosis on Avoidant Personality Disorder). Teens with avoidant personality traits may display any of the following:

• view themselves as socially inept or personally unappealing
• use of fantasy as a form of escapism to interrupt painful thoughts and emotions
• tend to avoid social interaction for fear of being ridiculed and rejected
• self-imposed social isolation
• self-harm
• self-critical about their problems relating to others
• mistrust of others or oneself
• feelings of loneliness
• feelings of helplessness
• feelings of inadequacy and inferiority
• extreme sensitivity to negative evaluation by others 
• exhibits heightened self-doubt
• emotional distancing related to intimacy
• drastically-reduced or absent self-esteem
• depression
• avoids physical contact because it has been associated with an unpleasant stimulus
• avoidance of social interaction despite a strong desire to be close to others 
• anxiety
• agoraphobia
• a pattern of social inhibition

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

Treatment—

Treatment for HFA and AS teens with avoidant personality traits should involve psychotherapy led by a professional with specific experience in working with individuals on the autism spectrum. Treatment often moves slowly at first, because “special needs” teens who have experienced chronic peer-abuse have a tendency to distrust others, including some adults.

Treatment approaches often include the following:

1. Talk Therapy – This is a technique wherein the therapist leads the teenager in conversation about his experiences, attitudes and behaviors. It can be incorporated into any therapeutic approach. By maintaining a conversational dialogue about the teen’s fears, shame, and insecurities, he learns to be less sensitive to criticisms and rejection.

2. Social Skills Training (SST) – This is a form of behavior therapy that is used by therapists – and even parents and teachers – to help HFA and AS teens who have difficulties relating to others. A major goal of SST is teaching the teenager (who may or may not have emotional problems) about the verbal - as well as nonverbal - behaviors involved in social interactions. There are many children on the autism spectrum who have never been taught such interpersonal skills (e.g., making "small talk" in social settings, the importance of good eye contact during a conversation, etc.).

Furthermore, many of these “special needs” 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). SST helps autistic teens to learn to interpret these and other social signals so that they can determine how to act appropriately in the company of peers in a variety of different situations. When teens on the spectrum improve their social skills or change selected behaviors, they will raise their self-esteem and increase the likelihood that peers will respond favorably to them. Therapists learn to change the teen’s social behavior patterns by practicing selected behaviors in individual or group therapy sessions.

3. Psychodynamic Therapy – With this method, the counselor actively empathizes with the HFA or AS teen’s painful inner experience to build the trust relationship. The goal of this therapy involves helping the teenager develop a keen and accurate sense of self-awareness. The counselor then assists her in identifying unconscious thought processes that influence her daily behavior. As a result, the teen can examine and find closure for conflicts and painful emotions stemming from past dysfunctional relationships. The counselor will then use talk therapy to guide the teen in seeing connections between her deep personal shame and how it affects social and interpersonal functioning.

4. Group Therapy – Most counselors would recommend waiting until the HFA or AS teen has made some progress toward recovery before putting him in a group therapy environment. But for the teenager who is ready, group therapy can give the avoidant personality a positive social experience and help him accept feedback in a safe and controlled setting.

5. Cognitive Behavioral Therapy (CBT) – This approach assumes distorted and inaccurate thinking patterns create the foundation for avoidant personality tendencies. The counselor uses CBT strategies to change the distorted thought patterns by examining - and refuting - the truth of the assumptions surrounding them. For example, suppose a teen with autism strongly believes she is inferior to her peers and that others do not like her.

The counselor would test the validity of the teen’s belief by asking her to name a few friends who have enjoyed spending time with her in the past. The counselor may also ask the teen to talk about past social experiences that she enjoyed. In this way, the counselor shows the teen that people do enjoy her company and that social activities can be enjoyable. This demonstrates that the teen’s fear and insecurity about social situations are illogical and unsubstantiated. This technique is called “cognitive restructuring.”

If you have a teen with HFA or AS, you are dealing with many issues that parents of “typical” teens do not have to deal with.  The teenager on the spectrum is emotionally more immature than his peers. He may be indifferent - or even hostile - to your concerns. He may refuse to do ANYTHING other than play video games. And he may hate school with a passion because he is dealing with social ostracism or academic failure on a daily basis.

However, by utilizing some of the treatment methods listed above, you can help your teen to weather the storm of adolescence and prepare for the challenges of adulthood. There is no reason why the future cannot be a bright one if interventions are started early.

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

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

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

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

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

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

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

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

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

Aggressive Children on the Autism Spectrum: Advice for Parents and Teachers

“I’m an elementary school teacher in the Penfield Central school district. I have a young boy (age 7) in my class with high functioning autism that shoves other classmates impulsively. I have tried behavior modification. He will say what he did was wrong, and we will roleplay the proper way to handle his frustrations. However, he still pushes other students and is running the risk of being suspended. There seems to be no pattern or functional cause for these outbursts. I want to help this special needs student, but am running out of options. Does you have any ideas that may assist me!?”

The incidence of aggressive behavior in children with High-Functioning Autism (HFA) and Asperger’s (AS) is not uncommon – and occurs for a host of reasons. Faced with a world in which they find it difficult to interact socially, communicate clearly, and control their own emotions and behavior, young people on the autism spectrum sometimes respond with aggression toward others as a way to cope.

To be effective, interventions for aggression in HFA and AS children need to take the following factors into account:

1. Aggressive kids on the autism spectrum often don't even recognize – much less feel – the suffering of others. The lack of demonstrated empathy is possibly the most dysfunctional aspect of HFA and AS. Children on the spectrum experience difficulties in basic elements of social interaction, which may include (a) the failure to develop friendships or to seek shared enjoyments or achievements with peers, (b) the lack of social or emotional reciprocity, and (c) impaired nonverbal behaviors in particular areas (e.g., eye contact, facial expression, posture, gesture, etc.). Thus, one of the dynamics involved with your HFA student is the fact that, due to his disorder, he is not aware of the fact that he is actually “hurting” other students emotionally or physically at the moment he is pushing them away. Without that awareness, he sees no need to change his behavior.

2. Children on the spectrum suffer from “mind-blindness,” which is essentially the opposite of empathy and can be described as “an inability to develop an awareness of what is in the mind of another person.” Generally speaking, autistic kids are delayed in developing a “theory of mind,” which normally allows developing children to “put themselves into someone else's shoes” (i.e., to imagine the thoughts and feelings of others). Thus, kids with HFA and AS often can’t conceptualize, understand, or predict emotional states in other people.

3. Autistic children also suffer from “alexithymia,” which can be described as a state of deficiency in understanding, processing, or describing emotions, and is defined by (a) difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal, (b) difficulty describing feelings to other people, (c) constricted imaginal processes (as evidenced by a scarcity of fantasies), and (d) a stimulus-bound, externally-oriented cognitive style.

4. Most kids on the spectrum have difficulty processing everyday sensory information (e.g., sounds, sights, smells). This is called “sensory sensitivity,” and it can have a profound effect on a child’s behavior. “Typical” children process sensory information automatically without needing to think about it much. However, children with autism have difficulty processing everyday sensory information and are much more likely to become stressed or anxious – and even feel physical pain. This can result in difficult behavior. If the HFA or AS child gets sensory overload, he may experience a “meltdown” – or simply shut down. He experiences what is known as “fragmentation” (similar to being tuned into 20 TV channels at once).

