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Avoiding Meltdowns and Tantrums on Easter: Tips for Parents with Children on the Autism Spectrum

Easter can be a hectic, stressful time for all families. This special day can be particularly overwhelming for families of children with Asperger’s (AS) and High Functioning Autism (HFA). Preparing and planning early can help parents relieve some of the holiday stress. 

Below are some very important tips to help your child circumvent Easter meltdowns and tantrums:

1. Determine how far in advance you need to prepare your child for this special day. For example, if he has a tendency to become anxious when anticipating an event that is to occur in the future, you may want to adjust how many days in advance you prepare him. Preparation can occur in various ways by using a calendar and marking the date of the holiday, or by creating a social story that highlights what will happen during the day.



2. Have alternative food items on hand. Oftentimes, children with AS and HFA want the same foods over and over again. While it's good to help your child explore new possibilities, a holiday event is not the right time to push the boundaries. If, for example, your child prefers peanut butter sandwiches to ham, mashed potatoes and green beans, this is the time to make those expectations a reality. Wait until a quieter, less stressful moment to offer new foods.

3. Have an “emergency back-up plan.” Even when you've knocked yourself out to make Easter special for your AS or HFA child, and even when things go beautifully for a while, events can quickly spin out of control. An unexpected glitch, unnoticed by everyone else, can send your child into a meltdown. Often, a quiet room or a favorite video will solve the problem. If you are visiting friends or family while your child begins to meltdown, the only good solution may be to leave.

4. Have realistic expectations. You may want enthusiastic involvement from your AS or HFA child on Easter, but it's unlikely you'll get it. All too often, the sensory and social demands of this holiday make it tough for these kids to really engage in the day’s activities. Knowing that ahead of time will help you moderate your expectations.

5. If you are traveling for Easter, make sure you have your child’s favorite foods or items available. Having familiar items readily available can help to calm stressful situations. Also, prepare your child by using social stories for any unexpected delays in travel. If you are flying for the first time, it may be helpful to bring her to the airport in advance and help her to become accustomed to airports and planes. Use social stories and pictures to rehearse what will happen when boarding and flying.

6. If you will be celebrating Easter at someone else’s home, let your host know ahead of time what to expect and what your AS or HFA child may be like. For example, explain that she will be eating different foods, or otherwise receiving "special" treatment (of course, even an autistic child needs to follow the basic rules of the house, such as no hitting, no climbing on the furniture, etc.). Also, with the help of your host, decide on a “safe haven.” Oftentimes, children with AS and HFA become overwhelmed or upset in a strange environment, and it can be hard for them to manage their feelings in these cases. If you set aside a quiet spot (e.g., a den or bedroom) for your child and let her know about it, she can quickly retreat to regroup. Ideally, you'll also equip the safe haven with a DVD or CD player so you can load a favorite video or music CD.

7. If you will be entertaining guests, plan ahead – and share your plan with your child. Kids with AS and HFA fare better when they know just what to expect. Thus, it's best to have a clear plan for your Easter event - even a simple one - that you share ahead of time. Plans don’t need to be elaborate, but they should include details (e.g., “When our guests arrive, you can either help me in the kitchen, or you can play your video games”). Also, prepare a photo album in advance of relatives and other guests who will be visiting. Allow your youngster access to these photos at all times, and go through the photo album with him while talking briefly about each family member. Furthermore, prepare family members for techniques to use to minimize anxiety or behavioral incidents, and to enhance participation. For example, help them to understand if your youngster prefers to be hugged or not, needs calm discussions, or provide other suggestions that will facilitate a smoother Easter holiday.

8. If your AS or HFA child does not do well with self-management, develop a signal or cue for him to show you when he is getting anxious, and prompt him to use time-outs as needed. You can even practice using time-outs in a calm manner at various times prior to Easter. Take him into the “time-out room” and engage him in calming activities (e.g., play soft music, rub his back, turn down the lights, etc.). Then when you notice him becoming anxious at any time during Easter, calmly remove him from the anxiety-provoking situation and take him to his time-out area.

