Aspergers Syndrome and Repetitive Patterns of Behavior

Preoccupation Unusual in Intensity or Focus

Many kids with Aspergers Syndrome have a preoccupation that is unusual in intensity or focus. They may talk relentlessly about their particular area of fascination, completely unaware of their listener’s fading interest. According to Tony Attwood, "The most popular special interests of boys with Aspergers Syndrome are types of transport, specialist areas of science and electronics, particularly computers."

Females with Aspergers Syndrome can be interested in the same topics but clinical experience suggests their special interest can be animals and classic literature. Other common areas of interest are schedules and statistical information, as described in the following examples.

Danny went through phases of being intensely preoccupied with different odd interests. One of his first preoccupations was peoples’ birthdays. In fact, the first question he would ask upon being introduced to someone was the date of his or her birthday. He had an impressive memory for such information, storing the birth dates of dozens of people he had met. The preoccupation with birthdays seemed to give way after a couple of years to an interest in the hours stores open and close. He would walk down the street, paying close attention if a store’s hours were posted out front. Again, he had an incredible memory for such information, which, his parent joked, had a certain usefulness as far as she was concerned. Danny’s next fascination concerned movies. He was not particularly interested in the content of movies or in critiquing them, but rather was preoccupied with the ratings (e.g., G, PG, PG13, R) movies received. Similarly, he liked to create lists of the movies in which his favorite actors and actresses appeared. In addition, he had a unique method of categorizing movies, and was able to rattle off which movies fell under his rather unusual headings (e.g., movies that dealt with the subject of weddings, movies in which horses appeared).

Inflexibility Regarding Routines or Rituals

Of all the impairments common to those with Aspergers Syndrome, probably the one most likely to cause difficulties for others is inflexibility regarding routines and rituals. This particular difficulty has enormous potential to adversely affect the lives of family and friends as shown in the following example.

Evan firmly believed that he must watch certain television programs, especially particular game shows. One day a show that he always watched at a particular time was not on; in fact, it was taken off the air several days in a row. This disappointment was apparently more than Evan could bear and led to prolonged tantrums. His parent called the television station, inquiring about the status of the show but to her dismay, was informed the show had been cancelled.

In light of the child with Aspergers Syndrome difficulties with flexibility, it is helpful for those dealing with him or her to be creative and flexible in their interventions. Certainly, it is important for there to be as much consistency and predictability as possible. If changes are necessary, telling the person in advance, whenever possible, is helpful. Sometimes it is possible to reframe an issue in a different way. For example, Sean was insistent that he eat three meals every day. If the family woke up late and his parents wanted to serve brunch and then dinner, this plan was unacceptable to him. His parent learned that offering him a cracker in the middle of the day and calling it lunch was an acceptable arrangement as far as Sean was concerned.

Another useful technique to consider is to involve the child with Aspergers Syndrome in collaborative thinking or negotiation. For an in depth discussion of this approach, the reader is referred to The Explosive Child by Ross Greene, Ph.D. The following interchange is an example of this technique.

James's parents were considering moving him to a new residential home and he was invited to have dinner and meet the staff and students at the new residence. Before returning him to his current placement, his parents’ plan was to take him out for dessert while they had dinner. James found this idea unacceptable; in his world, if he were going to be in a restaurant with people eating dinner, he needed to be eating dinner as well (even though he had just had dinner). His response to his parents' disapproval of his plan was to tell them they needed to take him home and then they could go out to dinner by themselves. After explaining to him that this plan did not work for them (logistically, it would have them driving far out of the way), his parent asked him if he had any ideas as to how they might resolve the problem to everyone's satisfaction. James thought a moment and then asked, "Is it okay if I have a piece of bread and a drink?" His parent thought this was a fine idea. Apparently, James considered bread and a drink sufficient to meet his definition of a meal. If his parent had not involved him in the discussion, they would never have been able to come to this resolution.

Stereotyped and Repetitive Motor Mannerisms

An additional category under the heading of restricted and/or repetitive patterns of behavior, interests and activities is that of stereotyped and repetitive motor mannerisms. There are a number of mannerisms in which the child with Aspergers Syndrome may engage. These mannerisms include hand or finger flapping, rocking, or complex whole body movements such as spinning or jumping. These behaviors differ from tics in that they are voluntary movements in the motor sense; voluntary in this case does not imply that they are easily stopped. In fact, there is considerable support for the notion that these movements have a calming or regulatory effect on the nervous system. An unfortunate consequence is that these behaviors call attention to the oddness of the child, often resulting in teasing or ostracism.

