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Is My Child "High-Functioning"?

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

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

Children on the Autism Spectrum and High Pain Tolerance

It is not uncommon for Aspergers and high functioning autistic (HFA) youngsters to experience great pain and discomfort that goes unreported, unnoticed by others, undiagnosed, and untreated. Enduring pain and allowing it to become chronic is extremely detrimental to your youngster's ability to function, grow, and learn. Untreated pain and discomfort will also seriously affect your Aspie’s behavior and ability to communicate with others.


Urinating In All The Wrong Places

Question

My son is peeing in corners …on his lounge chair …on his Frisbee (toys). He suffers from ASD, ODD, ADD, ADHD, SPD, ANXIETY NOS. Does anyone else’s child do this?? If so, how have you got them to stop?????? We need help ASAP!!

Answer

In summary, children who pee in all the wrong places do so because (a) they can, (b) it brings them a sense of pleasure, and (c) it gives them a sense of control …let me explain:

About 25% of kids can be strong-willed, and they can find unique ways to "express their will" – and peeing on toys might be an expression of dominance, anger, or mastery (e.g., “look what I can do”). Your son’s emotional state when he pees on toys will help lead you to the underlying issue, (e.g., anger, dominance, mastery).

Usually this kind of behavior is seen when an ASD youngster is feeling stressed, unfairly disciplined, overlooked, or over-controlled. It seems to be a kind of secretive rebellion, a way of "marking territory." Regardless, you obviously want to redirect this behavior immediately so he doesn't start falling back on it whenever he's angry, stressed, or seeking some form of control over his environment.

What can you do? Here are some tips:

1. Use a “praise and rewards” system. You want your statement, ''You remembered to use the potty every time today! Great Job!'' to feel so good to hear that he'll want to hear it again every day. Also, you will get better cooperation if you use positive discipline in general, which is even more important for your child, in case he is rebelling against your discipline practices.

2. Do the “clean-up” together. Say, "Oops, did you pee here? Come on, let's get this cleaned up." Stay calm, hand him the paper towels, and have him help.

3. Consider play therapy. You may want to initiate a play session with his stuffed animals, and have one of them pee all over the house. Make it funny. If you get him laughing, you'll know you're on the right track. You might even have one stuffed animal you're holding ask the one your child is holding, "Why is he doing that?!" You might be surprised at the answer. Your son’s answer will give you some clue as to his motivation for pursuing this bad habit.

4. Consider a reward chart. Some therapists do not recommend reward charts in general, because they get children focused on the external reward, rather than on the rewarding feelings of "doing the right thing." More importantly, if you don't get to the feelings underneath that are causing your child to pee in all the wrong places, it won't work! However, if you do give him help with those feelings, a reward chart could be helpful as an additional incentive to help him break this habit. To try this, every time your child pees in the toilet, he gets a star, and a certain number of stars get him something he really wants – within a few days. Make sure the stars seem really valuable to him. In fact, you might want to launch this by giving him a small reward that he values (e.g., a snack, a small piece of candy) every single time he pees in the toilet. This may seem like overkill, but you need to make the toilet MUCH more rewarding than the lounge chair.

5. Give your child permission to pee outside if he wants. Tell him the rule is that people are allowed to pee outside sometimes, but only over there behind the shed where no one can see and it won't hurt any flowers. That way he will be able to have the satisfaction he's getting from this behavior, but in a more appropriate way.

6. Help your child with whatever feelings are driving him. Your child won’t be able to explain what feelings are driving him. Your job is to help him vent any feelings of fear or anger that are causing him to act-out. The best way to do that is to notice when he is close to a meltdown, and then to "love" him through it.

7. Be patient as he learns to restrain his “impulsivity” (“Hey, peeing right here - right now - sounds like fun”). Aspergers kids can be very impulsive, and it takes a little practice to overcome this “not-so-good” trait.

8. Increase his visits to the bathroom to make it less likely that he'll find himself with a full bladder and feel tempted. Make rules about bathroom habits: "The rule is that we use the bathroom before we go to bed, before and after a snack, after dinner, etc." When he doesn't like the rule, empathize: "I know, you don't want to go right now, but that's the rule. We all go right after meals." Externalizing the rule reduces the chance of a power-struggle between the two of you. Many Aspergers kids are very attached to rules and will follow them as long as they don't feel bossed around.