9. If your AS or HFA youngster is on a special diet, make sure there is food available that he can eat. Also, be cautious of the amount of sugar consumed!

10. Know and understand your “special needs” child. Know how much noise and other sensory input she can take. Know her level of anxiety and the amount of preparation it may take. Know her fears and those things that will make Easter more enjoyable for her. If you detect that a situation may be becoming overwhelming, help her find a quiet area in which to regroup. Also, there may be some situations that you simply need to avoid altogether (e.g., large family gatherings).

11. Preparing the AS or HFA child’s siblings. Since Easter is a time for the whole family to enjoy, it's important to make siblings aware of how stressful this day can be for their “special needs” brother or sister. Before the day begins, take time to remind your other kids of their sibling's sensory issues, communication difficulties, low frustration tolerance, and likes and dislikes. Next, share the family's strategy for avoiding potential issues and discuss what they will do if their best efforts are unsuccessful.

12. Try to maintain a sleep and meal routine that resembles the average day (if possible). Even though it’s a very special day that only happens once a year, making major changes in routine on this day will likely make for major meltdowns to go with it.

As parents, we may put pressure on ourselves to make Easter perfect, which is unrealistic. In the end, the most important thing to remember is that Easter is a time to cherish one another and the joy of being together. Whether it's scaling back or starting new traditions, celebrate this holiday in a way that makes the most sense for your unique family situation.

How to Prevent Meltdowns and Tantrums in Aspergers Children

Research on Criminal Offenses Committed by People with Asperger’s

A recent study in one of England’s high-security psychiatric hospitals estimated that approximately 2% of the hospital’s male population had Asperger’s (AS), now called high functioning autism. This significantly exceeds the 0.36% prevalence estimated for the general population. This over-representation of AS was subsequently confirmed in two other English high-secure units.

Asperger’s and criminal offenses:
  • Both alcohol and drug abuse, as well as drug offenses have been reported in this population, although drug abuse is comparatively rare.
  • Epidemiological studies indicate that people with AS do commit sexual offences, but there is evidence that the rates of sexual offending in general – and of child sex offences in particular – are lower among offenders on the autism spectrum.
  • Violence in a community sample was more common among those with AS, and there is evidence that offenders on the autism spectrum are more likely to have previous convictions for assault. Similar rates of violent offending by people on the spectrum have been reported in high-secure units in England. 
  • There is growing evidence that people with AS are more likely to commit fire-setting offenses than people without the disorder.



A number of factors may mediate offending in people with AS:
  • aggressive behavior
  • circumscribed interests
  • comorbid psychiatric conditions (e.g., bipolar affective disorder, depression, antisocial personality disorder, attention-deficit hyperactivity disorder, conduct disorder, and schizophrenia)
  • hyperactivity/impulsivity
  • inattention
  • late diagnosis
  • neuropsychological impairment
  • poor educational achievement
  • social exclusion
  • substance abuse
  • truancy

Another study revealed that offenders on the autism spectrum spend more time (11.26 years on average) in high-secure settings than offenders with other psychiatric disorders. The relatively longer stay may be responsible for the over-representation of people with AS in English high-secure units.

People on the autism spectrum held in secure units are more vulnerable to exploitation, bullying and intimidation by virtue of their “odd” behavior and social naivety. The risks arising from these factors are compounded by their inability to articulate their frustrations appropriately.  People on the spectrum who behave in an exemplary manner in a particular environment may re-offend if they are transferred to a less appropriate setting or an unfamiliar one with a new set of rules and routines. Among this group of offenders, a lack of comprehension of the consequences of their criminal behavior, as well as their egocentric justification of their acts, further increase the risk of re-offending following transfer to less secure conditions or discharge into community placements.

The majority of AS offenders held in high-secure units are (a) detained under the mental health category of mental impairment, (b) transferred as sentenced prisoners, (c) transferred prior to sentencing, and (d) have committed sexual offenses. In most cases, the index offenses have taken place in the context of substance abuse.

In summary, research suggests that offenders with AS are more likely to commit (a) offenses of a sexual nature, (b) fraud, (c) fire-setting offenses, and (d) drug offenses, but less likely to commit violent offenses.

