"Nothing we have done to get our ASD teen to avoid the ups and downs of his behavior and mood swings has helped. We need help now!"
Disciplining a teenager with Aspergers or High-Functioning Autism (HFA) is likely to bring out the best and the worst in a parent. Moms and dads try to help their “special needs” teenager make up for what's missing by increasing their love and attention, but he or she often triggers special frustrations in parents.
Most teens go through predictable stages of development in adolescence. You know about when to expect what behavior and how long it will last. Knowing you don't have to weather this “difficult behavior” indefinitely helps you cope. But with many teens on the autism spectrum, stages seem to go on forever, as do the frustrations in both the teenager and the parent.
Parenting an Aspergers or HFA son or daughter is a tough job. The ups and downs and joys and sorrows are magnified. You rejoice at each accomplishment, and you worry about each new challenge. Here are some important tips for disciplining the special needs teen:
1. Aspergers and HFA teenagers need developmentally-appropriate structure, but it requires sensitivity on your part to figure out what is needed when. Watch the teen, not the calendar. Try to get inside his head.
2. Be prepared to run out of patience.
3. Be sure to change your standards. Before a child is even born, moms and dads imagine what his life will be like (e.g., piano lessons, baseball, graduating from college, marriage, etc.). Even with a “typical” teen, you have to reconcile these dreams with reality as he grows up. With a teen on the autism spectrum, this is a bigger task. You learn to live in the present. The milestones of your teen's life are less defined and the future less predictable (though he may surprise you). In the meantime, set your standards for your teen at an appropriate level.
4. Don't compare your “special needs” child to other “typical” children. Your Aspergers or HFA teen is special. Comparing her to others of the same age is not fair.
5. Don't focus on the disorder. Instead, practice positive parenting to the highest degree that you can without shortchanging other members of the family. Feeling loved and valued from positive parenting helps a teen cope with the lack of a particular skill.
6. Visual aids may help your teenager see the reason for the consequence. Make an “if/then chart” or a “discipline chart” that shows exactly what will happen if the teenager engages in a particular behavior. Another visual aid that comes in handy is a “rewards chart.” Equal importance should be placed on good behavior, including lots of praise and tangible rewards, to balance out the negativity.
7. View “misbehavior” as a signal of needs. Everything teenagers do tells you something about what they need. This principle is particularly true with Aspergers and HFA teenagers.
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8. There are occasions when negative consequences become necessary (e.g., grounding, taking away privileges, etc.), but they should always be immediate, definite, and relevant. Teens on the spectrum tend not to perceive cause and effect and are likely to have short memories, so prolonged consequences not only lose their impact, but also their effectiveness. Taking away the teen’s favorite activity for being rude to his mother or father, for example, is not relevant to the infraction. The focus for the teen, then, becomes the lost privilege and his anger at his mom or dad – not what he did to incur the consequence in the first place. A more appropriate consequence might be for the mother or father to respond, "I won't listen to that kind of talk," and walk away.
9. Teens with Aspergers and HFA thrive on structure and clear rules. Thus, posting a list of unacceptable behaviors and their consequences can be very helpful.
10. These young people tend to enjoy being isolated, because it is less stressful for them and they do not have to socialize with others. For these teens, being sent to their bedrooms for a time-out can actually be a positive experience unless modified slightly (e.g., being sent to the bedroom with no computer privileges).
11. Reset your anger buttons. Your "special needs" teen will do some things that exasperate you.
12. Remember that discipline literally means "teach" – not "punish." Negative punishments rarely change unwanted behavior permanently. They only stop the behavior in that particular time and setting. Positive consequences, on the other hand, have been shown to be far more effective in changing inappropriate behavior patterns. Aspergers and HFA teens respond well to praise, encouragement, and positive reinforcement. Complimenting the teenager for a responsible, cooperative, or compassionate act will tend to promote that behavior.
13. Moms and dads should list the behaviors that they feel are most deserving of attention. This is an important step because some behaviors may need intervention or therapy in order to be eliminated rather than simple disciplinary tactics. Odd self-soothing behaviors are common in young people with sensory processing issues, and they can be easily replaced with more appropriate ones.
14. Give your teen choices. Initially, you may have to guide your teen into making a choice, but just the ability to make a choice helps the teen feel important. Present the choices in the teen's language. The more you use this tip, the more you will learn about your teen's abilities and preferences.
15. Help your teen build a sense of responsibility. There is a natural tendency to want to rush in and do things for a “special needs” teen. For these teenagers, the principle of "show them how to fish rather than give them a fish" applies all the more. The sense of accomplishment that accompanies being given responsibility gives the teen a sense of value and raises his self-esteem.
16. Know that “different” doesn't mean “lesser.” In a teenager's mind, being different means being substandard. This feeling may be more of a problem for “typical” teens than for Aspergers and HFA teens. Most teenagers measure their self-worth by how they believe others perceive them. Be sure your teen's siblings don't fall into this "different equals inferior" trap. This is why the term "special needs" is not only socially correct, but it's a positive term, not a value judgment. In reality, all teenagers could wear this label.
