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Aspergers/HFA Children and Inflexibility: 25 Tips for Parents

"Why is my (high functioning) son so set in his ways. When he gets an idea in his mind, no amount of logic will budge him - very stubborn on multiple fronts."

Parenting kids with Aspergers (AS) and High-Functioning Autism (HFA) means making and sticking to routines and schedules – or paying the price! Kids with the disorder often insist on a rigid routine, and something as simple as the "wrong" cereal for breakfast can send them into a tantrum or a meltdown. They often insist that things remain the same!

Consider trains versus cars: AS and HFA kids are much more like little mental trains compared to the average mind that is much more like a car driving on a road. They require a specific route, a specific timetable, and often a specific set of rules for the journey from A to B. Unpredictability is not something that they appreciate – it is widely suggested that the firm, repeatable structure and routine which these kids form in their mind is what makes them secure and comfortable. Interjecting the hand of change for the sake of change is often – as moms and dads have discovered – a catastrophic event.

The Reasons for Inflexibility—
  • 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, or someone is violating a rule and this is unacceptable to the youngster.
  • Anxiety about a current or upcoming event, no matter how trivial it might appear to you.
  • He cannot see alternatives.
  • He does not know how to let go and move on when there is a problem.
  • He does not understand the way the world works.
  • He feels that you must solve the problem for him even when it involves issues you have no control over.
  • He is “rule-bound.”
  • He sees only one way to solve a problem.
  • He suffers from black-and-white thinking.
  • He tends to misinterpret situations.
  • 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 youngster will act inappropriately instead.
  • Often, if your youngster cannot be perfect, she does not want to engage in an activity.
  • Other internal issues (e.g., sensory, inattention (ADHD), oppositional tendency (ODD), or 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 or fantasy.
  • There are no small events in his mind – everything that goes wrong is a catastrophe.
  • Transitioning from one activity to another. This is usually a problem because it may mean ending an activity before he is finished with it.

The Behaviors Associated with Inflexibility—
  • Becoming easily overwhelmed and having difficulty calming down.
  • Creating their own set of rules for doing something.
  • Demanding unrealistic perfection in their handwriting, or wanting to avoid doing any writing.
  • Demonstrating unusual fears, anxiety, tantrums, and showing resistance to directions from others.
  • Displaying a good deal of silly behaviors because they are anxious or do not know what to do in a situation.
  • Eating a narrow range of foods.
  • Having a narrow range of interests, and becoming fixated on certain topics and/or routines.
  • Having trouble playing and socializing well with peers or avoiding socializing altogether. They prefer to be alone because others do not do things exactly as they do.
  • Insisting on having things and/or events occur in a certain way.
  • Intensely disliking loud noises and crowds.
  • Lecturing others or engaging in a monologue rather than having a reciprocal conversation.
  • Preferring to do the same things over and over.
  • Reacting poorly to new events, transitions, or changes.
  • Remaining in a fantasy world a good deal of the time and appearing unaware of events around them.
  • Tending to conserve energy and put forth the least effort they can, except with highly preferred activities.
  • Wanting things to go their way, when they want them to, no matter what anyone else may want. They may argue, throw a tantrum, ignore you, growl, refuse to yield, etc.

Questions to Ask Yourself—

To help you determine the reasons why your youngster behaves the way she does, you should ask yourself the following questions:
  1. Because a situation was one way the first time, does she feel it has to be that way always?
  2. Does she need to be taught a better way to deal with a problem?
  3. Does she see only two choices to a situation rather than many options?
  4. Has she made a rule that can't be followed?
  5. Is she blaming me for something that is beyond my control?
  6. Is she exaggerating the importance of an event?
  7. Is he expecting perfection in herself?
  8. Is she misunderstanding what is happening and assuming something that isn't true?
  9. Is she stuck on an idea and can't let it go?