Further research of a clinical nature within the AS offender population is greatly needed. More specifically, the prevalence of AS among those detained in medium and low-secure psychiatric facilities is needed to create services for the vast majority of offenders with the disorder who find themselves detained for longer than necessary due to the lack of knowledge of methods of rehabilitation.



References—

1.    Allen D, Evans C, Hider A, et al (2007) Offending behaviour in adults with Asperger syndrome. Journal of Autism and Developmental Disorders; 38: 748–58.
2.    American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA.
3.    Attwood T (2007) The Complete Guide to Asperger’s Syndrome. Jessica Kingsley Publishers.
4.    Baron-Cohen S, Wheelwright S, Robinson J, et al (2005) The Adult Asperger Assessment (AAA): a diagnostic method. Journal of Autism and Developmental Disorders; 35: 807–19.
5.    Barry-Walsh JB, Mullen PE (2004) Forensic aspects of Asperger’s syndrome. .Journal of Forensic Psychiatry and Psychology; 15: 96–107.
6.    Blair J, Mitchell D, Blair K (2005) The Psychopath: Emotion and the Brain. Blackwell Publishing.
7.    Crocombe J, Mills R, Wing L, et al (2006) Autism Spectrum Disorders in the High Security Hospitals of the United Kingdom. A Summary of Two Studies.
8.    Elvish J (2007) The exploration of autistic spectrum disorder characteristics in individuals within a secure service for people with learning disabilities. Thesis for Doctorate in Clinical Psychology. The Tizard Centre, University of Kent.
9.    Farrington DP (2007) Childhood risk factors and risk-focused prevention. In The Oxford Handbook of Criminology (4th edn) (eds M Maguire, R Morgan, R Reiner): 602–40. Oxford University Press.
10.    Frith U (ed) (1991) Asperger and his syndrome. In Autism and Asperger Syndrome: 1–36. Cambridge University Press.
11.    Golan O, Baron-Cohen S (2006) Systemizing empathy: teaching adults with Asperger’s syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology; 18: 591–617.
12.    Hare DJ, Gould J, Mills R, et al (1999) A preliminary study of individuals with autistic spectrum disorders in three special hospitals in England. National Autistic Society.
13.    Hawes V (2003) Developmental disorders in prisoners volunteering for DSPD assessment. In Proceedings of the 2nd International Conference on the Care and Treatment of Offenders with a Learning Disability (eds C Dale, L Storey): in Presentations on ‘Working with offenders’.
14.    Klin A, McPartland J, Volkmar FR (2005) Asperger’s syndrome. In Handbook of Autism and Pervasive Developmental Disorders (eds FR Volkmar, A Klin, R Paul, et al): 88–125. Wiley.
15.    Lord C, Risi S, Lambrecht L, et al (2000) The Autism Diagnostic Observation Schedule–Generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders; 30: 205–23.
16.    Lord C, Rutter M, LeCouteur A (1994) The Autism Diagnostic Schedule–Revised: a revised version of a diagnostic interview for caregiver of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders;24: 659–85.
17.    McDougle CJ, Naylor ST, Cohen DJ, et al (1996) A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Archives of General Psychiatry; 53: 1001–8.
18.    Mouridsen SE, Rich B, Isager T, et al (2008) Pervasive developmental disorders and criminal behaviour: a case control study. International Journal of Offender Therapy and Comparative Criminology ; 52: 196–205.
19.    Murphy D (2003) Admission and cognitive details of male patients diagnosed with Asperger’s Syndrome detained in a Special Hospital: comparison with a schizophrenia and personality disorder sample. Journal of Forensic Psychiatry and Psychology; 14: 506–24.
20.    Murphy D (2007) Hare Psychopathy Checklist Revised profiles of male patients with Asperger’s syndrome detained in high security psychiatric care. Journal of Forensic Psychiatry and Psychology; 18: 20–126.
21.    Myers F (2004) On the Borderline? People with Learning Disabilities and/or Autistic Spectrum Disorders in Secure, Forensic and Other Specialist Settings. Scottish Development Centre for Mental Health (http://www.scotland.gov.uk/Resource/Doc/47251/0023734.pdf).
22.    Research Units on Pediatric Psychopharmacology (2002) Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine;347: 314–21.
23.    Research Units on Pediatric Psychopharmacology (2005) Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry; 62: 1266–74.
24.    Royal College of Psychiatrists (2006) Psychiatric Services for Adolescents and Adults with Asperger Syndrome and Other Autistic-Spectrum Disorders (Council Report CR136). Royal College of Psychiatrists (http://www.rcpsych.ac.uk/files/pdfversion/cr136new.pdf).
25.    Schwartz-Watts DM (2005) Asperger’s disorder and murder. Journal of the American Academy of Psychiatry and the Law; 33: 390–3.
26.    Scragg P, Shah A (1994) Prevalence of Asperger’s syndrome in a secure hospital.British Journal of Psychiatry; 165: 679–82.
27.    Siponmaa L, Kristiansson M, Jonsson C, et al (2001) Juvenile and young adult mentally disordered offenders: the role of child neuropsychiatric disorders. Journal of American Academy of Psychiatry and the Law; 29: 420–6.
28.    Soderstrom H, Nilsson T, Sjodin AK, et al (2005) The childhood-onset neuropsychiatric background to adult psychopathic traits and personality disorders. Comprehensive Psychiatry; 46: 111–6.
29.    Viding EM (2007) Re: The callous unemotional traits (e-Letter). British Journal of Psychiatry; 29 May (http://bjp.rcpsych.org/cgi/eletters/190/49/s33#3699).
30.    Wing L (1981) Asperger’s syndrome: a clinical account. Psychological Medicine;11: 115–29.
31.    Wing L (1997) Asperger’s syndrome: management requires diagnosis. Journal of Forensic Psychiatry; 8: 253–7.
32.     Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2005) A case–control study of offenders with high-functioning autistic spectrum disorders. Journal of Forensic Psychiatry and Psychology; 16: 747–63.
33.    Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2006) High functioning autistic spectrum disorders, offending and other law-breaking: findings from a community sample. Journal of Forensic Psychiatry and Psychology; 17 : 108–20.
34.    Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2009) Circumscribed interests among offenders with autistic spectrum disorders: a case–control study. Journal of Forensic Psychiatry and Psychology; in press.
35.    Woodbury-Smith MR, Volkmar FR (2008) Asperger Syndrome: a review.European Journal of Child and Adolescent Psychiatry; 56: 1–11.
36.    World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO.