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

5. For many kids with HFA and AS, aggression toward others is a powerful source of self-esteem, particularly if they lack other confirmation of their human worth. Kids with autism already know that they are “different.” Many – if not most – have already been teased, harassed, bullied and rejected by peers by the time they reach the 2nd grade. As a result, their self-esteem is exceedingly low. To compensate for this, many of these children will seek revenge in the form of aggression whenever they feel slighted. This is certainly not an excuse for aggressive behavior, but it does give parents and teachers some insight into a possible root cause of the dysfunctional behavior.

6. The HFA or AS youngster who engages in aggressive behavior often views the world as an unsafe place in which there are only victims and victimizers. Thus, they choose to be one of the latter (often times at an unconscious level). The power that is felt by hurting others – in combination with already numbed emotions – can make for a destructive mixture. Aggressive children almost always think of themselves as victims (e.g., of unfair teachers, of other bullies, of prejudice, etc.) and believe that their aggressive acts are therefore totally justified. If, for example, another student bumps up against them in the hallway, they may immediately take offense, certain that they were attacked. They can’t imagine that perhaps the bumping was just clumsiness on the other student's part or an attempt to tease that really wasn't hostile.

7. Aggressive behavior in children with HFA and AS is usually a result of anxiety, which leads to difficulty letting go of an issue and "getting stuck" on something. This is rigidity, and it is the most common reason for behavioral problems. Understanding your HFA student involves knowing the traits associated with the disorder and how they manifest themselves in everyday behaviors. How does your “special needs” student see the world, think about matters, and react to what is going on around him? Reasons for rigidity in children on the spectrum include:

• a misunderstanding or misinterpretation of another's action
• a violation of a rule or ritual; changing something from the way it is “supposed” to be; someone is violating a rule, and this is unacceptable to the autistic youngster
• anxiety about a current or upcoming event, no matter how trivial it might appear to you
• immediate gratification of a need
• lack of knowledge about how something is done; by not knowing how the world works with regard to specific situations and events, the autistic youngster will act inappropriately instead
• internal issues (e.g., attention difficulties, oppositional tendencies, depression, anxiety, other psychiatric issues)
• the need to avoid or escape from a non-preferred activity, often something difficult or undesirable
• the need to control a situation
• the need to engage in - or continue - a preferred activity, usually an obsessive action
• difficulty transitioning from one activity to another

The following video contains information that is especially important for teachers as they try to make sense of the HFA or AS child’s thoughts and behaviors:

Here are some specific strategies teachers and parents can employ to reduce aggression in children with HFA and AS:

1. Children with HFA and AS have difficulty expressing emotions. Sometimes stress over not being able to verbalize frustration causes aggressive behavior in these young people. For example, if the youngster is angry because he can't button his coat, but is unable to describe how he feels about lacking that skill, he may act-out aggressively. Examining the root problem and addressing it can help to curb aggression. Calm reactions on the part of the teacher or parent are important here.

2. Sometimes aggressive behavior is predictable. For example, does wearing a warm winter sweater cause the child to become upset? Maybe the fabric feels uncomfortable against his skin, or the smell of the drier sheet is offensive to him. Examine every component of a situation that seems to trigger aggressive actions and make the necessary adjustments.

3. If aggressive behavior has developed suddenly or has gotten worse over time, then find out if the youngster has a food allergy. Other factors to consider are environmental conditions, change in medication, or a change in the home or school setting. Some drugs contribute to aggression. Also, seasonal or food allergies can cause discomfort that the youngster can't describe, leading to extreme behavior.

4. When the youngster with autism acts-out, the family may blame him for ALL the family's dysfunction. Oftentimes, I will see a family that will present an aggressive youngster for treatment. This is the sacrificial lamb for the family's toxicity. Moms and dads need to examine their own behavior, and if need be, the entire family should seek counseling.

5. Medications are frequently used in the management of aggression, and current psychopharmacologic treatment strategies involve treating aggression as part of each particular syndrome. Before prescribing medication for aggression, the clinician should ensure that the child has a medical evaluation to rule out contraindications to treatment and to determine whether the aggressive symptoms may improve without the use of drugs (e.g., through the use cognitive-behavioral therapy). A psychiatric evaluation is also necessary to determine whether depression, anxiety, or other problems are present. Treatment of these conditions may also result in reduced symptoms of aggression.

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

6. Try to promote appropriate social interactions and help the HFA or AS student “fit-in” better. Social-skills training can take place both in the classroom and in more individualized settings. Approaches that have been most successful utilize direct modeling and role-playing at a concrete level. By rehearsing and practicing how to handle various social situations, the youngster can learn to generalize the skills to other settings.

7. Try to insure that school staff outside of the classroom (e.g., PE teacher, bus driver, school nurse, cafeteria monitor, librarian, etc.) are familiar with the HFA or AS youngster's style and needs. Those less structured settings where the routines and expectations are less clear tend to be difficult for children on the spectrum.

8. Teachers should take full advantage of the youngster's areas of “special interest.” The HFA or AS youngster will learn best when an area of high personal interest is on the agenda. You can also use access to the special interests as a reward to the youngster for successful completion of other tasks, adherence to rules, and meeting behavioral expectations.

9. Put as many details as possible into an IEP so that progress can be monitored and carried over from year to year. It may be helpful to enlist the aid of outside consultants familiar with the management of young people on the autism spectrum (e.g., psychologists, psychiatrists, etc.).

10. Most autistic students respond well to the use of visuals (e.g., schedules, charts, lists, pictures, etc.).

11. Kids on the spectrum can be fairly rigid about following "rules" quite literally. While clearly expressed rules and guidelines (preferably written down) are helpful, they should be applied with some flexibility. The rules don’t automatically have to be exactly the same for the autistic youngster as for the other students, because his needs and abilities are different.

12. Keep teaching fairly concrete. Avoid language that may be misunderstood by the HFA or AS youngster (e.g., sarcasm, confusing figurative speech, idioms, etc.) Try to simplify more abstract language and concepts.

13. If motor clumsiness is a significant problem, an Occupational Therapist can provide helpful input.

14. HFA and AS kids often don’t understand rigid displays of authority – and will themselves become more rigid and stubborn if forcefully confronted. Their behavior can then get rapidly out of control. Thus, sometimes it’s better for the teacher to simply back-off and let things cool down. When possible, anticipate such situations and take preventative measures to avoid the confrontation through presentation of choices, negotiation, and diversion of attention elsewhere.

15. Classroom routines should be kept as consistent, structured and predictable as possible. Students with autism usually don't like surprises. They need to be prepared in advance for changes and transitions (e.g., schedule breaks, vacation days, etc.).