Temple Grandin - Focus on Autism and Asperger's Syndrome

Documentary about Asperger's Syndrome

Aspergers and Impairment in Communication

Inappropriate Questions/Comments—

The uttering of inappropriate comments or questions can be a serious problem. Sometimes the remarks are inappropriate to the setting. Sometimes the comments are sexually inappropriate. In any case, the remarks or questions do not take into account the impact on the other individual involved. For example, Conner was attending a funeral. Oblivious to the impact his question would have on the grieving friends and relatives, he wondered out loud about the process of bodies decomposing. In another example, Mike found himself attracted to a young woman and proceeded to stare at her. When she asked him what he wanted, he told her in sexually explicit details what he was staring at and the specific nature of his interest.

Lack of Symbolic Play—

For most kids, play is a crucial area of communication and development. Kids with Aspergers Syndrome generally display problems with imaginative or symbolic play. In autism, there is sometimes a lack of symbolic play. Some autistic kids do play imaginatively for brief periods of time, but unlike their typically developing peers, they usually cannot sustain and elaborate on the play. There may be rather elaborate imaginative play, especially in females with Aspergers. According to Tony Attwood, "Females with Aspergers Syndrome can create imaginary friends and elaborate doll play which superficially resembles the play of other females but there can be several qualitative differences. They often lack reciprocity in their natural social play and can be too controlling when playing with their peers... While the special interest in collecting and playing with dolls can be assumed to be an age appropriate activity and not indicative of psychopathology, the dominance and intensity of the interest is unusual. Playing with and talking to imaginary friends and dolls can also continue into the teenage years when the individual would have been expected to mature beyond such play."

Some clinicians consider play of paramount importance to the development of the youngster. Stanley Greenspan, M.D. has developed a treatment technique which he terms “Floor Time.” In this approach Greenspan utilizes play to “open and close circles of communication”. For example, when one individual makes a communicative overture, the expectation is that the other individual will respond to this overture in a reciprocal way. He believes play is critical not only for the development of social interaction, but also for the development of logical, flexible and creative thinking.

Literal Thinking—

In addition to problems with imaginative play, individuals with Aspergers Syndrome have a tendency to think in a literal way. Moms & dads and teachers are sometimes astonished to learn how a youngster with Aspergers Syndrome has misunderstood a commonly used term or expression. Idioms are particularly problematic. Individuals with Aspergers Syndrome often have great difficulty with metaphors and with information that is implied but not stated directly. On occasion, the youngster’s misperception becomes apparent, as in the following examples.

Edward was told by the staff in his group home that wake-up on weekends was 10:00 a.m. Staff were surprised to see that he was lying in bed awake for hours on week-end mornings. When asked about it, he replied that he was not allowed to get out of bed until 10:00, rather than understanding that he could stay in bed as late as 10:00 if he chose to do so.

Similarly, the same youngster was told by his parent to put on his winter jacket. He found two winter jackets hanging on the banister, but told his mother he did not know which one was his. To her surprise, he said he could not tell which one to wear because they both had a name-tag with his name on it. In fact, he had been wearing one of the jackets all winter; he had outgrown the other one, but his mother had failed to remove his name from inside.

"Theory of Mind"—

In addition to the problems in communication mentioned above, individuals with Aspergers Syndrome may have trouble with a concept referred to as "theory of mind". Briefly, this notion, first described by Simon Baron-Cohen, refers to difficulty in perspective taking. An example of this difficulty is that individuals with Aspergers may assume other people have the same knowledge as they do, even when there is no basis for this assumption.

For example, Nicholas was very interested in movies, frequently talking about the latest movies he had seen. He would discuss the content of movies with anyone who would listen, not recognizing that they could not possibly know what he was referring to, since they had not seen the movie under discussion.

A related matter is the inability many with Aspergers Syndrome have to recognize how other people are perceiving them. This difficulty contributes to a lack of shame or embarrassment about their behavior.

Asperger’s and Impairment in Social Interaction

1. Difficulty Using Non-Verbal Behaviors in Social Interaction—

There are several broad categories of difficulties falling under the general heading of impairment in social interaction. First of all, people with Aspergers Syndrome have difficulty using non-verbal behaviors in social interaction.