17. Know that “different” doesn't mean “unable.” While it is true you have to change your expectations of an Aspergers or HFA teen, you don't have to lower your standards of discipline. It's tempting to get lax and let your teenager get by with behaviors you wouldn't tolerate from your other kids. Your teen needs to know, early on, what behavior you expect. Many moms and dads wait too long to start behavior training. It's much harder to redirect a 130 pound young man than a 50 pound boy. Like all teenagers, the Aspergers or HFA teen must be taught to adjust to family routines, to obey, and to manage his behavior.
18. Moms and dads need to be in agreement when applying discipline to any teenager, but especially for teens on the spectrum. If one parent thinks grounding is the appropriate punishment, while the other feels that time-outs will be more effective, this will be confusing for the teenager.
The Struggles in Adolescence for Teens on the Autism Spectrum
Disciplining a teenager with Aspergers or HFA is not an easy task, particularly in light of some of the characteristics commonly associated with the disorder (e.g., a short memory for misdeeds but not for the consequences, the inability to perceive cause and effect and to generalize from one situation to another, the tendency to blame others rather than assume responsibility for behavior, etc.). Nonetheless, with patience, humor, and a sense of perspective, moms and dads can become their teen's ally, even in their role of authority.
“I have a 14-year-old son with high functioning autism who behaves in a way that mystifies me...I cannot do anything right, according to him. I had never heard of Oppositional Defiant Disorder, and after reading the symptoms, I think that he should be seeing a doctor about possibly having this disorder. I have noticed symptoms like the ones mentioned in him since he was very young. I have tried to talk to him about it and he has told me that he feels out of control at times with his temper, especially when it comes to people of authority. I have learned to not talk about anything he might turn on. I e-mail him across the house and have learned to speak to him in his language. Is it possible for a child to have both disorders? What action should parents take in these cases?”
Many parents have difficulty recognizing the difference between a strong-willed, emotional teen with High-Functioning Autism (HFA) or Aspergers’ (AS) and one with Oppositional Defiant Disorder (ODD). Clearly, there's a range between the usual independence-seeking behavior of teens and out-of-control defiant behavior. It's normal to exhibit oppositional behaviors at certain stages of an adolescent’s development. However, your teen’s issue may be more serious if his behaviors:
Have lasted at least six months
Are persistent
Are clearly disruptive to the family or school environment
The following are behaviors associated with ODD:
Tantrums
Spiteful or vindictive behavior
Refusal to comply with adults’ requests or rules
Difficulty maintaining friendships
Deliberate annoyance of other people
Blaming others for mistakes or misbehavior
Argumentativeness with parents, teachers and other authority figures
Anger and resentment
Aggressiveness toward siblings and peers
Acting touchy and easily annoyed
Academic problems
Oppositional defiant behavior often occurs along with other behavioral or mental health problems, such as autism spectrum disorders, depression, ADHD, and anxiety. The symptoms of defiant behavior may be difficult to distinguish from those of other behavioral or mental health problems. It's important to diagnose and treat any co-occurring disorders, because they can create or worsen irritability and defiance if left untreated.
Stressful changes that disrupt an HFA or AS teen's sense of consistency increase the risk of disruptive behavior. However, though these changes may help explain disrespectful or oppositional behavior, they don't excuse it.
If your HFA or AS teen has signs and symptoms common to ODD, make an appointment with your physician. After an initial evaluation, the physician may refer you to a mental health professional who can help make a diagnosis and create the right treatment plan for your teen.
Here's some information to help you prepare for an appointment:
Write down your family's key personal information (e.g., factors that you suspect may have contributed to changes in your teen's behavior).
Make a list of stressors that your teen or close family members have recently experienced.
Write down the signs and symptoms your teen has been experiencing – and for how long.
Take a trusted family member or friend with you to the appointment. Someone who accompanies you may remember something that you missed.
Make a list of your teen's key medical information (e.g., any physical or mental health conditions that he has been diagnosed with).
Write down the names of any medications your teen is taking (include any over-the-counter medications).
Write down questions to ask the physician in advance so that you can make the most of your appointment.
Questions to ask the doctor if your HFA or AS teen is referred to a mental health provider include:
What treatment approach do you recommend?
What factors do you think might be contributing to my teenager’s issues?
What else can I and my family do to help my teenager?
Should he be screened for any other mental health problems?
Should I tell his teachers about this diagnosis?
Is this condition likely temporary or chronic?
Is my teen at increased risk of any long-term complications from this condition?
Do you recommend family therapy?
Do you recommend any changes at home or school to encourage my teen’s recovery?
What do you believe is causing his symptoms?
Are there any other possible causes?