Anxiety-Reduction Strategies for Kids and Teens with ASD

How can parents help their ASD (high-functioning autistic) child to have fewer meltdowns and less anxiety-related issues?



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



ASD [High-Functioning Autism and Asperger's] in Females vs. Males

Why are the symptoms of Autism Spectrum Disorder different in girls as compared to boys? 




 

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


Asperger Syndrome: A Form of Schizophrenia?

Could Asperger's (high-functioning autism) be a form of Schizophrenia? 





Asperger’s Teen Isolation: Antisocial Behavior or Self-Preservation?

Most neurotypical children (i.e., those not on the spectrum) get their batteries recharged by associating with peers. When they are home by themselves for any length of time, they get bored and lonely. In other words, their batteries become run down and need recharging. So, they get out of the house and go find their friends to get recharged.

This situation works the opposite way for most children on the autism spectrum. When they find themselves in social situations – especially for lengthy periods of time in group settings (e.g., school) – their batteries run down. When they are out in the community, they have difficulty paying attention to what others are doing, what others are saying, how they are supposed to respond to others – all the things that keep them from engaging in their special interest (e.g., computer games).

Having to tread water in the ocean of social contacts is exhausting for these children. In other words, it totally runs their batteries down. So, they hibernate, disengage, and find time to be alone to engross themselves in their special interest as a way to recharge.

Click here for the full article... 



Asperger's and Criminality

Are people with Asperger's more likely to be criminals compared to the general population? You may be surprised by the answer! 





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...