Eye contact may be impaired, meaning that the youngster may not look at others upon greeting or during conversations and may not respond when others try to catch his/her eye.

It is easy to see why others might inaccurately perceive the youngster to be rude or not paying attention.

Social smiling may be impaired. In this case, people with Aspergers Syndrome may not smile back at someone smiling at them, may not smile during greeting or may not smile in response to something someone else said.

Facial expressions used to communicate may be odd. Sometimes the expressions are limited or flat, sometimes they are inappropriate and at other times are exaggerated.

Again, it is easy to see why others might misread what the youngster with Aspergers Syndrome is thinking or feeling. For example, Jake, a rather sweet and kind youngster, broke out into laughter when his brother injured himself. Clearly, his response was inappropriate to the situation and would not be expected from a youngster his age. Similarly, Joe, upon learning that a family friend would be arriving for a visit, let out an excited cry, as if this were the most wonderful and extraordinary event that could possibly happen.

Body postures regulating social interaction may be affected. A very common example of this difficulty is that those with Aspergers Syndrome may not know how to judge social distance and may stand too close.

2. Difficulty Forming Peer Relationships—

The second category of difficulties falling under the heading of impairment in social interaction is difficulty forming peer relationships.

Some kids with Aspergers Syndrome seem to lack interest in others and may prefer solitary activities. Marty, age 6, was very skilled at building with blocks and Legos. However, when another youngster would approach to try to join his play, he would become extremely angry, not wanting his play to be disturbed.

Inappropriate overtures towards others or inappropriate responses to the approaches of other people are common occurrences. Jim, age 5, was fascinated with his next-door neighbor, George, a toddler of 18 months. Unfortunately, his way of showing his interest in George was hitting him over the head. Another youngster with Aspergers Syndrome, Benny, was somewhat more sophisticated in his technique: his way of showing his interest was throwing his arms around another youngster in a bear hug.

Difficulty forming friendships is a common fact of life for kids with Aspergers Syndrome. Interestingly, what these kids mean by friendship may be decidedly different from what their typically developing peers mean. For example, Nicholas repeatedly referred to another youngster in his school, Tom, as his best friend, although no one had observed the two boys talking or playing together. When asked what makes them friends, Nicholas replied that Tom said hello to him.

Impairment in group play with peers is another common difficulty. Unfortunately, most of the team sports so common to school-age kids are terribly difficult for kids with Aspergers Syndrome. Their troubles with social interaction and peer relationships make organized group sports a real challenge. Oftentimes, sports in which individual achievement is stressed (e.g., track, archery, fishing) are more successful.

3. Difficulty in Sharing Enjoyment—

The third area of impairment in this section is difficulty sharing enjoyment. Young kids with Aspergers Syndrome are less likely than their typical peers to share objects, such as food or toys, with others. People with Aspergers Syndrome are not as likely to show other people items in which they are interested. Lastly, they generally make more limited efforts to share feelings of enjoyment with others.

4. Lack of Social or Emotional Reciprocity—

The fourth kind of social interaction impairment is a lack of social or emotional reciprocity. This area includes such difficulties as inappropriate or limited responses to the approaches of others, as well as limited offers of comfort shown towards others.

For example, Max enjoyed going to the supermarket with his mother. He liked to help prepare the shopping list, easily located the items on the shelves, loved to sample the free food often available, and calculated the correct change while in the check-out line. However, when the cashier spoke to him and tried to make small talk, he generally did not look at her, did not answer her questions, and sometimes made a remark completely off the topic, but one that was of interest to him.

Similarly, Ben was walking outside with his mother on a cold winter day, when his mother slipped and fell on the ice. Ben clearly was aware something was not quite right, as he immediately began to scream. What he did not do was ask his mother if she were okay, and offer to help her, as a typical youngster his age probably would have done.

ASD Kids & Meltdowns: 5 Critical Tips for Parents

Kids with ASD level 1 the world over share a common trait: meltdowns (also known as a tantrum, a birko, a go-off or spack-attack).

The visible symptoms of a meltdown are as varied as the kids themselves, but every parent is able to describe their youngster’s meltdown behavior in intricate detail.