Being ready to answer the physician's questions may reserve time to go over any points you want to talk about in-depth. You should be prepared to answer the following questions from your physician:
What are your teen's symptoms?
When did you first notice these symptoms?
How would you describe your teen's home and family life?
How often over the last six months has your teen been touchy, easily annoyed or deliberately annoying to others?
How often over the last six months has your teen been spiteful or vindictive, or blamed others for his own mistakes?
How often over the last six months has your teen been angry or lost his temper?
How often over the last six months has your teen argued with you or his teachers?
How often has he refused to follow through with your rules or requests?
How have you been handling your teen's disruptive behavior?
How do you typically discipline your teen?
Have your teen's teachers reported similar symptoms?
Has your teen been diagnosed with any other medical conditions?
Do any particular situations seem to trigger defiant behavior in your teen?
Treatment—
Treating oppositional defiant behavior (whether or not your teen has a formal diagnosis of ODD) involves several types of psychotherapy and parent-education training. The cornerstones of treatment for oppositional defiance usually include:
1.Social skills training: Your teen may benefit from therapy that will help him learn how to interact more positively and effectively with peers.
2. Parent training: A mental health provider with experience treating oppositional behavior may help you develop skills that will allow you to parent in a way that's more positive and less frustrating for you and your teen. In some cases, your teen may participate in this type of training with you, so that everyone in your family develops shared goals for how to handle problems. As part of parent training, you may learn how to:
Remain calm and unemotional in the face of opposition.
Recognize and praise your teen's good behaviors and positive characteristics.
Offer acceptable choices to your teen, giving him a certain amount of control.
Limit consequences to those that can be consistently reinforced and last for a limited amount of time.
Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both parents will do with the teen.
3. Individual and family therapy: Individual counseling for your teen may help him learn to manage anger and express his feelings more healthfully. Family counseling may help improve your communication and relationships, and help members of your family learn how to work together.
4. Cognitive problem solving training: This type of therapy is aimed at helping your teen identify and change through patterns that are leading to behavior problems. Research shows that an approach called collaborative problem solving — in which you and your teen work together to come up with solutions that work for both of you — is highly effective at improving oppositional-related problems.
Although some parent-management techniques may seem like common sense, learning to use them in the face of opposition isn't easy, especially if there are other stressors at home. Learning these skills will require consistent practice and patience. Most important in treatment is for you to show consistent, unconditional love and acceptance of your HFA or AS teen — even during difficult and disruptive situations. Don't be too hard on yourself. This process can be tough for even the most patient mom or dad.
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Parenting Strategies—
At home, you can begin chipping away at problem behaviors in your HFA or AS teen by practicing the following:
Develop a united front. Work with your partner/spouse to ensure consistent and appropriate discipline procedures.
Set up a routine. Develop a consistent daily schedule for your teen. Asking your teen to help develop that routine can be helpful.
Set limits and enforce consistent reasonable consequences.
Recognize and praise your teen's positive behaviors. Be as specific as possible (e.g., "I really liked the way you helped pick up your room tonight").
Pick your battles carefully. Avoid power struggles. Almost everything can turn into a power struggle — if you let it.
Model the behavior you want your teen to exhibit.
Build in time together. Develop a consistent weekly schedule that involves you and teen being together.
Assign your teen a household chore that's essential and that won't get done unless he does it. Initially, it's important to set your teen up for success with tasks that are relatively easy to achieve, then gradually blend in more important and challenging expectations.
Take care of yourself. Counseling can provide an outlet for your own mental health concerns that could interfere with the successful management of your teen's defiant behavior. If you're depressed or anxious, that could lead to disengagement from your teen, which can trigger or worsen oppositional behaviors. Let go of things that you or your teen did in the past. Start each day with a fresh outlook and a clean slate. Learn ways to calm yourself, and take time for yourself. Develop outside interests, get some exercise, and spend some time away from your teen to restore your energy.
Remind yourself that your teen’s defiance is most likely a temporary inconvenience rather than a permanent catastrophe.
At first, your teen is not likely to be cooperative or appreciate your changed response to his behavior. Setbacks and relapses are normal, so be prepared with a plan to manage those times. In fact, behavior often temporarily worsens when new limits and expectations are set. However, with persistence and consistency, the initial hard work will pay off with improved behavior.