9. Just in case he's rebelling against what feels like too much control, give him fairly constant choices. Don't overwhelm him with ten choices at a time, just let him choose, whenever it would be ok for him to decide between two things.

10. Make it clear that "all people pee in the toilet" – but don't get into a struggle with your child about this. You can't win it, because he can always continue the behavior, and it will just require that you “up the ante” to a level of punishment that would be clearly inappropriate. The truth is that improving your relationship with him will have more impact on eradicating this behavior than any kind of punishment you could devise, and punishment always undermines your relationship.

11. Most young kids are feeling their testosterone. They need opportunities to wrestle, play superhero, and demonstrate their prowess in any way they can. This is totally age-appropriate, including when he brags to you that he is stronger than Superman. (Your response to that? "Wow!") Make sure he has plenty of opportunities to feel powerful, so he doesn't need to use his territory-marking strategy.

12. Shower him with unrequested love, appreciation and attention. Setting aside a regular daily time just to spend with your child can be challenging, but that may be the most important action you can take. You want him to feel so connected to you that he just can't bring himself to do something that he knows displeases you.

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

Insomnia in Teenagers with Autism Spectrum Disorder

"Any advice on what to do for a teenager with ASD who has severe insomnia?"

According to the research, insomnia is a significant problem for ASD (high functioning autistic) teens compared to "typical" teens. Whether it is due to anxiety, noise, caffeine, or physical discomfort, these tips may help your teenager get a good night’s sleep:

1. Avoid caffeine, especially after 12:00 PM. Some ASD teens are sensitive to caffeine. It's highly unlikely for these young people to have a caffeine habit (e.g., Mountain Dew) and not be an insomniac.

2. Weighted blankets and soft sheets are a must.

3. Quiet blankets are supportive of a good night’s rest as well. A crackly sheet or comforter can wake the “light sleeping” teenager with the slightest movement.

4. Does your son or daughter scratch a lot at night? He or she is probably allergic to the detergent, or you may be putting too much soap in the wash and not getting a clean rinse.

5. Chamomile tea has been found to be helpful with sleep. The chamomile flower contains relaxants. At bedtime, have your teen drink a cup of pure chamomile (not the blends with peppermint or honey, which have stimulants that will be at cross purposes with the chamomile).

6. Do away with digital alarm clocks. They stare at the your teenager with bright red numbers, telling him how many hours and minutes until he has to get up for school. Digital clocks tend to raise the anxiety level of the teen. However, your teen should have a clock handy so he doesn’t have to get out of bed to check it. Cell phones or laptops nearby can do the trick.

7. Have some “downtime” before bed. Autistic teens need one hour of downtime for every hour of socializing, and this is especially true at night. Unlike most adolescents, teens with ASD can't just turn off the T.V., walk into the bedroom, and fall face first into bed, passed out like a drunken sailor. They need to engage in their rituals and routines and bring their adrenalin levels back to normal.

8. Earplugs will deaden noise, and although some teens say they don't like the feel of them, there are different shapes, materials and sizes. Most teens with ASD tend to prefer the medium size foam ones – although they almost always do fall out at some point – so keep an extra set handy so you don't have to scramble to find them in the middle of the night. Noise-canceling headphones are a good alternative to ear plugs.

9. Light cardio and fresh air are good precursors to good sleep. The teen may be lethargic or mentally exhausted if he has been sitting at the computer playing video games for 3 hours. Going for a short walk and getting some fresh air serves as a “pre-bedtime” relaxation exercise.

10. Lavender has been shown by researchers to usher in and improve the quality of sleep. You can use essential oil in an infuser, dried lavender in a sachet, or fresh lavender in a vase. Aromatherapy, in general, can be very relaxing (avoid stimulating scents like lemon, though).