Meltdowns can be short lived, or last as long as two hours. They can be as infrequent as once a month (often coinciding with the lunar cycle/full moon) or occur as frequently as 4-6 times a day. Whatever the frequency and duration, an Aspergers youngster having a meltdown is difficult for parents and teachers to deal with.

Meltdowns in these young people are triggered by a response to their environment. These responses can be caused by avoidance desire, anxiety or sensory overload. Triggers need to be recognized and identified.

So how do we deal with a meltdown? What should you do when one occurs?

A parent's (or teacher's) behavior can influence a meltdown’s duration and intensity, so always check your response first:

1. Slow down
2. Quiet down
3. Prioritize safety
4. Calm down
5. Re-establish self-control in the youngster, and deal with the issue

So as you see, the first four steps in the effective management of meltdowns involves YOU, the adult. Let's look at each of these steps in turn:

1. Slow down. Meltdowns often occur at the most inconvenient time (e.g., rushing out the door to school). The extra pressure the "fear of being late" creates adds to the stress of the situation. Kids with ASD respond to referred mood and will pick up on your stress. This stress is then added to their own. So forget the clock and focus on the situation. Make sure the significant people in your life know your priorities here. Let your boss know that your youngster has meltdowns that have the capacity to bring life to a standstill, and you may be late. Let your youngster’s teacher know that if your youngster is late due to a meltdown, it’s unavoidable and your youngster shouldn’t be reprimanded for it.

2. Keep your speaking voice quiet and your tone neutrally pleasant. Don’t speak unnecessarily. Less is best. Don’t be “baited” into an argument. Often times, Aspergers kids seem to “want” to fight. They know how to “push your buttons,” so don’t be side-tracked from the meltdown issue.

3. Prioritize safety when your youngster is having a meltdown. Understand that he can be extremely impulsive and irrational at this time. Don’t presume that the safety rules he knows will be utilized while he is melting down. Just because your youngster knows not to go near the street when he is calm doesn’t mean he won’t run straight into 4 lanes of traffic when he is having a meltdown. If your youngster starts melting down when you’re driving in the car, pull over and stop. If your youngster tends to “flee” when melting down, don’t chase him. This just adds more danger to the situation. Tail him at a safe distance (maintaining visual contact) if necessary.

4. Take 3 slow, deep breaths, and rather than dreading the meltdown that’s about to take place, assure yourself that you’ve survived meltdowns 100 times before and will do so this time too.

5. When your ASD child is calm and has regained self-control, he will often be exhausted. Keep that in mind as you work through the meltdown issue. Reinforce to your youngster the appropriate way to express his needs and wants.

Remember that all behavior is a form of communication, so try to work out the message your son or daughter is trying to convey with his meltdown rather than responding and reacting to the behavior displayed.

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

 

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Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

 ==> Cassandra Syndrome Recovery for NT Wives

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Pressed for time? Watch these "less-than-one-minute" videos for on the go.

 COMMENTS:

•    Anonymous said... Good article
•    Anonymous said... Gotta love those meltdowns ;)
•    Anonymous said... It's double trouble when they reach their teens as my son is 17. Good luck everyone x
•    Anonymous said... Very helpful, thanks!
•    Anonymous said... Very validating as this is usually what I do.

More comments:

• Jane said... Thanks for these tips! It never ceases to amaze me how my son can go through an entire morning of getting ready for school, seemingly fine, then at the last second (could be triggered by having a sibling go out to the bus stop first) have a total meltdown! It is times like that when he runs off and I want to scream. Thanks for the reminder of what to do and not to do!
• Mom With Bipolar said...I really like this post. "so try to work out the ‘message’ your Aspergers youngster is trying to convey with their meltdown, rather than responding and reacting to the behavior displayed" This is so important! Thanks.
• Jackie said...Good suggestions here. I was reading this as we were re-cooperating from a meltdown over it being the wrong time to cook biscuits. Things have calmed and I enjoyed my biscuits and strawberry jam for brunch.

Autism Meltdown-Management 101: Key Points for Parents and Teachers

A meltdown is a condition where the youngster with Aspergers or High Functioning Autism temporarily loses control due to emotional responses to environmental factors. It generally appears that the youngster has lost control over a single and specific issue, however this is very rarely the case. Usually, the problem is the accumulation of a number of irritations which could span a fairly long period of time, particularly given the strong long-term memory abilities of young people on the autism spectrum.

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