Resources for parents of children and teens on the autism spectrum:
COMMENTS: • Anonymous said… Absolutely possible! My daughter has High Functioning Autism and ODD. We have found that by changing how we approach certain triggers, we can avoid the ODD eruptions. If she does blow up, we've also learned that it is not the time to push her or try to persuade her unless it is a safety issue. she can only have a learning experience once she has calmed down. • Anonymous said… Following. Yes please which meds have been given and which worked best in your situations • Anonymous said… I am exhausted! What meds have helped? I have a 17 year old with Aspergers and a suspected ODD diagnosis. • Anonymous said… I believe it to be under the umbrella... ocd and add/odd are subcharacteristics of HFA and Aspergers. My son was orignianlly diagnosed ODD/OCD/Major Depression (missing the BIGGER picture for a couple of years until finding a doctor who knew what Aspergers looked like). Once medicated (this took time to find right fit), years of counselling and finding something he enjoyed and was good at, much of the ODD symptomology extinguished. It's understandable how one would be oppositional when his/her life is so "out of control"- anger, fear, frustration all leads to a normal brain to want to gain control over his/her environment; couple that with the angst of teenage years for the neurotypical as well and you have a big mess. Most difficult years for me and mine were ages 11 to 16. Again, medication helped tremendously; in addition to, all of the other components to a comprehensive plan (counselling, family support). I point to the medication because if one is crawling out of his/her own skin...behavior modification will not work. My son is 31 today, still medicated and is successful and happy (gainfully employed, lives on his own, is delightful). It's a long hard road, but worth the pain. • Anonymous said… I do think it is unfortunate to label a particular behaviour as a disorder. We have had occasions over the years when my son has dug his heels in and refused to do as expected of him. He quite logically explains that he is unable to comply with our expectations at times when he doesn't feel in control of a situation and feels over-anxious. He is 19 now and recently started playing guitar. A family friend helps run a folk club and invited us to go along. I was amazed the first time that Oliver got up when invited and performed in front of everybody. He attended again on the next meeting and again performed. My friend had arranged to pick up us again a couple of weeks later and I was so looking forward to this but Oliver made it clear that he wan't going to go this time. I was disappointed but nothing would persuade him. AFTER the event when I was able to talk to Oliver calmly he explained that he just hadn't felt ready with his new song but would go again in the future when he felt better prepared. We have been a couple of times since. The real problem over the years was always my own frustration with his decisions when they interfered with my own plans but if I stayed objective and calm we could in due course talk things over together. I could help Oliver understand my disappointment when things didn't go as planned and Oliver would help me see how difficult it was for him to do things if he was over-tired, unprepared, stressed or just having a bad day. • Anonymous said… I have looked at PDA and although there are similarities with ODD and PDA, our son is definitely ODD and both of these diagnoses can operate in ASD. We have been on our journey for more than five years and with therapy, medication and great support we've made incredible accomplishments with our son. It is as many have said though...very exhausting. • Anonymous said… PDA strategies are ery different to strategies for ODD. Reducing demands and providing an anxiety free environment is ideal. Anxiety free isnt possible but a happier calm child has a better chance of learning strategies to deal with demands. • Anonymous said… I was that child...tho they did not have a label for it back then. I would recommend to be respectful and ackowledge his feelings but at the same time dont walk on egg shells. Use "i" statements like "i need u to..." and avoid labels like "youre" this and that etc. At the same time clear boundaries and expectations and a consistant reward and consequence system. Another huge thing is the consequence having something to do with the action and not being a punishment. I know this wouldve helped if my parents had known better. but i got a lot of name calling from my parents and was made fun of by kids at school as well as my parents. It cannot have been easy for them and they mustve gotten some relief out of letting off some steam. A psychiatrist even recommended that they slap me (yes a westwood, ma psychiatrist who is still practising). I would say that has been the most detrimental thing to my aspergers and ODD and would not recommend it. • Anonymous said… I've never heard of ODD but it sounds like my daughter might have this. Thanks for mentioning it. • Anonymous said… My aspie gas O.D.D. & believe, it's a challenge!!!! • Anonymous said… My daughter was dx with ODD 10 years ago and it never sat right with me, after researching PDA I believe she has that • Anonymous said… My son has Asperger's and O.D.D. We are also questioning P.D.A. but CAMHS aren't keen on giving it as a diagnosis. Worth reading about it though. My son is 15, not hit puberty yet and it's really hard going most of the time x • Anonymous said… My son has both its very difficult and trying 😣 • Anonymous said… My son is 14 and is diagnosed ODD, Aspergers and Mixed Mood/Anxiety. His first diagnosis was ODD aged 9. • Anonymous said… My son is on seraquel, Prozac and trazadone ..he's 18 and doing much much better, hang in there! • Anonymous said… My son was diagnosed when he was 4 with ASD ADHD and odd its a real challenge to say the least.. • Anonymous said… My sons defiance seems to come from anxiety. Wanting to gain/regain control because he frequently feels powerless or vulnerable. Not sure if he has ODD but giving him explanations about why things need to be done and helping him find ways to feel more in control and