Teachers need to educate themselves about autism spectrum disorders – and how it affects behavior and the learning process. Without a clear understanding of HFA and AS, teachers will not understand the affected child’ motivations or behaviors. Actions that are clearly a part of the disorder can be confused with defiance and dealt with inappropriately. Oftentimes, the child on the spectrum who is acting-out with aggression or other forms of behavioral problems is not making a concerted effort to be oppositional, rather he is trying to cope in a world that feels hostile to him.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> 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


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

COMMENTS:

•    Anonymous said… Absolutely. My daughter was having the same issue and come to find out the kids were teasing her.
•    Anonymous said… Could u maybe try to explain that because he has so much amazing energy that you could really use his help with an extra job you need some help with. Keep him extra busy , stimulated something that will help redirect the energy but also keep him engaged feeling great but that he is in control of himself and the situation( this being a healthy way)
•    Anonymous said… Draw two stick figures, one is labeled with your student's name. Show the other figure pushing your student. Ask him how his stick figure feels. Make it visual. I hope this makes sense- It works great!
•    Anonymous said… Emotion coaching - to allow you to make a connection with the child to find out what is going on in their world, it highlights that you care what they are going thru before you jump to the conclusion of what has happened.
•    Anonymous said… Have you incorporated Sensory Breaks into his school day? My son needs large muscle motor input breaks to regulate his mood. i.e.: the teacher has him carry to filled jugs of water to the office each morning, he also " gets" to help pull down the tables in the cafeteria and push them up at the end of lunch, he does pull ups and stairs when he is fidgety and sometimes pushed the book cart around in the library. These are things OT can help schedule throughout a student's day that are calming
•    Anonymous said… He is copying what is done to him behind teacher's backs. Or he is responding to these kids. These kids just are able to hide it better. Once a kid was pinching my daughter behind her back where I couldn't see. She finally admitted to it, why my daughter was hitting her.
•    Anonymous said… Honestly, sometimes I am happy she knows how to push back and doesn't take crap from anyone, but i know don't lay your hands on people.
•    Anonymous said… I agree that it is probably a reaction to something. Is it always at a certain time ie in line, when he's physically close to other kids? Could be a sensory thing ie reaction to light touch or pushing, or sensory seeking,or reaction to kids words, looks or taunts. Having had 2 of my 3 kids bullied, mean kids know how to stay under the radar.
•    Anonymous said… I found a boy i helped with at school would do this to remove people from his personal area, he would kick and push people who walked past him, i found if i moved him to the side of a foot traffic area, preferably more than an arm/leg length, and gave him another form of sensory distraction, in his case it was holding one of my braids or an earring so his touch was occupied he was able to focus more on the task without having the impulse to 'touch'(kick and punch) other people that happened to venture past him
•    Anonymous said… I love that you are asking here for advice... my son went through hell at primary and was always blamed in incidents .. he wasn't diagnosed until high school ... usually other children knowing his triggers would sneakily do something then sit back and watch the drama knowing my son would be sent home or suspended.. breaks my heart as I was always asking him to apologise ... now he finds it hard to deal with authority
•    Anonymous said… I'll bet that technically his behavior is not aggressive but rather is reactive-- at least in HIS mind he's protecting his space or defending some line. Or, as Trina outlines above, frustrated at others stepping out of line.. Aspies tend to have very linear thinking, and are big on following rules, so adults need to teach them to live within a "no touch" rule, and provide an alternate behavior to diffuse the frustration. Oh, and meds may help lengthen his fuse.
•    Anonymous said… It could be a sensory issue. What if he had some time in a motor room or by himself to take a break and do some wall push ups? Scheduled breaks to decrease sensory over load before it occurs work better than randomly waiting until you ( or he) think he needs a break.
•    Anonymous said… My 10 year old is this way with younger brother. I just hope it never happens at school.
•    Anonymous said… My daughter does this exact thing, no matter how many times we all try to explain, she can't see to control it....
•    Anonymous said… My daughter used to get enraged with the kids around her at that age because they weren't following directions. She would follow the rules but others around her would be talking or turned around-touching walls or art hanging from the walls. She would usually start by stating the rule to them quietly; offering to help them but she would end up screaming at them. She had a couple of kids who were button pushers and they would make faces at her. I would try moving him to the front of the line or give him a job in line that requires carrying something for the teacher or himself. I'd prefer a child not have a fiddler or something out of the ordinary as the goal is to learn age-appropriate behaviors that they can continue to refine.
•    Anonymous said… My daughter was the same, from primary where the boy nxt to her poked her with a pencil then laughed when she lost it in class to being beaten up in college for her smart mouth instead of just walking away  :( And no amount of trying to explain to teachers worked either
•    Anonymous said… my son is the same age and does the same thing. He is in an EC class. Rewards don't work for him. All of his teachers since preschool agree that rewards do not work for him. My son only has 7 kids in his class and is not being bullied. I know a lot of kids are. My son does get suspended for any pushing offense.
•    Anonymous said… My son was like that, HFA now 8. He felt he should take things into his own hands, like he was on par with adults. I think the main cause behind it though was was suffering with high anxiety at the time between sensory difficulties and struggling to cope in the normal school environment without and support (prior to any diagnosis). I believe over time it has improved but reality is though children with AS can be easy targets in school, whereby other children deliberately target them to frustrate them in order to receive a reaction- as was in my son case some of the time. Other times it was misunderstanding a social situation. I would say since he was support with part time SNA, Resource hours, visual schedules, Movement breaks, OT as well as overall others adults having a better understanding of his needs he is generally less likely to behave in this manner (I guess he hasn't got the same level of anxiety). I also completed a social story about adults being in charge. And most importantly when my son finally did approach a teacher or member of staff about a grievance he was listen to and it was addressed. When he does this I make a point of telling him well done, highlighting that this was the best option and we discuss the "what if" had he not done so. Bear in mind typically he would have difficulties expressing his angry verbally, restraining him self from reacting and was normally in Trouble with the staff for his physical behaviour! Eventually things did change, but we still have moments, more so at home on hitting when tired, frustrated etc
•    Anonymous said… My son will explain to me (when he's calm) what instigated it, there could have been an incident that occurred some time ago but there is always a trigger
•    Anonymous said… My son's aggression vanished once the teacher implemented Sensory breaks every 1-2 hrs. Swueexing TheraPutty is also a nice break, chewing gum , bouncing on a therapy ball or minitramp.. It just might prevent a suspension
•    Anonymous said… My suggestion is to investigate whether or not the other kids in the class are doing things that trigger his behavior. Many times a spectrum kiddo with react to something like name calling or other types of bullying by becoming aggressive and sadly, many times, the focus is only on the spectrum kiddo. As care givers (and I count teachers in that category as well) we have to broaden our thinking. Consider how you might want to behave if your co-workers treated you differently by bullying you in some way. Now consider how a child has less ability to control their emotions. Talk with him maybe do a timeline of the last couple of days in class to see if you can find a trigger to his behavior. I do a linear timeline like "So you got to school and what did you do first?" "And then what happened?"... and so on. You might be surprised at what you find when you explore his world a little more closely. Social isolation and harassment can make people of any age become aggressive and most kids on the spectrum are treated vastly different because they behave differently. Also consider what his options are if he is getting mistreated by classmates. For instance, does he have the option of having sensory breaks? Does he have a person he can go speak to about things that make him upset outside of the classroom? Does your school have a "safe room" for kids to go to when they're feeling overwhelmed or angry? All of these things make a child feel as though they are welcome and cared for in the school environment and all too often schools don't take the time to make small adjustments that provide a more inclusive environment for everyone. I appreciate that you care enough to put the question to the group. I hope some of my suggestions are helpful.
•    Anonymous said… Other kids do things to my son in class that frustrate him. High functioning autism is hard because we forget how sensitive they really are. The smells, the sounds, even how something feels can throw them over the edge. Parents have to be involved with home intervention as well. It takes a village.
•    Anonymous said… reward system for not shoving is necessary. He won't learn anything just by reminders, he does not have the empathy or social skills to understand his affect on others, he just does what comes naturally. A social story is a start, but definitely needs a reward system to make him feel motivated to change.
•    Anonymous said… The issue is sometimes it's just rage. They have no control. They don't even remember whats just happened sometimes. Its not behavior. It's a response.. prevention is better than a cure. Triggers can be something not so obvious.. over stimulation, irritation... learning the triggers is hard because they're not always obvious but its the only way  :(
•    Anonymous said… The only person my 10 year old high functioning aspie is aggressive with is his older brother. He happens to be a button pusher and knows every single button to push. Start watching for the subtle ways your student's buttons are being pushed. They are there I promise.
•    Anonymous said… There may "seem to be" no cause, but get someone to actually watch the class for a while and you might find some kid is very sneakily winding them up while no one is looking. It's surprisingly common. Apart from that look fir triggers, other kids too close, background noise, florescent lights. Neurotypical folks gave no idea just how maddening those things can be.
•    Anonymous said… Watch what the other kids are doing to him. Observe. You may see whispered taunts, them making faces at him, anything to get him into trouble for this. "Accidentally" shoving into him as they walk past.