11. Melatonin is not a sleeping pill – it's a natural sleep aid. However, the teen should not take more than 3 mgs (even though it is sometimes sold in 5mg tablets), because that much may act like a depressant the next day. Your teen can start with 3mgs, and then take an additional 1-2 mgs later if he wakes up too early (e.g., 3:00 AM).

12. White noise (e.g., from a fan) is also a good way to block out unwanted sounds.

13. Relaxation CDs (e.g., rain forest sounds) can be quite soothing for some ASD teens.

14. Some find the television (set at a low volume) to be calming, helping them to drop off into a relaxing sleep. However, others report that watching television before bed works more like a stimulant for them. Thus, decide if bedtime television is right for your teen.

15. Vigorous exercise has been reported to help ASD teens get to sleep more quickly – and to stay asleep longer. However, make sure he does not exercise within 3 hours of bedtime.



Comments:

Anonymous said...
just dont accidently give your child his am pill(adderal) thinking your giving him his pm pill(remeron) from all the confusing caios. he is still awake in his room taking his legos apart and putting them back together. defiently getting med trays

Anonymous said...
My 15 year old doesn't seem to need as much sleep, is this common for Aspies? When he sleeps, he sleeps soundly and gets himself up using his cell phone alarm.

Anonymous said...
This is a great article, my son has always had trouble sleeping, we are going through this list and trying everything on it, thanks!

Anonymous said...
Hello there! This publish couldn’t be published any greater! Studying by way of this article reminds me of my prior place mate! He often held referring to this. I'll ahead this short article to him. Fairly certain he'll have a very great go through. Thanks for sharing!

AmEpHySt said...
I am going to an professional to get sleeping tablets suitable for my 8 yr old because he gets no sleep at all. Melatonin may work for some but not for all. That's a reality. He's been mistaken as sick when in fact he's tired from lack of sleep and his eating habits turned to crap because of it.

Parenting Tips for Raising Aspies

Here are some important parenting strategies, specific to the Aspergers condition:

Aspergers and the "Fixated Personality" Type

In previous posts, we talked about the “avoidant personality,” the “approach personality,” and the “disruptive personality” in Aspergers (high functioning autistic) children, teens and adults. In this post, we will examine the fourth and final type called the “fixated personality.”

The fixated personality type can be characterized by a preoccupation with orderliness, perfectionism, and the need to control one’s environment (e.g., to have things in a particular order).

Some of the symptoms of the fixated personality type may include:
  • compulsion to make lists and/or schedules
  • feelings of excessive doubt and caution
  • obsessive need for cleanliness
  • perfectionism (that may sometimes interfere with task-completion)
  • preoccupation with order and organization
  • preoccupation with remembering and paying attention to minute details and facts
  • rigid following of rules and regulations
  • rigidity or inflexibility of beliefs
  • stubbornness
  • unreasonable insistence that others submit to his way of doing things

Some of the specific behavioral manifestations of the fixated personality type among Aspergers children and teenagers may include:
  • repeatedly checking homework
  • cleaning rituals
  • counting rituals
  • grooming rituals (e.g., hand washing, showering, teeth brushing)
  • hoarding and collecting things
  • ordering or arranging objects
  • repeating rituals (e.g., going in and out of doorways, needing to move through spaces in a special way, rereading, erasing, rewriting)
  • rituals to prevent harming self or others
  • rituals to undo contact with a "contaminated" person or object
  • touching rituals

Parents can look for the following possible signs of the fixated personality type:
  • continual expressions of fear that something terrible will happen
  • dramatic increase in laundry
  • persistent expressions of fear of illness
  • sudden drop in test grades
  • exceptionally long amount of time spent getting ready for bed
  • high, unexplained utility bills
  • holes erased through test papers and homework
  • raw, chapped hands from constant washing
  • reluctance to leave the house
  • requests for family members to repeat strange phrases or keep answering the same question
  • unproductive hours spent doing homework
  • unusually high rate of soap or paper towel usage

Environmental and stress factors can trigger fixated personality traits. These can include ordinary developmental transitions (e.g., starting school) as well as significant losses or changes (e.g., death of a loved one, moving to a different home or city).

It can be helpful to keep family routines as normal as possible, and for all family members to learn strategies to help the Aspergers youngster. It is also important to not let the “fixations” be the boss of the house and regular family activities. Giving in to fixations does not make them go away.