Below are some ways you can help your youngster prepare for – and handle – change:

1. Acknowledge your youngster’s worries and fears. Allow him to feel angry, sad, and confused during times of change. These feelings are normal and your youngster needs to be allowed to express them. Acknowledge his feelings and respond sympathetically. You might say, “Yes, saying goodbye to a friend is really hard. That makes me feel sad, too.” Be sure to let your youngster know that you take his concerns seriously. For example, you can say, “Are you worried about going to a new school? I used to worry about that when I was your age, too,” or “I know you miss your old friends from last year. It’s hard when things change.”

2. Be a role model for your kids in handling your own stress in a healthy way. If your kids see you talking to others about problems, taking time to relax, and living a healthy lifestyle, your example is likely to rub off.

3. Be clear about rules and consequences. Let your kids know specifically what is expected and together decide on consequences for misbehavior. Then follow through. Teach ways of handling difficult situations. Talk through and role-play with your kids how they can handle a stressful situation.

4. Do what you can to be available during times of transition and change. For example, if your youngster has a hard time at the beginning or end of the school year, try to be more available during these times. Do what you can to simplify your family life so that you can focus on your youngster’s needs.

5. Encourage healthy eating. Teach your kids by words and example that eating a healthy diet makes their bodies better able to handle stress.

6. Encourage vigorous physical activities. If your kids do not exercise often, try family activities like bike riding, hiking, or swimming.

7. Encourage your youngster to write about worries in a journal.

8. Give back rubs and hugs. A short back or shoulder rub can help your kids relax and show them you care. Gentle physical touch is a powerful stress reliever.

9. Have a positive attitude. If you are confident about an upcoming change, your youngster will be positive, too.

10. Help your youngster mark the change. If your youngster’s best friend is moving away, help your youngster mark the occasion with a card, a gift, or a special event. Keep farewells and goodbyes simple and low key.

11. Help your youngster prepare for the move to a new school or town. If your youngster is going to a new school, visit the school before the first day of class, get a copy of the school newspaper, or go online and look at the school’s Web site together with your youngster. Try to help your youngster meet new teachers and staff before the start of school. If you will be moving out of town, try to visit your new neighborhood with your youngster before you move so your youngster is familiar with her new surroundings.

12. Help your kids talk about what is bothering them. Don’t force them to talk, but offer opportunities; bedtime or car trips are good times for this. Instead of asking, “What’s wrong?” ask questions such as, “How are things going at school with your teacher?” Do not criticize what your kids say or they will learn not to tell you things that bother them.

13. Involve your youngster in decisions about the change. For example, if the change involves a move, let your youngster choose colors for his new bedroom and arrange his things when you move in. When starting a new school or a new school year, let your youngster choose what to wear on the first day and to pick out his school supplies. Kids typically have no control over the major changes in their lives. By involving and including your youngster in such decisions, you help him feel more in control of the changes in his life.

14. Maintain family routines. Knowing what to expect helps your youngster feel grounded and secure, especially during times of transition. Maintain family routines around bedtime, TV, and family meals as much as possible.

15. Make regular use of “social stores” to help your youngster adjust to changes.

16. Show your youngster the positive ways that you handle change. Talk about how you feel during times of change and about what you do to cope. For example, let your youngster see the lists you make to help you stay organized and focused.

17. Spend special one-to-one time. Find hobbies or other activities that you can do alone with your youngster. This allows for time to talk as well as time for having fun together.

18. Stick to a routine to keep them feeling secure, but don't shield them from changing situations; doing so will strengthen their belief that the details of life should stay the same.

19. Talk about the change. Talk about what will happen and what the change will mean for all of you. For example, if you will be moving to a new installation, talk about how hard that is, how fun it is, and what to expect. Answer as many of your youngster’s questions as you can, such as how long the move will take, how far your new home is from school, and what you know about the school and town.

20. Talk with your youngster’s teacher or child care provider about changes going on in your family life.

21. Teach relaxation skills. Show your kids how to relax by remembering and imagining pleasant situations like a favorite vacation or happy experience.

22. Teach your kids that mistakes are OK. Let them know that all people, including you, make mistakes. Mistakes are for learning.