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Hypotonia in Kids on the Autism Spectrum

“My 10 year-old child with high-functioning autism is very smart, but he is very, very poorly coordinated. He has difficulty riding his bike, bowling, catching, hitting a tennis ball, kicking, shooting a basketball, diving in a pool, swinging a bat, and throwing. He can't run fast without tripping, and he has terrible posture. As an infant, he was a later walker (almost 17 months). He was a very sloppy eater, and still has trouble cutting with a knife or the edge of his fork. Also, he had some speech articulation issues. We were hoping he would grow out of all this, but he hasn't. I wonder if there is anything we could do to help him be less awkward. Does what I've described sound "normal" for some children with autism? Or does it sound concerning? How physically uncoordinated should he be before we try to get professional help for him?”


Many children with High-Functioning Autism (HFA) have a comorbid condition called Hypotonia, which is sometimes referred to as "floppiness." This is because the muscles are meant to help support the skeletal system and are designed to prevent certain kinds of motion. Because the muscles are not especially tight, children with Hypotonia frequently experience "hypermobility" (i.e., the ability to move limbs into awkward positions). They often find that they're able to very easily carry out feats that require flexibility, but not strength or balance (e.g., splits, back-bending, shoulder rotation, etc.). Also, they may display uncommon flexibility in other joints (e.g., fingers).



This kind of flexibility comes with a price. HFA children are generally very uncoordinated and awkward. In running, this plays a role in the so-called "unusual gait." A myth is that muscle tone just impacts the large muscles, but this is not the case. Muscle tone impacts all activities requiring muscles (e.g., speech, pencil grip, writing, etc.).

Hypermobile joints are less stable than usual, which means that the HFA youngster needs stronger muscles to support the body. The increased compliance (i.e., give) in the connective tissue also affects the blood vessels and internal organs, which can lead to constipation, trouble with bladder control and voiding, and low blood pressure.

Hypermobility affects the development of motor control in many ways. Since the joints are naturally less stable, more muscle strength is needed for proper posture and movement control. Young people with hypermobility have difficulty climbing, gripping a pencil for drawing and handwriting, hanging from monkey bars, managing stairs, running, sitting erect while working at a table, and walking long distances. Also, these kids often have tight muscles in the hips and shoulders, which affects shoulder movements needed for drawing and handwriting, as well as sitting comfortably on a chair or cross-legged on the floor.

==> Parenting Children and Teens with High-Functioning Autism

Due to tightness in the hip muscles, the affected child will often experience pain in the legs following exercise, or when he or she is going through a growth spurt. The youngster often has an increased tendency to respond negatively to discomfort, which can make night pain related to exercise very troublesome. In addition, toe walking is often seen in these children, which is associated with tightness in the calf muscles and the muscles crossing over the back and sides of the hips and legs. In most cases, children who walk on the toes have hypermobile joints. 

Fine motor skills are hard to learn if you have autism. These fine skills are essential for drawing or coloring, grasping objects, riding a bike without training wheels, zipping-up jeans, and tying shoelaces. However, when muscle tone is low, these skills are much harder to perform properly.

When an HFA child isn't proficient at something (e.g., riding a bike), but all his friends can do it, this deficiency can create a sense of isolation in the child. Imagine watching all the other kids in your neighborhood doing various activities very easily while you don’t appear to have the same abilities. Consequently, HFA children can start thinking they're “dumb.” This is definitely not the case. Intelligence has nothing to do with it!

HFA children often slump a great deal when seated or standing for long stretches. Occasionally, they'll stand with their legs crossed in what seems to be an uncomfortable manner. Even though this appears painful, this is really an extremely comfortable position for these kids. Additionally, they frequently sit with their head and shoulders rolled forward, and will often lean on walls, furniture, door frames and desks. Moms and dads of kids on the autism spectrum will probably be very familiar with being "leaned on."

Hypotonia doesn't prevent HFA kids from enjoying themselves, however. They are able to run and have fun with other kids without feeling any harmful effects. The issue is that they are a little slower and tire easier. Consequently, team sports (e.g., soccer, basketball, football) are often not suitable to these children.

While the slumping and leaning habits are not necessarily good posture, they are not particularly harmful to the child, unless of course the position is adopted for very long intervals without proper breaks.

Usually, kids are believed to have Hypotonia because they have poor postural stability and poor performance on movement tasks. The presumption is made that these issues result from Hypotonia, but this isn't always the case. HFA children may have problems with understanding movement skills and obtaining basic strength needed for action for a combination of reasons (e.g., joint hypermobility, a fearful temperament, difficulty with the thinking skills needed for learning, difficulty predicting what happens next, the inability to learn from watching other people and from their own experience, etc.). Thus, the real issue is not what you can do for an HFA child with Hypotonia, but instead what you can do to improve overall performance on age-appropriate movement tasks. This depends on the underlying reasons for the child’s problems, which may or may not have anything to do with Hypotonia.

Children with HFA (ASD level 1) can have a comprehensive assessment by a physiotherapist and/or occupational therapist to determine the nature and degree of the problem. Listed below are a few of the areas where motor clumsiness is evident, and some ways of improve specific skills:

1. Rapid Movements— Research has noted that, while engaged in activities that require motor coordination (e.g., cutting out shapes with a pair of scissors), a significant percentage of kids with HFA were known to hurry through the task. They seemed to be impulsive, unable to take a slow and calculated approach. With such haste, errors occur. This is often infuriating for the child and the teacher. The child may require guidance and reassurance to work at a suitable pace, having time to correct mistakes. Occasionally the youngster can be asked to slow down by having to count between actions and using a metronome to indicate a suitable pace.

2. Manual Dexterity— This area of movement skills involves the ability to use both of your hands (e.g., learning to dress, tie shoelaces, eat with utensils, etc.). This may also extend to the coordination of feet and legs (e.g., learning to ride a bike). If the HFA child has problems with manual dexterity, a good technique to help is "hands on hands" training (i.e., a parent or teacher physically patterns the child's hands or limbs through the required movements, gradually fading out physical support).