powerful sometimes has really helped. The more I push the more he pushes back. You have to bend and manoeuvre. Tiring and time consuming but works for us. • Anonymous said… Not only possible..very likely, Autism always pairs with another disorder from what I have been told through the many hospitals and psychiatrists we have seen, my son who is 18 now was diagnosed with both way back when, it's a long hard struggle and a lot of work, do the testing for diagnosing ..stay strong friend! • Anonymous said… ODD and Aspergers combined have been the most challenging diagnoses I have ever encountered! I am worn out as a parent. Meds have helped but it has been a tough journey. • Anonymous said… Our 11 year old is on the Spectrum as high functining (aka Aspergers) with multiple diagnoses, one being ODD. We have him in therapy and he's learning how to manage it. It is definitely exhausting, but very treatable. Hang in there...if you can find a support group for yourself...you'll find that helps. • Anonymous said… Our son was diagnosed at age12 with high function autism. He is now 15 and I strongly feel he also has ODD. • Anonymous said… Please research PDA. People with ASD with Demand avoidance behaviours usually have Pathological Demand Avoidance. If they dont have ASD then they probably have ODD. PDA is part of the Autism spectrum. • Anonymous said… Ugh, what do you do when this keeps on into adulthood? • Anonymous said… Vincent my 4 yr old seems to have ODD. I'm not sure if it is a symptom of Autism or a standing disorder in him. I was told, I needed to verify if he was indeed not Autistic because ODD can be a symptom of Autism. Not sure how I feel about my developmentally delayed child possibly being diagnosed as Autistic when I am not even sure if I believe he is, and know in my heart that he could be due to how he is AND his delays. I'd hate for him to be misdiagnosed whem he very well may just have ODD. So, If I were you I would research and speak to multiple professionals about weather or not this is a symptom of or an actual disorder for your individual child. • Anonymous said… We have tried several meds throughout the years (Clonodine, Intuniv, Prozac etc)! What worked the best for my child was Seroquel. • Anonymous said… Yes our son was diagnosed with Aspergers and ODD at 15, although he had these symptoms for years...The medicine Lamictal has really helped!
* Anonymous said...What do you recommend for my 15yo high-functioning ASD with ODD who absolutely refuses anymore counseling or meds? We’ve done both over the years, with no real success. The meds we’ve tried have all had side effects that make him feel horrible. He also hates how they numbed his appetite, and he said they made him super quiet “like a zombie” (teachers confirm this). They didn’t improve his grades (he also has dyslexia & math LD)The counseling, though good advice from the counselors, had no effect on him outside the counseling room, and now he refuses to go anymore. If we try to force it, with consequences and such, we get the out-of-control, angry, horrible behavior nonstop…it’s unbearable. So we’ve been on no meds & no counseling for 6 months now. Behavior is inconsistent, but grades and motivation at school are still bad. Still rude and illogical when the mood hits, but we avoid power struggles and allow for reasonable compromises when he’s trying to exert control. He has good and bad days. It’s like he’s in that gray gap- not bad enough to force meds or professional treatment, but not on the healthy road to success with his choices and behaviors. Any advice? Again, meds and counseling he refuses at this point. Thanks for any advice. * Anonymous said...I have a 10 YO Son ASD, ODD, working with the local health food store on supplements, 5 HTP heavy metal detox etc. To help him to be able to control himself. It has worked for tons of friends, I will keep you posted. Also homeopathic remedies are helping too. Post your comment below…
"My son, 17 y.o. with HFA, is no longer interested in trying to relate to his peers or do anything social. He says 'nobody' likes him. I would describe him as a recluse at this point. Is this something I should be concerned about, or just let him do his thing, which appears to me to be a very lonely way to live.?"
Peer-group rejection occurs when a person is deliberately excluded from social relationships among his or her age group. Unfortunately, this phenomenon is common for teens with Asperger’s (AS) and High-Functioning Autism (HFA).
Research dealing with the implications of peer-group rejection on later development suggest that AS and HFA teens experiencing continuous rejection often experience a decline in their self-image, a state of despair, behavioral difficulties, loneliness and seclusion – and in some cases, serious emotional disturbances.
AS and HFA teens who experience peer-group rejection often choose to isolate themselves, which makes a bad problem worse. Here are some of the common reasons for isolation:
A depressed adolescent loses interest in everyday activities and drops out of social groups at school. Depression is a Catch-22. It can cause isolation, but may also come from a lack of social interaction. For example, Michael (diagnosed with Asperger’s) was depressed when his attempts to fit-in with the boys in his class always backfired. They were sports-minded, but Jack was more artistic. He was mocked by his male peers for his “weird” artwork and eventually stopped trying to win their friendship. Over a period of weeks, he became depressed and began to isolate.
An adolescent who feels rejected may spend too much time on social networking sites and lose touch with peers. He or she may replace genuine social interaction with chat rooms and conversations with strangers. Adolescents who interact online lose out on genuine social interaction. For example, Craig (diagnosed with High-Functioning Autism) was a computer geek who spent hours chatting online. After months of this, his social skills were under-developed and his understanding of face-to-face interaction was damaged by hours upon hours of Internet use.
Moodiness and erratic behavior can drive an AS or HFA adolescent away from his peers.
Shyness can be a cause of social isolation.