“Fixated” Aspies become less fixated at different rates, so try to avoid any day-to-day comparisons and recognize and praise any small improvements. Keep in mind that it's the disorder that is causing the problem, not the child. The more that personal criticism can be avoided, the better.

Treatment for the fixated personality type can involve the following:
  1. Behavior therapy: Discussing with a psychotherapist ways of changing compulsions into healthier, productive behaviors. An effective form of this therapy has been found to be cognitive analytic therapy.
  2. Cognitive behavioral therapy: A systematic approach to changing unwanted thoughts, feelings and behaviors.
  3. Psychopharmacology: A psychiatrist may be able to prescribe medication to facilitate self-management and also enable more productive participation in other therapies.
  4. Psychotherapy: Discussion with a trained counselor or psychotherapist who understands the condition.


==> Discipline for Defiant Aspergers & High-Functioning Autistic Teens

Aspergers and the “Disruptive Personality” Type

In previous posts, we talked about the “avoidant personality” and the “approach personality” in Aspergers (high functioning autistic) children, teens and adults. In this post, we will examine the “disruptive personality,” which unfortunately presents the most challenges to parents and teachers.

The disruptive personality is:
  1. a type of cognitive-behavioral style in which the "Aspie's" way of thinking, perceiving situations, and relating to others is sometimes destructive
  2. often comorbid with ADHD and/or ODD

Aspergers children and teens with disruptive personality typically have little regard for right and wrong. They may often violate the rights of others, landing in frequent trouble or conflict. They may lie, behave violently, and have drug and alcohol problems. Also, Aspies with disruptive personality may not be able to fulfill responsibilities to family, school, or work.

Disruptive personality traits may include:
  • Aggressive or violent behavior
  • Agitation
  • Impulsive behavior
  • Intimidation of others
  • Irresponsible school-related or work-related behavior
  • Lack of remorse about harming others
  • Persistent lying or deceit
  • Poor or abusive relationships
  • Recurring difficulties with the parents and teachers
  • Repeatedly violating the rights of others
  • Using charm or wit to manipulate others

There may be a link between an early lack of “empathy” (i.e., understanding the perspectives and problems of others) and later onset of a disruptive personality style. These personality problems may be inherited, and identifying them early may help improve long-term outcomes.

Complications and problems associated with the disruptive personality include:
  • Aggression or violence
  • Alcohol or substance abuse
  • Anxiety
  • Depression
  • Reckless behavior
  • Relationship difficulties
  • School and work problems
  • Social isolation
  • Strained relationships
  • Suicidal behavior

Psychotherapy is the main way to treat a child or teen with a disruptive personality style. Types of psychotherapy may include:
  • Psycho-education: This education-based therapy teaches coping strategies and problem-solving skills.
  • Psychodynamic psychotherapy: This approach aims to raise awareness of unconscious thoughts and behaviors and — by bringing them to light — change their negative impact.
  • Cognitive behavioral therapy: This type of therapy helps to uncover unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

Psychotherapy may be provided in individual sessions, in group therapy, or in sessions that include family or even friends. The right type of psychotherapy depends on each person's individual situation.

If you have a child or teen with a disruptive personality style, it's critical that you also get help for yourself. Mental health professionals can help teach you skills to protect yourself from the aggression, violence and anger common to this personality type. They can also recommend strategies for coping.

Parents can help their Aspergers child with disruptive personality traits in the following ways:
  1. Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
  2. Take a time‑out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time‑out to prevent overreacting.
  3. Pick your battles. Since this particular child has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time‑out in his room for misbehavior, don't add time for arguing. Say "your time will start when you go to your room."
  4. Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
  5. Maintain interests other than your "disruptive" Aspie so that managing your child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) in dealing with your child.
  6. Manage your own stress with exercise and relaxation. Use respite care as needed. 
  7. Come up with a specific parenting-plan to address the behavioral problems associated with a disruptive personality.

ASD: Difficulty Identifying and Interpreting Emotional Signals in Others

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that affects an individual's ability to communicate, interact w...