23. Tell stories about dealing with stress. For example, if your youngster is afraid of a new situation, tell a story about how you once felt in a similar situation and what you did to cope, or find a library book that shows a youngster coping successfully with stress.

24. Try to keep other changes in your youngster’s life to a minimum during times of transition. For example, if you are going through a big change at home, this is not the time to send your youngster to a new camp or new after-school program.

25. Warn them ahead of time when changes are going to occur.

AS and HFA kids often appear pig-headed, stubborn, and down-right rude when they are faced with change. Let’s be honest; they don’t want to step outside their sandbox. Moms and dads in this situation not only need to understand that their youngster is routine-based, but they need to proactively predict when their youngster will require a routine. But, never forget that your youngster doesn’t believe that he is doing something wrong by presenting as stubborn towards change. He is merely trying to protect himself — and he wants you to help him feel secure by allowing him to do things in a sturdy, structured way. Using the tips above should make things run a bit more smoothly.

==> My Aspergers Child: Preventing Tantrums and Meltdowns in Aspergers Children

The Positive Traits of Aspergers

"Professor Asperger" talks about the positives associated with having Aspergers Syndrome:

How To Live With Aspergers: 30 Tips For Aspies

Living with Aspergers (high functioning autism) is not something to shy away from. You can run – but you can't hide. So, if you think you have Aspergers, or if you have had it for a while, the following tips will help you in multiple areas of your life (i.e., spiritually, physically, mentally, emotionally, socially, financially, and vocationally):

1. Be self-aware. Go online and read all about Aspergers. Folks who have it tend to be outspoken, and can have overall issues with the natural 'flow' of communication between two "normal" folks. Once you start to notice your own differences, you can actually adjust them.

2. Consider finding a group for support, most likely to be found online. However, take into consideration that most Aspergers individuals can be hard to talk to since they're, well, not always so good at that. You can use this group throughout your journey through life.

3. Consult a therapist to learn more about Aspergers. A therapist can develop a treatment plan to assist with daily living. Use the treatment plan to develop social skills. Some of the things practiced may include how to converse with folks in different social situations.

4. Determine what you want your quality of life to be and make a flexible plan so you can account for little hiccups. Unfortunately as black and white as life can be, it's really light grey/dark grey. So while you could know you want to have friends and be social, you may not want to be the kind of shallow 'non-Aspergers' individual who cheats on their significant other, lies, and doesn't pay bills on time.

5. Do not discuss sensitive topics. A treatment plan will discuss how to approach sensitive issues.

6. Don't think of Aspergers as a disease. Think of it as a personality type. Every personality type has its positives and negatives. Folks with Aspergers are generally very intelligent, but need help with social skills, such as anxiety management, choice making, and being optimistic.

7. Find someone to tutor you in a game (e.g., poker). Practice social skills while learning how to play the game.

8. If it's difficult for you to follow social rules, it might help to learn the reasons behind them. A good etiquette will help you learn, even if it never becomes easy, how to follow those rules.

9. If reading facial and body language is difficult for you, one trick is to watch soap operas. Soap opera actors are very emotive, and if you listen to their words for context and then freeze the screen on a facial expression or bit of body language, you can learn by rote what might come more naturally to others.

10. Join some clubs that feature activities of interest. People with Aspergers tend to be interested in a few narrow activities, and uninterested in anything outside of them.


11. Learn how to "lose" a game in such a way that it is not obvious that it was intentional.

12. Learn to play chess or other popular games. Join folks who can play them.

13. Learn when it is appropriate to touch folks. Practice what you learned and try to follow treatment plan recommendations.

14. Learn which specific aspects of Aspergers give you the most trouble, and try to work around them.

15. Maintain eye contact, but do not stare .The best way to achieve eye contact is to look at their left eye briefly and then shift to their right eye.

16. Make lifestyle choices that reflect your needs. If sensitivity to noise and crowds are one way Aspergers manifests for you, there is no need to build your life around a career that requires you to spend your time in noisy crowds.

17. Make sure to remember the basics. You have to remember to keep up the basics because they are what got you to the moment. When you remove vital, necessary parts of human life, you are just setting yourself up for a problem!