Many young people on the autism spectrum have one particular “special interest,” and may engage in – and talk about – that interest to the exclusion of all other social activities and conversations. For example, Josh was diagnosed with Asperger’s at age 8. He had a particular interest in trains and train schedules, but his classmates found his incessant talk about them boring. They eventually left him out of social activities, which made him feel socially clumsy and unwanted – and resulted in isolation.
Some AS and HFA adolescents may be ostracized by their peers because they either excel academically or underachieve. Fitting-in is important to teens, but those who stand out are often pushed to the fringes of social groups.
Though most want to be accepted by their peers, AS and HFA teens tend to be very hurt and frustrated by their lack of social competency. Their inability to “connect" to others is made worse by the negative feedback that they receive from their painful social interactions (e.g., bullying, teasing, rejection, etc.). The worse they perform socially, the more negative feedback they get from their friends and classmates, so the worse they feel and perform. Due to this consistent negative social feedback, many of these “special needs” teens feel depressed, anxious and angry, which just compounds their social difficulties by further paralyzing them in social situations. In addition, although negative behaviors often lead to peer-group rejection, the reverse is also sometimes true (i.e., being ostracized can bring out the worst in AS and HFA teens, which leads to even more ridicule and rejection).
The AS or HFA teen can be rejected on an individual basis, or by an entire peer-group. In addition, rejection can be either “active” (e.g., bullying, teasing, ridiculing, etc.) or “passive” (e.g., being ignored, getting the silent treatment, etc.). Some level of rejection is an inevitable part of life for all teens. However, it can become a serious problem when it is prolonged or consistent, when the relationship is important, or when the teen is highly sensitive to being rejected. Furthermore, the experience of peer-group rejection often leads to a number of adverse psychological consequences (e.g., aggression, anxiety, depression, feelings of insecurity, heightened sensitivity to future rejection, school refusal, loneliness, low self-esteem, and even suicidal ideation).
Research reveals that most teens who are rejected by their peers display one or more of the following behavioral patterns:
high rates of aggressive or disruptive behavior
high rates of inattentive, immature, or impulsive behavior
high rates of social anxiety
increased preference for solitary activities (e.g., playing video games)
low rates of prosocial behavior (e.g., engaging in meaningful conversation, sharing, etc.)
One of the strongest effects of sustained peer-group rejection is “global impairment” (i.e., impairment across several domains, including behavior, emotions, social relationships, and involvement in activities). Studies suggest that long-term peer-group rejection is consistently associated with problems in (a) relationships (e.g., peers, siblings, and adults other than parents), (b) emotions (e.g., feeling unhappy or sad, not having fun, feeling nervous or afraid), (c) behavior at home, and (d) low involvement in activities (e.g., sports and hobbies).
Additional research on peer-group rejection reveals the following:
“Active rejection” (e.g., bullying, teasing, ridiculing, etc.) is more stable, more harmful, and more likely to persist after the teen transfers to another school.
An analysis of 15 school shootings between 1995 and 2001 found that peer-group rejection was present in all but two of the cases (87%). The documented rejection experiences included both acute and chronic rejection, and frequently took the form of ostracism and bullying. The researchers assert that although it is likely that the rejection experiences contributed to the school shootings, other factors were also present (e.g., depression, poor impulse control, etc.).
Peer-group rejection, once established, tends to be stable over time, and thus difficult for the AS or HFA teen to overcome.
Rejected teens are likely to have lower self-esteem, and to be at greater risk for “internalizing” problems (e.g., depression).
Some rejected teens display “externalizing” behavior and show aggression (acting-out) rather than depression (acting-in).
Teens with developmental disabilities are more likely to be rejected, and this rejection may lead to a negative developmental cycle that worsens with time (i.e., their emotional growth becomes stunted).
Rejected teens are more likely to be bullied.
Peer-group rejection is believed to be less damaging for teens with at least one close friend.
For the AS or HFA teen who has poor social skills or struggles to build friendships, the idea of interaction with peers is extremely unappealing. Many of these young people can’t think of anything they would hate more than being “forced” to be outgoing. Who can blame them? Nobody enjoys doing things they “suck” at.
The bottom line is this: AS and HFA teens have a “developmental disability,” which simply means that their emotional age is much younger than their chronological age. So, for example, your 16-year-old AS or HFA son is emotionally more like a 12-year-old – yet he is thrown in with a bunch of 16-year-old classmates. Thus, the odds are high that he has already had numerous uncomfortable peer-encounters at school. You can see why the critically important skill (i.e., the ability to engage in age-appropriate social interaction) needed in the teenage years may be the one thing that the AS or HFA teen associates with failure.