3. Locomotion— When the HFA child walks or runs, the movements may seem awkward or "puppet" like, and many of these kids walk with no associated arm swing. There may be deficiencies in upper and lower limb control. This particular feature can be very noticeable, and other kids may mock the autistic child, resulting in his or her desire not to take part in running sports and physical education in school.

==> Parenting Children and Teens with High-Functioning Autism

A physiotherapist or occupational therapist can develop a remedial plan to ensure the child’s movements are coordinated. Therapy can include the use of a large wall mirror, video recording, modeling, and imitating more "fluid" movements using music and dance. An intriguing fact is that the ability to swim seems least affected, and this exercise can be encouraged to allow HFA kids to experience genuine proficiency with movement.

4. Handwriting— A teacher may invest a lot of time interpreting and correcting the HFA youngster’s illegible “chicken scratches.” The child may also be aware of the poor quality of his handwriting and may be hesitant to take part in activities which involve extensive writing. Unfortunately, high school instructors and potential employers consider the neatness of handwriting a way of measuring intelligence and character. As a result, the young person on the spectrum may get embarrassed or upset at their own inability to write neatly and consistently. The child may need an assessment by an occupational therapist and remedial exercises, but today's technology can help reduce this issue.

Kids on the autism spectrum are often very competent at using computers and keyboards, and they may prefer typing over writing homework and exams. In this case, the presentation of their work is then similar to the other kids. A parent or teacher could also act as the youngster’s scribe to guarantee the legibility of her written answers or homework. The ability to write longhand may become a lot less important in the future.

5. Basic Skills— Catching and throwing precision seems to be especially affected in HFA children. When catching a ball with two hands, the arm movements of the child are often badly coordinated and affected by problems with timing (e.g., the hands close in the correct position, but a fraction of a second too late). One study noted that children on the spectrum would frequently not look in the direction of the target prior to throwing. Clinical observation additionally indicates that they have poor coordination in their ability to kick a ball.

One consequence of not being proficient at ball games is the exclusion of the HFA child from some of the most well-liked games on the playground (i.e., kick ball). These “special needs” children may avoid such games simply because they understand they lack proficiency, or are intentionally excluded since they're a liability to the team. As a result, they're much less able to improve ball skills with practice. From an early age, mothers and fathers should help their child practice ball skills in order to guarantee that he has fundamental proficiency to be included in the games. The child can be enrolled in a junior soccer or basketball team to enhance coordination and to learn to play specific games. It's also vital that you have your child’s eyesight examined to determine whether wearing glasses enhances hand-eye coordination.

6. Balance— In HFA children, there can be an issue with balance, as tested by analyzing the ability to stand on one leg with eyes closed. A number of autistic youngsters are not able to balance when placing one foot in front of the other (i.e., tandem walking, which is the task of walking a straight line as though it were a tightrope). This may affect the child's ability to use some playground equipment and activities in the gym. The child may need practice and encouragement with activities that require balancing.




Here are some exercises for babies and younger children with Hypotonia to develop fine motor skills:

• Use deep pressure massage on the hands and feet, focusing on the pad of the big toe and each of the fingertips.
• Talk to your child often. Tell him what you're doing, especially when bathing, grooming, dressing or changing him. Verbally repeat each step in the process often. Play mimic games with your child, repeating the sounds he will naturally make. Encourage him to make sounds by making faces, singing, and talking nonsense syllables.
• Rub the hands and feet together, first left hand to left foot, then right hand to right food, then across the body.
• Resist any thrust of your child's legs while you're holding her, and hold her often in a standing position while supporting her well in the torso. 
• Play patty cake and patty foot to bring hands and feet into the center of the body.
• Place toys or objects at the midline of the body and encourage drawing the limbs in to pick these objects up successfully.
• Use small beanbags for weights and movement training.
• Place child-safe mirrors on crib walls or down near the floor where your child can see himself often. This helps increase his self-image and self-reflection.
• Make a safe place for your child in every room of your house, and bring her along as you go about your normal routine. The frequent changes in environment and constant contact with you will help stimulate your child's mind and awareness.
• Lightly brush from the heel to the toe on each foot and from the base up to the fingertips on each hand with light massage strokes or a soft 1-inch paintbrush.
• Hold bright or desirable small objects out, encourage reaching for it and praise any attempt or success to do so.
• Help your youngster to do occasional rounds of heel walking, where all of her weight is balanced on her heel and her toes stick in the air.
• Give your baby a lot of smiles, hugs and cuddles. This both increases emotional bonding and stimulates his senses.
• Use a backpack with books or toys in it for weight training.
• Expose your child to as many different pleasant stimuli as you can think of (e.g., mobiles, wind chimes, patterned cloth for crib sheets and bumpers, musical or noise toys in bright primary colors, etc.). Primary colors are bright red, blue and yellow. Babies see high-contrast things the best, and love these colors. An effective tactic that some parents have used is to cut out suitable pictures from magazines and placing on the baby's walls, which allows the frequent change-out of pictures needed to give stimulation without breaking the bank.
• Draw feet up to the baby's mouth, circling the mouth with each big toe. Repeat with hands and fingertips in order to increase awareness of extremities and oral motor control.
• Create tape recordings of your child's own sounds, the sounds of your family, and appropriate music. Play these tapes often, and dance your child around rhythmically in your arms during music or sounds. This helps her to become aware of her own body.

 ==> Parenting Children and Teens with High-Functioning Autism

Treatment—

Speech and language therapy: A speech and language therapist can assess your HFA youngster’s feeding and swallowing, and help identify swallowing problems that can sometimes be associated with Hypotonia. The therapist will also be able to make recommendations about feeding support.

Occupational therapy: Occupational therapy teaches the child the skills needed to carry out day-to-day activities (e.g., the therapist may focus on improving your child’s hand and finger skills needed for dressing and feeding). Your child will also be taught exercises and tasks she can perform on a daily basis. Equipment to help her move around more easily may also be recommended (e.g., ankle or foot supports if the child’s ankles or feet are affected by Hypotonia).

Physiotherapy: A physiotherapist will assess your youngster’s muscle tone and ask him to carry out a series of exercises and tasks. In treating Hypotonia, the main objectives of physiotherapy are to strengthen the muscles around the joints of the arms and legs so they provide more support and stability, and to improve posture and co-ordination to compensate for low-muscle tone. The therapist will design a program that includes a range of exercises for your youngster to do on a daily basis. Therapy will be integrated into your youngster’s daily routine and everyday activities, both at school and at home.