18. Many folks with Aspergers have extraordinary minds and the ability to solve problems in a way that non-Aspergers folks struggle with. Be proud of your mind and your differences.

19. Memorize folk's behavior when they are distressed. Ask friends how actions may have caused distress. Ask friends how to prevent causing distress in the future.

20. Folks may sometimes think you are lying, even when you are being truthful. The best way to avoid this is to always tell the truth to the best of your ability (e.g., if you do not know the correct answer to a question, respond accordingly).

21. Some agencies have special social and support groups for adults on the spectrum. Look around to see if there is one around you and join one! This will give you a safe place to make friends and learn social skills.

22. Since you don't always pick up cues about other folk's feelings, it's smart to ask if they are interested or have time to listen before you launch into an involved discussion of your favorite topic.

23. Spend some time thinking about the things you enjoy and those that are difficult for you, and how you can arrange your life to emphasize your strengths and work with your weaknesses.

24. Take pride in your uniqueness. Some aspects of living with Aspergers can make life difficult. Sensory issues and social awkwardness are two common manifestations that often are problematic. But folks with Aspergers have qualities that are worthy of pride as well. Maybe you have a good grasp of language and vocabulary, or an excellent memory, all of which are also common Aspergers manifestations.

25. Talk “with” folks – don't talk “at” them. A good ratio in a one on one conversation is to listen about 60% of the time and talk about 30%. Try not to talk for more than five minutes at a time. Let the other individual, or folks, set the pace of the conversation.

26. Try to be less critical of things, starting with the outside of your world, the folks in the street who walk too slow, the waitress who brought you the wrong food, and work your way toward your own world, your friends, family, just make sure to take it at the pace you can handle.

27. Try to behave in a manner that is seen as acceptable. Allow enough of your uniqueness to come through to intrigue folks, but try to keep most of it under control.

28. Use caution when trying to adjust your life. Don't let anyone ever tell you you're weird. Or let them, but don't even think twice about it.

29. When someone is talking about a problem in their life, they don't necessarily want to know how to solve it, even if you have the answer. Instead, ask them how they feel about the situation or what they have already tried or are considering. This lets them know you care and respects their ability to solve their own problems.

30. Work on being more animated during conversations (e.g., display a variety of facial expressions that correspond to what you’re saying).


Aspergers/HFA Children and Problems with Bathing/Showering

"Any tips for helping my high functioning daughter to take a bath? This is a daily battle that is becoming unbearable."

Sometimes getting your Aspergers or high functioning autistic youngster to take a bath or shower can be like pulling teeth. While some of these kids do enjoy playing in the tub, there are those who fight not to have to get washed up.

Here are some tips for helping your youngster to enjoy bath time and actually want to bathe:

1. Allow your youngster to use bath crayons in the bathtub. Bath crayons are great because they come in a few different colors and wash off easily on any type of tub. Let your youngster draw pictures in the bath tub and wash them away with the tub water. You can even teach your youngster how to write his name, words, sentences, or anything you like and give him a little education during bath time. Just be sure to explain to your youngster that bath crayons are only for tub time and never to be used anywhere else.

2. Buy bath mousse and let your youngster get creative. Bath mousse is sold anywhere that bath toys and crayons are and can be used to make all sorts of fun things in the bath tub. The nice thing about bath mousse is that it washes away easily, leaving no mess. Your youngster will love to make castles, animals, and monsters with the bath mousse. Bath mousse comes in different colors so there is a color to suit every youngster. When bath time is done, simply have him help you rinse the bath mousse from the sides of the tub and you've also then taught him to be responsible.

3. Don’t fight over the use of a wash cloth. Often times, AS and HFA children do not like the feel of a wash cloth.

4. Even though the youngster may not see any need to use soap or shampoo, if you put the shampoo in a bottle that has measurement marks on the side and highlight exactly how much should be used each time the hair is shampooed, there is a much better chance that the hair will be shampooed. The same can be done with bar soap or perhaps even liquid wash soap.