Here are several crucial steps that parents and teachers can take to help the AS or HFA teen to deal with rejection:
1. With or without an autism spectrum disorder, most teens become less willing to take a parent’s word or advice. Thus, parents need to hook-up their “special needs” teenagers with other trustworthy adults. If you want your teen to learn or try to do something, arrange for the suggestion or information to come from a trusted adult other than you, the parent. For example, handpick your teen’s guidance counselor, or look for other good mentors (e.g., uncle, scout or youth group leader, psychologist, social worker, peer mentor, “Big Brother,” social skills group leader, weight room coach, martial arts teacher, etc.).
2. Special interests may change, but whatever the current one is, it remains an important aspect of motivation, pleasure, relaxation, and reassurance for the “special needs” teen. So, as long as it isn't creating additional problems, allow your teen to engage in his special interest.
3. Side-by-side conversations (e.g., while walking or driving in the car) about the “issues of the day” may be more comfortable for your teen than talking face-to-face.
4. Seek out activity-based, practical social skills groups designed especially for AS and HFA teens. Participating in such a group, being accepted by group leaders and peers, is probably the most powerful way to allay a teen’s potential despair at not fitting-in socially and not having any friends.
5. Schedule regular monthly educational team meetings to monitor your teen’s progress, to ensure that the IEP is being faithfully carried out, and to modify it if necessary. Because AS and HFA teens can be so volatile or fragile, and because so many important things must be accomplished in 4 short years of high school, these meetings are crucial.
6. Remember that teens on the spectrum are relatively immature (socially and emotionally) compared to “typical” teens of the same chronological age. Imagine sending a 10-year-old girl off to high school (even if she is chronologically 15), or putting a 13-year-old boy behind the wheel of car (even if he has a chronological age of 18), or sending a 16-year-old off to college or the Navy. We need to adjust our expectations for teens on the autism spectrum – and make sure they still have appropriate supports.
7. Look for volunteer activities or part time jobs at the high school or in the community. Be persistent in asking the school to provide help in the areas of career assessment, job readiness skills, and internships or volunteer opportunities.
8. Look for opportunities for a sheltered, successful overnight stay away from home with no parent (e.g., long weekend visits to relatives, a week or two of a carefully chosen sleep-away camp, taking a course on a college campus, etc.).
9. If you have not talked to your teen about autism spectrum disorders, you or someone else should do so, to the extent that your teen is ready to hear it. It’s difficult for AS and HFA teens, because they so much want to be “normal” and successful. A diagnosis can seem threatening – or even totally unacceptable. In truth, however, the adults with AS and HFA who do best are those who know themselves well – both their own strengths, which point them toward finding their niche in the world, and their own blind spots where they need to learn new skills or seek out specific kinds of help.
10. Have realistic, modest goals for what your teen or the family can accomplish in a given time period. You may need to postpone some plans for career goals, trips, culture or recreation.
11. Go with the flow of your teen’s nature. Simplify schedules and routines, streamline possessions and furnishings. If, for example, your teen only likes plain T-shirts without collars or buttons, buy them. If she likes familiar foods or has a favorite restaurant, indulge her.
12. Even for a previously well-adjusted teen, multiple stressors during the teenage years may bring on anxiety and depression. Stressors include increased academic/abstract thinking and social demands at school, peer pressure, increased social awareness, and fears of the future. Highly anxious teens who do not get professional help may be at risk for school failure, acting-out, alcohol and substance abuse, and even suicide attempts. Seek the assistance of a child and adolescent psychiatrist who specializes in autism spectrum disorders.
13. Build and use any support networks you can (e.g., extended family, close friends, church/synagogue groups, empathetic school staff, etc.). If you don’t have a good network, consider individual or family therapy for some support during a stormy, demanding life passage.
14. Boys on the autism spectrum may need to spend increased amounts of time with their fathers, and/or other male role models as they undertake to become men. If dad has taken a back seat, let him know his son really needs his attention now. If you are a single mother, look especially hard for male mentors at your son’s school or in the wider community.
15. Although most teens with AS and HFA are more docile and child-like, be prepared to tolerate/ignore considerable distancing, surliness, or acting out, knowing that it won’t last forever. At the same time, set some firm limits, and keep a close eye on your teen’s welfare.
16. Teens with AS and HFA are less prepared than “typical” teens for the new challenges of sexuality and romance. Some are oblivious, while others want a girl or boy friend, but are clueless about how to form and maintain a relationship. Boys especially may be at risk for accusations of harassment, and girls especially at risk for becoming victims. Teach appropriate rules, or see that another adult does. Look for supervised activities in which boys and girls can socialize safely together, supervised by a staff person who knows about autism spectrum disorders and can coach appropriate social skills.
17. Teens on the spectrum need to learn when to ask for help, from whom, and how. It’s very helpful to have someone such as a trusted guidance counselor whose door is always open, and who can coach your teen in problem solving.