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

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

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

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

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

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

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

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

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

COMMENTS:

•    Anonymous said…   Lots of kids with ASD have movement issues due to the lack of priopercepitation, the input from the environment to their bodies. Spatial awareness is often affected. Anytime you have an issue with sensory processing you will issues with the "body in space" concept. Lots of kids seem to have hypotonia but actually have a lack of sensory input from their body. Hypotonia can be comorbid. So can Dyspraxia (dyspraxia is on the Developmental Coordinator Disorder Spectrum), but Dyspraxia is literally the abscence of any other explainable reason for movement oddities, so most kids will only get that DX at an older age.
•    Anonymous said…   My son 9 is exactly the same he can't dress himself, ride a bike, swim do his own shoes etc even though we practice every night.
•    Anonymous said…  It's unfortunately normal. My 13 yr old son has HFA and still can't tie his shoes, prefers to eat with his hands (even with this he still uses what I call a "mitten hand" grasp), and just cannot play team sports. Being in middle school and having these difficulties is devastating, particularly because he is very intelligent and in all advanced classes. We are fortunate enough to have two boys right in our neighborhood who have accepted his quirks and give him a ton of leniency when they try to play kickball, but if anyone else joins he usually just quits rather than be embarrassed. He's always been a toe walker and routinely complains of pain in his hips too. I hate it but there isn't really anything I can do that I haven't already done...
•    Anonymous said…  Kids on the spectrum tend to have difficulties with bilateral coordination. The OT I spoke with about my daughter said she suspected its due to the limited communication between the two hemispheres in the brain.
•    Anonymous said…  My 19 year old struggles to spread peanut butter with a knife. He does his best, but it's a mess. Sometimes to anoint of frustration for him. We keep supporting him to be independent...meaning we clean up the counter often!!
•    Anonymous said…  My 27 month old daughter just started crawling (after lots of PT). Her hypotonia was diagnosed when she was 13 months old. Hypotonia can actually effect some parts of the body than other. She mostly has issues in her legs; her feeding and fine motor skills have not been affected whatsoever. There's a supportive Facebook group called Hypotonia Parents that has been useful.
•    Anonymous said…  My 9 year old daughter is HFA and just learned to tie shoes. She is also uncoordinated and seems to trip over her feet a lot. She did some OT and that helped her a lot.
•    Anonymous said…  My Aspie boy just finished 15 mo. of intense Occupational Therapy/Physical Therapy and Speech Therapy. He is showing some improvements in all areas. I've been told by both of his physical therapists that swimming and rock wall climbing next would continue to improve his balance, bilateral coordination and endurance. He's been given yoga ball activities for home maintenance.
•    Anonymous said…  My daughter is 10 and has the same issues. Sports, gymnastics, riding a bike, skating etc are all things she has no coordination to do. She can however swim. She is very clumsy, can't tie shoes or even a simple knot. Her vocabulary has always been extensive. And she is super smart. But exercise is simply not her thing...except for swimming. She does ride a bike now but just learned last year.
•    Anonymous said…  My son had some minimal improvements with OT and speech, but not a significant amount. These therapies aren't cure-alls... and I'm sure most of us have tried OT (for years). I'm hoping to hear other suggestions...
•    Anonymous said…  My son has asperbergers. Most of your issues fit however my son was an early Walker and taller with an extensive vocabulary. I had to pull him out of high school is junior year because of sensory issues. He's 22 and still can't ride a bike, tie his shoes or skip. He is in college this year with a 4.0 GPA. One thing to remember about these kids is that they don't fit into a box. They are all unique.
•    Anonymous said…  My son has had some of these delays. He still can't swim. He's finally riding a bike. I noticed that he was sort of like a wet noodle on his bike - very hunched over and all over the place and I kept talking to him about keeping his back straight. That concept seemed very foreign to him and I don't think it's something you typically have to tell kids. It made me wonder if something like horseback riding therapy would be or would have been helpful. I think balance and core strength could be a big issue. I haven't done it but I've heard wonderful things from other parents about it.
•    Anonymous said…  My son has this as well. He walked at 22 months and still struggles with sloppy eating, riding a bike, etc. He is almost 9
•    Anonymous said…  My son was advised to throw a tennis ball against the wall...this has really helped his coordination so much..
•    Anonymous said…  Occupational and Physical therapy can help address these issue. Please seek help as soon as you can. Sooner is better.
•    Anonymous said…  Occupational and physical therapy will help. Also, hitting a ball off a T, as in t-ball helped my son.
•    Anonymous said…  Read some stuff by sally Goddard. It helped me find a therapist that works on the mid line coordination as well as other things  :)
•    Anonymous said…  Team sports have been disastrous.
•    Anonymous said…  The definitions of disabilities changes more often than the public knows. There's actually a government handbook of these. Schools can provide speech, occupational therapy, and social skills class Three of my kids go to these. My daughter diagnosed with Aspergers is 11. She has none of those problems but my other two do. My son can't do buttons and lacks fine motor skills. I had always thought it was because he started video games at two and is obsessed with them. Other parents with gaming kids don't have that problem mostly. Speech helped a lot BC her teacher makes it fun n I didn't stop harassing school until they did it there too. All kids are different, that's why theirs a spectrum theory. Too many symptoms are available.
•    Anonymous said…  The Masgutova Method has saved my kid's life
•    Anonymous said…  We have spent the last year with frequent medical tests trying to find the reason why our 20 year old with HFA / Aspergers is having spine, joint issues... this describes her as a child exactly and now as an adult i am beginning to understand that the hypotonia has become a long term contributor to major issues she is now struggling with... we didn't get a clear diagnosis until a couple years ago!
*   Anonymous said... My 9 year old HFA/AS son still can’t manage a bike- even with training wheels. I just explained to him that everyone has different talents and there are a lot of children that are good at sports but they can’t recite all the presidents (including years of their presidency and how they died!) )like he does... Strengths and weaknesses are in each one of us. 

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COMMENTS & QUESTIONS [for March, 2017]

 Do you need some assistance in parenting your Aspergers or HFA child? Click here to use Mark Hutten, M.A. as your personal parent coach.

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Mark,

I find there a lack of supports where I live. Since he's been kicked out of school (behavior and substance use)and now having to attend the At Risk Youth Program for schooling, I am still concerned that my son is not getting what he really needs which is:
-Coping Skills
-Learning realistic thinking and emotional regulation skills
-Learning to take responsibility for his doings/ and show remorse.
-pro-social communication
-learning self control and how to control his impulses
-Problem solving
With being 6 months away from being 18 (considered an adult here in Manitoba Canada) he is no more near appropriate acting age which scares me. I worry that he has few anti social traits and will turn into that for adulthood.

What are your thoughts on Dialectical Behavior Therapy for ADHD and ODD?

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Mark,

I try, I'm all about structure since he was little after my schooling in child psychology.

Funny you say military, we are a military family... This is why I believe we struggle with patenting. My husband is very drill sargent authoritarian and I am authoritative... I've always been the parent to sit my kids down and discuss stuff, talk about what we did wrong, how we can make better choices and what kinds of ideas we can do next time we're in that situation.....

So far my week with him has been fabulous.
He managed to only disrespect my rules once of the drugs being done in my house, and actually did when his dad was home, which dad in return flushed down the toilet. My son proceeded to call him a effing dink. Normally my husband would have reacted hugely and done something, but instead he says he has followed through with ignoring the behavior.

I hope and pray I'm on the right track, not sure how much longer I can live in chaos.

Thanks for your words, advice and direction.