5. In order to have the same amount of water in the tub every time, you could install a decal on the side of the tub that shows exactly how high the water needs to go.

6. Let your youngster keep bath toys near the tub to play with. Bath toys of all sorts are a great way to help your youngster enjoy bath time. They make all sorts of toys specifically geared toward bath time fun. Try buying a bath basketball set and playing with your youngster or even plastic fish and a fishing pole. There are many bath time games that you and your youngster can play to help him enjoy bath time. If you don't want to have to go out and actually purchase bath toys, any of your youngster's toys (that don't have batteries) can be played with in the tub.

7. Put a hook on the back of the bathroom door so that a routine can be set for your youngster to know that this is where his/her “own” towel will always be before the bath, and that this particular place is where the towel is to be put back when the drying off has been done.

8. To make a routine to get the feet done, you can always put 2 decals in the shape of feet in the bottom of the tub. This will then be their special place to routinely put their feet when washing them and for getting in and out of the tub.

9. Try blowing bubbles with your younger child in the bathtub. Kids love blowing bubbles and watching them hit the water still intact. Children also love it when you blow a bunch of bubbles at once. Blowing bubbles in the bathtub will help your younger child enjoy bath time and want to take a bath when you tell him it's time.

10. When it comes to taking a bath or shower you might need to have a whole set of rituals that the youngster can adhere to.

11. When the AS or HFA youngster is finished with their bathing ritual, having the same set of towels or at least the same colored towels after each bath helps set the routine for drying themselves off.

12. You can put a small decal on each of the water handles to show how far they need to be turned.

If your daughter dreads a dunk in the tub even more than the family cat, bath time at your house is undoubtedly a nightly battle. Yet teaching kids good hygiene habits is definitely worth the effort. How often your youngster needs a soak depends on the time of year, the type of skin he has, and how dirty he gets.

Kids with normal skin who are active can bathe daily, and those with dry skin might choose to bath every one-to-two days. In the summer, especially if kids are playing outside, and once puberty starts, baths should be daily.

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children

Anxiety-Free Haircuts for Aspergers and HFA Kids

With Aspergers and High Functioning Autism (HFA), the brain seems unable to balance the senses appropriately. It's common for these youngsters to have sensory problems. They may be hypo-active (low sensitivity) or hyper-reactive (high sensitivity) or lack the ability to combine the senses.

Aspergers and HFA kids often have a "fight or flight" response to sensation. This condition is called "sensory defensiveness" and may be diagnosed as a "sensory processing disorder." These children can be sensitive to many things (e.g., the noise hair clippers make, the sensation of cutting hair, feeling loose hairs on their body, seeing hair fall on their clothing or the floor, etc.). When their perceptions are accurate, they can learn from what they see, feel, or hear. On the other hand, if sensory information is faulty, their experiences of the world can be confusing. Many young people with Aspergers and HFA are highly attuned - or even painfully sensitive - to certain sounds, textures, tastes, and smells.

Here are some proven strategies that will facilitate your Aspergers or HFA child getting an anxiety-free haircut:

1. Allow your youngster to give an old doll or teddy bear a haircut while his own hair is being cut. This may help your youngster learn to generalize the experience. You or the barber can also use the doll or teddy bear to demonstrate what it is you need or expect your youngster to do. For example, act out directions to "turn your head to the right" or "hold your head down." These are strong visual cues and may be better understood.

2. At home, find opportunities to teach daily living skills, particularly hygiene and grooming. For example, your youngster may learn how to:
  • choose an appropriate outfit to wear
  • clean the shower/tub
  • determine how long to stay in the shower or tub
  • put his dirty clothes away
  • run his own bath water at the right temperature
  • shower or take a bath independently
  • undress/dress
  • use deodorant
  • wash his body properly

3. Before you begin, it is better to wash the hair to remove any hair products build-up. Cutting clean, dry hair with clippers is much faster and easier. Use unscented shampoo and conditioner if your youngster is sensitive to smells or odors. (Warning: Some kids on the autism spectrum do not like having their hair washed.)

4. Be sure your youngster has a cape, sheet or towel draped over him.

5. Buy a good quality home hair-cutting kit. Look for clippers with blade guards to avoid cutting the hair too short.

6. Develop a routine for haircuts. Does your youngster need a haircut or trim every week, every other week or once a month? Try to schedule them for the same day of the week and time of day whenever possible (e.g., every other Saturday morning). Be consistent.

7. Edge the front, sides and nape of the neck first for a shape-up then cut the hair. Should your youngster not tolerate a haircut before you or the barber is done, a shape-up will give him a clean, fresh haircut look, even if the hair has not been entirely cut.

8. Explain to your youngster exactly what you are planning to do during the haircut. Use short sentences or visual supports using personal photos or picture icons. Take pictures while your youngster is getting a haircut. Take a picture of all the items used.

9. Focus on the task at hand. Try to cut the hair as fast as you can without rushing. Try not to stop cutting hair to talk to others, in person or on the phone.

10. For a youngster that is sensitive to the buzz sounds of the clippers or the snap of a scissor, try using soft, flexible ear plugs. Does your youngster like to sing? Sing a song. Play some of their favorite music.

11. Observe your youngster while cutting his hair. Is there anything he particularly dislikes or finds intolerable? If so, try to eliminate it or make it better.

12. Once the haircut is done, admire your youngster's clean-cut appearance (e.g., "You look handsome!"). Show him how he looks in the mirror, if tolerated. Take before and after photos so he can see the benefits of getting a haircut. Use this opportunity to begin to teach him how to comb and brush his own hair.

13. Help your youngster learn how to help put items away, clean and oil the clippers, sweep or vacuum cut hair off the floor, put dirty clothes and towels in the hamper or washing machine, etc. He can also learn how to sort laundry, load and wash his clothes, put clothes in the dryer, fold clothes, and iron.

14. Reassure your youngster during the haircut. Explain each step of the way in a slow and steady voice. Praise him (e.g., "Good job keeping your head still"). Let your youngster know that there is an end in sight. This step may be faded out gradually as your youngster becomes more familiar with the process.

15. Remember to give your youngster a reward or bonus that he will enjoy. Give your youngster a choice for his bonus. A reward or bonus will show him that although we must do unpleasant things sometimes, we also get to do things that we enjoy.

16. Schedule a haircut when your youngster is least likely to be sensory overloaded or feeling overwhelmed by the information he is taking in through the five senses: hearing, vision, touch, smell and taste. Try to avoid scheduling haircuts after school or when your youngster is ill or tired.

17. Take each haircut session one at a time. Observe your youngster, take notes if necessary. You will learn more about him each time.

18. Think of a few activities, toys or food your youngster really enjoys to use as his special reward or bonus. What does he like to do? What makes him happy?

19. Under supervision allow your youngster to handle the clippers and other items used for the haircut. At home, allow him to help you prepare for it (e.g., he can get a towel and the comb or brush). Teach him how to clean the clippers (e.g., brush off any loose hairs from the blade and oil the clippers). This can be a good motivator – and it's fun learning in the natural environment.

20. Unless your youngster is better able to tolerate a haircut, keep their hairstyles simple (e.g., "fades" and elaborate parts and designs in the hair will take longer to cut).  


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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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

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Aspergers 101: The Basics

Essential Aspergers Information That All Parents And Teachers Need To Know:

Aspergers/HFA Children and Dental Appointments: 40 Tips for Parents

Taking your Aspergers (high functioning autistic) son or daughter to the dentist can be a difficult experience for both child and parent. Here are some helpful tips to effectively deal with dentist appointments:

1. Ask the dentist to lean the chair back before your child gets in it, because sometimes Aspergers and HFA children don’t like the feeling of being moved backwards.

2. Bring along a sibling or friend and let your child watch as the doctor or hygienist performs the task on them first.

3. Collaboration and teamwork are essential for a successful trip to the dentist.

4. Consider some physical exercise (e.g., riding a bike) to be done before and after the visit for calming.

5. Create and read a social story about going to the dentist with your child. The social story should take the uncertainty out of what will happen at the dentist office.