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I am emailing to see whether your program will work for me. In a nutshell, I have more behavior problems from my husband that is worse than both of my children put together. He has been diagnosed with ADHD in the past and i am constantly having to talk with him about his behavior and the destructiveness it causes in the household. Whenever I do try to engage him in a mature manner he gets worse. He deliberately does exactly what you ask him not to do and when I ask him to stop he makes rude noises, gestures, he twists it and it is always my fault. I feel so frustrated because I already have two children and there are many days that are completely and totally taken up with him and his behavior to the point my other two children get left out or subject to the best mustered up care I can give them under the circumstances. If i am working with one of my actual children, he will come along and undermine everything i am doing. I often feel robbed of a household other women take for granted. I do not have the luxury of having relaxing evenings at home, and anytime he does happen to be up in the mornings during the week, he creates chaos. I literally have to wait till he goes to work before i can get anything done around the house and find myself having to hide my attempts at running an effective household or he meddles and nothing i try to accomplish becomes a reality. He makes very little attempt to behave in an adult way, yet expects intimacy like an adult. I am at my wits end.

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Dear Mr. Hutten,
I must start by expressing my immense gratitude for all your work. Your articles, books, and videos have been a life saver and an impotence for me to try again to repair my marriage.
My husband and I have been married for almost 25 years. We have 8 children together. Our oldest is married and has his own baby. We have stayed committed to the relationship albeit a challenge from the very beginning.
The first fifteen years of my marriage were primarily dictated by my husband's (obsessive) studying. I was very supportive of his efforts, and  our families helped us out financially. I took on all of the family responsibilities. I single handily took care of the children, shopped for everything, payed  the bills ,and managed all our vacations and outings.
When we did spend time together there were always misunderstandings. He was very rigged in his thinking and I spent so many years negotiating  to get him to be flexible about almost everything. He is a loner personality. So convincing him to reach out for advise or help has been my biggest challenge.
I thought he suffered from ADD, OCD, and social anxiety.
The last 10 years have been a mini hell on earth. Our families wanted us to become financially independent. Naturally I took on that burden once again. My husband has never had a job. I was pregnant with my last child when I started to deteriorate emotionally. My husband was going through a depression. I think he was finally coming to terms with his limitations. He could no longer hide behind a book.
This was around 2008. Our investments were not producing and money was difficult for everyone. At that point I was living over seas. My extended  family had moved back to the US and I was left with a large family to care for by myself. Of course   my husband was by my side but more like a child than a partner. In addition he required that I treat him like a partner and with an unusual amount of respect. He was so insecure that everything I said was consistently misinterpreted.
When I would get angry or hurt, he would then retreat and I became the aggressor.
I started experiencing postpartum depression. I got on medication but it made me very tired. The family started falling apart and my mother insisted we come back to live near her in Florida.
It was traumatic to move an entire family. Many of my children did not read or write English. I had to find a job and I was coming with 3 children who were challenging. Two with ADHD and one who we finally got diagnosed (several month ago) with AS/HFA.We moved to Lakewood, NJ for the many resources available to families in our Orthodox Jewish Community.
After facilitating every opportunity, I waited and waited for him to get a job. It never happened. I was attached to him in an unhealthy way showing signs of co dependence. I tried to get help for myself. We tried marriage counseling. He tried getting help for OCD. We tried imago therapy. But as much as we wanted to make it work that is how much it just didn't.
We separated and it was painful for everyone. My kids were just relieved that there was no more fighting, meltdowns, and crying fits. I have started repairing.
At first we were not having any communication I was worn out and he cut himself off from me. My sister started becoming the go between and she brought it to my attention that he has Aspergers. I had always suspected it, but I was in denial, mainly because I really didn't know enough about the syndrome.
My AS son sees a nurse practice monthly for medication refills. Several months ago we saw her and I told her about our separation. She also sees my husband regularly for Prozac and Vyvanse. She assumed I knew he had Aspergers and started discussing it with me. I wasn't sure how it was so clear to her. So I started googling and reading and I came across your u tube videos. What an eye opener!!! An understatement.
I started to understand that everything I knew in my heart that wasn't right, had a name and a reason for it. Something beyond my capacity to change.
I downloaded your Ebook on Living with an Aspergers partner. I am 40% through it.
I can't believe all this time has gone by. I have been so hurt and my children have been in so much pain. My husband is 49 years old and I hope we can still save the rest of our lives. I know things will never be the way I thought they should be but I am ready to embrace a new reality and work to get the relationship to a happier and healthier place.
My husband is still having a hard time accepting his diagnosis but his nurse practitioner was very straight out with him.
My husband is not living at home but looking for work and admits to needing to help himself first and foremost.
I need a therapist to help us as a couple to move forward. How can you help us?
We have done therapy through skype in the past.
If you are not available who are the resources you recommend in New Jersey.
I have reached out to my son's social skills therapist but there is no one in our community who deals with Aspergers and especially the way you do!
Thank you again for your life altering work,

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My name is Kay. To be honest, I'm not sure if you're who I should be contacting regarding this. For the past year or more, I've suspected I may have Asperger's or another spectrum disorder but haven't been sure what to do about it. I've periodically Googled for resources, but it's difficult to find any for adults and the process for getting diagnosed as an adult is still unclear to me. (I am a 27yo female.) I happened to find your page (http://www.myaspergerschild.com/2014/08/skype-counseling-for-adults-with.html?m=1) and wondered if you are capable of diagnosing someone or if you may be able to point me in the right direction in that regard. Thank you very much in advance for any answers you may have and I hope you have a pleasant weekend.

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I have a 15 year old who was adopted 4 years ago and lived with me for a year before
that as a foster child (she is actually my niece -- but did not really know me much before hand)

We have other daughters older and one younger then her.

She just will not do what she is told, she will not interact with others in the family, and when
we have company over she acts like an angel...so her behavior is by choice.

I have taken everything away, I have tried time out, I have tried having her write sentences, essays, letters of apology -- nothing is working.

I have made her sit out of family actives, and with advance warning of her consequences she has even gone to a theme park with the family and not rode on one single ride all weekend because she will not apologize for actions, or would rather not participate in a birthday party/cake/ etc vs. just saying the words Happy Birthday to a sibling.

I am at the end of my rope, I have tried counseling and they drop her because she refuses to participate and will not speak, to therapists and psychiatrists.

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My 10 yo daughter has recently been diagnosed with aspberger's traits/tendencies. She is having trouble with school and her social circle, and her teacher is also at a loss, despite being so very helpful with her for the past year and a half. She has been in therapy for a number of years and two social skills groups, and it has just been recently that this has been suggested, and her new psychiatrist does concur.

She's incredibly bright and bored.  Home seems to be pretty stable, but we do have bumps in the road.  She is in 4th grade. we have dealt with it on and off. She did 18 months of neurofeedback and about 8 months of a token economy.  My husband says that he was just like her when he was a kid, and he could very well be aspberger's(now a successful engineer), and aware that he has some of these same tendencies.

She already goes to a public, yet alternative (open program) school.  The girls in her class as much more socially sophistocated, not necessarily in a good way, but she doesn't get it.  The more she acts out, the worse they treat her (of course), and the worse she gets.  Her teacher is great, but is about to pull his hair out.  Whenever there is a sub, she makes a point of telling them that she doesn't have to listen to them because they aren't her teacher, and it's not their classroom. He, too, has difficulty at times. She's dangerously close to puberty, as well.  It will be within the year, based on her development.

Her teacher even said we should go out for a beer to brainstorm.  That's the best kind of teacher, from my point of view!  I would love to have some ideas in mind before we meet.  Better yet, have some changes already in place, if possible.  Things seem to be worsening.

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Dear Parenting Coach:

My name is Scott Pralinsky. I'm a psychologist who works with troubled teens. I've been living and working in Costa Rica for 15 years now, and run a summer camp for teens. 