6. Deep pressure can be used before and during the visit for calming.

7. Dentists should review your youngster’s medications and supplements.

8. Discover what could potentially be difficult at future visits.

9. Find some good books about practicing good oral hygiene and going to the dentist that you can read with your child.

10. For those children who grind their teeth or engage in self-injurious behaviors (e.g., picking at the gums, biting the lip), a mouth guard may be recommended.

11. Having a dental professional who can communicate with your child effectively will be very important.

12. If the noises of the office are upsetting, request to be moved to a more quiet or private area. If not available, the use of headphones or an iPod are good ways to limit noise.

13. If you have any dietary or chemical restrictions that you are following for your youngster, be sure to make your dentist aware of these before the appointment begins.

14. If your child has seizures, you will need to discuss this with your dentist. The mouth is always at risk during a seizure, because kids may chip teeth or bite their tongue or cheeks.

15. Ignoring inappropriate behaviors is something you’ll want to inform the staff about.

16. Include an incentive/motivator for when the appointment is over (e.g., stop for a treat afterward).

17. Instruct the staff that your youngster responds best to immediate praise for good behavior (e.g., “Great job keeping your mouth open” … “I like how you are holding still” … “You did great while I cleaned your back teeth”).

18. Instruct the staff to prompt the child with time durations as they work (e.g., “This will be all done when we finish counting to 10” … “I need to touch 20 teeth, so help me count them all” … “That gritty paste will only be there for 1 minute and then you can rinse and spit”).

19. Is your child familiar with daily tooth brushing? If not, consider working with an occupational therapist to teach him good oral hygiene habits.

20. Know that lighting in a dental office is often too strong for a child on the autism spectrum. Let him wear sunglasses and request that the staff try to keep the light out of his eyes as much as possible.

21. Let your child get familiar with the dentist office environment before the actual dental work is performed (e.g., let the child try out the chair, let the hygienist look in his mouth or count his teeth, let him listen to the sound the drill makes, etc.).

22. Let your child squeeze a therapy ball in his hands while he is in the chair (if he finds it comforting).

23. Let your child touch and examine the dentist’s tools before the dentist starts working, if possible.

24. Letting your child know ahead of time how long something is going to last can be very helpful.

25. Maintaining a calm voice may help to minimize behavior problems.

26. Make a fun game out of counting your child’s teeth before the dentist appointment.

27. Schedule a few short “trial visits” to start off with. Keep these visits very positive and short.

28. Sedation is sometimes a good idea (e.g., if the youngster has high levels of anxiety or discomfort, for uncontrolled movements like gagging, when extensive dental treatment is going to take place).

29. Share your child’s coping strategies with the dental staff before the visit.

30. Show the tool or action they are going to use before the procedure.

31. Slowly desensitize your child to the experience by talking about your personal experience with the dentist.

32. Tell your child what they are going to do before you ever get to the dentist.

33. There are many potential sensory challenges at a dentist’s office (e.g., tastes, smells, textures, sounds, lights, etc.). Knowing what areas your child tends to be sensitive will help you know what coping strategies to try.

34. To ensure that tastes are familiar and favorable, bring your child’s own toothpaste and toothbrush to the visit.

35. Try using a bean bag chair in the dentist’s chair during the exam to provide some snug comfort.

36. Use of visual routines and a timer are helpful for good daily brushing habits.

37. Use the child’s toothbrush or a plastic tooth mirror and get him comfortable with letting you put it in his mouth.

38. Vibration toys that are safe for oral use, or even electric toothbrushes, are good for getting your youngster accustomed to the strange sensations in his mouth.

39. Ask if the dentist has experience with Aspergers and HFA kids and if he/she has special procedures in order to optimize each visit. Ask about those procedures. Some procedures you might ask about are:
  • having a short wait time
  • having an appointment at a time of day when your child is at his best
  • having the same staff at each visit for consistency
  • sitting with your child in the room while doing the exam

40. Consult your child’s Occupational Therapist for additional suggestions.  


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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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