Here are the details for this years's sessions. 

We have had amazing success over the years with our youth who attend the camp. I'm very proud of what we've been able to accomplish over the years.

I'd love to have some help in promoting this experience. I'd be willing to offer you a 15% commission on any teens you could send our way who book and pay. 

I'm available to speak via phone or Skype if you'd like some information. 

Thank you for the work you do. I really feel the frustration from the parents I work with. And I'm glad you're able to support them in meaningful ways!

Warm regards,

Scott Pralinsky      

Founder & Executive Director           

Phone:  +1 218-506-TICO (8426)

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I just found your website and I am so thankful! I have a couple questions before I purchase the e-book. My daughter is 4 years old, and have a vision impairment (optic never hypoplasia) and her behavior has gotten worse and worse. Socially she is amazing! She talks to everyone and loves interacting, but when can't get her way or is removed from a place she is enjoying, all hell breaks loose, seriously. She bangs head, bites her hands or me, kicks, cries, screams at the top of her lungs, throws anything in site. This can last anywhere between 5 min to 30,40 minutes. It's exhausting. All therapist have always said she is misbehaving and frustrated bc of vision, but we just saw another one, and they feel she is on the spectrum. Is it possible for a child with Aspergers to socially be awesome and have no issues, but have horrible behavioral issues? In the beginning of school she  as being sent to the office throwing fits, throwing chairs, banging head and ect, and once she realized the routine she changed, and is not wonderful in school. At home, it's a struggle is uncontrollable fits everyday and I seriously need help. Does this sound like something your book can help me with?
I just need someone to give me guidance and stop saying it's just temper tantrums. It's been 4 years and getting worse each day.

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Dear Mark

We found your webpage incredibly interesting and hopeful and am currently subscribing to it so a huge thankyou to you for this.

My son is 17 and has AS and is struggling with anger to the point of it debilitating him, rage, stomach cramps, headache, shakes. He manages it fantastically He doesn't shout or hit anyone (he hits a punch bag or focuses on his breath) but it's the fact he manages it so well that causes the problem! He just pushes it down so every surge of anger is a response to not just that moment, but by more and more past negative experiences.

Although my husband and I want to be able to support him as best we can hence our interest in your site, we also want support for him. Do you ever come to the UK? Do you do intense focused wortk with teens with AS over in the USA? Or can you recommend any one you know who actually understands and works with teens with AS in the UK? Any help you can give us would be so gratefully received. He's so full of potential yet is terrified of himself and what he believes he could do if he lost control.

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 I am a single mom and we live in NYC. I was searching the web/Facebook for some kind of guidance/answers and OPS came up.  Quite frankly I'm  addressing you at this time out of desperation, frustration and perhaps a bit of fear for my 16 year old daughter.

She is currently an almost junior in HS, and I say almost because she didn't have the best start at HS during her 9th grade, and is now behind on quite a few credits. After many cuts, absences, IEP meetings, a visit to a neurologist where she was diagnosed with ADHD and is currently taking Adderall, summer school, Saturday school, etc. etc. things seem to get back on track. Junior year however brought unsafe sex, going to parties, smoking weed once in a while, staying out all night at unknown friend's out of retaliation (a one time thing to date), steeling a few dollars here and there out of my purse, quitting her job after only three days (not sure if she was let go instead), lying, being completely disrespectful, lack of empathy for me or any family member for that matter, outbursts of anger, cursing a lot more often and let's just say it what seems to be just plain meanness (although I know it's more profound than that). Last night I kind of hit rock bottom when she didn't show up home until 8:30pm (mind you she leaves school at 1:30pm) with no apparent reason in other words we hadn't argue nor there was an indication of specific problem/

trouble. During this period she didn't answer her cell phone, responded to any of my texts, had turned off her iPhone tracker, and so on. And the list goes on and on as you probably have heard it all over an over again in this line of work you have dedicated yourself to.

I have never attended any kind of online counseling, meetings or anything of the sort. I'm not savvy with it but I am willing to learn anything at all. She was going to therapy, I should mention but not only did she not want to pursue  it, I believe the therapist was not the right one for her either and it completely discouraged her. I am currently undergoing therapy myself and I'm hoping to bring her to one of my sessions on false pretense like my therapist needing family input or something like that, which I'm not proud of but I feel it might work and it's worth a shot. And speaking of therapist, she is the one that is suggesting I get a PINS warrant to protect myself legally and help her. I am not sure nor clear on this, and I'm certainly not too convinced on the repercussions of it.

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Mark - You write and record some great information for parents of adult children with Aspergers.  Do you also consult - via phone, Skype of FaceTime?  If so, are you available in the evenings or on weekends?

I have a son who will turn 46 years old in two weeks, and I am pretty sure he has Aspergers, but he has never been professionally diagnosed.  His mother and I divorced 20 years ago, but we are both interested in learning ways we can be of help to our son.  He's having a tough time now. Your articles are very helpful, but we'd really appreciate the opportunity to consult with you.

One thing we are concerned with is that we have never discussed the possible diagnosis of Aspergers with our son.  But there are several other things going on with our son now, and we would really like the help of a professional - for us, as his parents.  He is seeing a psychiatrist weekly, but she will not see his parents.  We live in Kansas City, and ideally would like to find a professional for us to see in person.

Thanks for all the great work you do, and I hope we have the opportunity to talk soon.

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Hi Mark,

I run the Wives and partners of aspies page with another mental health worker.
love your work and the more people creating awareness the better, people like you Steph Holmes, Grace Myhill, kathy marshack are amazing and of course our very own Aussie Tony Attwood.

You should really come down under and hold one of you tough message to hubbys seminars...Your words, changed my life as my hubby related to you, he is a very blokey bloke with tatts,loves his V8 cars and motorbikes, and his footy..He could not relate to any of the engineer guys that is sooo stereotyped in our early days of research..

He was the guy that self medicated with alcohol from 15 and loved being social, actually a real ratbag lol

Keep up the briliant work .

I highly respect your opinion.
I've had several ladies state their husbands and several children have also been dx with this.

I too didn't feel it was ASD specific but most likely a separate dx on top rather than crossover!

Although more and more is being understood and perhaps those with sensory issues like this may have trouble verbalising it as a difference due to it being their normal, alexithymia or even anxieties mask many truths.

Very interesting and fascinating.

Thanks

Oh I'm serious about coming to Melbourne Australia, you have a gift and a way of speaking that absorbs into people and reaches them and that creates real change, that is a rare quality among ASD aware therapists.

I'm sure Tony Attwood would support and help market that adventure!

Many find it difficult to get appropriate support, and it's so painful to watch couples and families finally reach out and be told "No, your hubby is not ASD, they are far too social or not sensory enough, or they make eye contact"
Completely disregarding learned behaviours and masking skills.
I offer my time for free, I'm so passionate about educating those in NT/ASD relationships, guiding and helping those find their own balance and happiness.

My day job is a nurse lol yep another empath! We also own a garden & building supplies.

It's uncanny out of 786 ladies within the group 90% are in carer roles of some sort, many nurses, social workers, teachers, holistic guides, doctors, and therapists of all areas..

We actually laugh now when ladies introduce themselves and say they are a nurse etc

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