Adolescent culture is social by nature. Teens tend to move around in groups of people their own age. Thus, an adolescent who is isolated, either by chance or choice, is at a distinct disadvantage – and is often treated as an outcast. The effects of rejection and isolation on an AS or HFA adolescent can be long-lasting and create problems that moms and dads need to address. By using the steps listed above, parents can help their “special needs” teen (a) overcome the negative effects of peer-group rejection, (b) learn critical social skills, and (c) gain the self-confidence needed thrive as an adult.
Resources for parents of children and teens on the autism spectrum:
• Anonymous said... I have a twenty year old who was excluded and teased when he was 15. The wound still exist. In college he still does not want friends and only interacts with video game faceless friends. I gave him therapy, support and love. The heart never forgets this pain. I believe this bulling by the next door neighbor boy is something he got over at some level. His social life consist of video gaming. Gaming just feels easier and safer to socially interact with others. Without games he would be alone? • Anonymous said... I have a very lonely, sad 16 yr old • Anonymous said... I understand. My son is 15 and i put him in a charter school. He did a shadow tour and told me he wanted to ho there. The school has been very supportive and he's met a few friends. Of course, they had tp approach him. • Anonymous said... It's heartbreaking seeing my 14 year old son with no friends...even worse was the constant bullying • Anonymous said... The same with my 12 year old • Anonymous said... Try finding other small groups or hobby clubs of people with the same interest as your child, a place where they feel they can fit in and belong and have confidence because it is an area of expertise. Through the common shared interest, they can find a social outlet. Check into gaming stores, sometimes they have meetings for those interested in certain games: video games, card games, comic books, etc. • Anonymous said... very true • Anonymous said… Great advice, tina...gaming clubs, etc. • Anonymous said... I am leery of the gaming stores... When I was in NYC we paid a visit to the Nintendo store and what really concerned me was the zombie nature of several grown men around a large white table playing Nintendo games well into the night. I am all for being social, but these men were not being social with each other. It was very off putting and I strongly believe would aid in furthering my son's avoidance behavior. I honestly left concerned... • Anonymous said... My son is 17. He has never had what most would call a friend. He has had peers who supported him and allowed him to safely socialize with them which he prefers to act however he wants and talk about whatever he wants while his peers tolerate him but .. that isn't real and I don't know how to help. He graduates from high school this year and .. what happens next? He doesn't have the maturity to study/participate in college and his math deficit and desire to build machines, tanks, firetruscks, sirens, etc doesn't lend itself to any jobs so .. just kinda lost. • Anonymous said... This breaks my heart. • Anonymous said... we have a 16 year old with similar theme!
• Anonymous said… My aspie 17 year old seems to be completely oblivious to how much he gets left out. He will follow people around, talking at them, and even continue talking after they turn around and ignore him. He goes to a private school with a higher number of ADHD and special needs kids, and we worship at a mega church. Both places have plenty of nice people who will listen (or pretend to listen) to his non-stop monologues about machinery. The church people especially try to befriend him, but he wants an audience for his monologues, not conversations, so they don't really know how to connect. They tell me what a neat kid he is, though. So, while he still ends up with no one who wants to invite him to hang out on weekends, he feels like he's incredibly popular and well liked since someone among the hundreds in the room will always be willing to hear his unending list of machinery factoids. It's when he's home that he's unhappy, because there is just so much we can handle hearing before we tell him to hush and try to teach him social skills. He gets angry and lashes out, simply because I tell him to try to listen to his siblings or participate in what the family is doing. So it's not being left out that bothers him - it's not being able to treat people as his audience and he's not treated like the star he knows himself to be that really ticks him off. • Anonymous said… Just to pick up on the gaming group comment. I can see how it would not be interactive. However, when my son was 13 - 15 he would go to CARD game tournaments (you don't have to take part in the actual tournament) It would lift my heart to see loads of like minded kids chatting and laughing in a way he never did with any other people. Sadly he grew out of the card game phase but I believe it taught him he will not always be lonely.
"I need some tips on how to deal with my HFA teenager. We're dealing with so many issues at the moment - depression, social isolation, backtalk, failing grades, and the list could go on and on here..."
Parenting adolescents brings many challenges – hormonal changes, self-identity, and the pressure of being socially acceptable, just to name a few. When you add Asperger’s or High Functioning Autism (HFA) to the equation, the element of difficulty increases significantly.
Parents can help their “special needs” adolescents, but this begins with becoming knowledgeable about what they face. Parents should learn as much about the disorder as possible and how they can support and help these young people face their challenges.
The “typical” teenager is really into his or her friends. The tools for developing social skills as an adolescent are shared experiences and conversation with peers. But, for the teenager who has poor social skills or struggles to communicate, the idea of conversation and interaction with peers is not appealing. For many teens with Asperger’s and HFA, they literally can’t think of anything they would enjoy less than “having” to be social. And who blames them? Nobody enjoys doing things they are not naturally good at.
Teens with Asperger’s and HFA are easily misunderstood. For example, one teenager might be unfiltered, blurting out the first thought that pops into his head, while another may struggle to form and express complete sentences. Both scenarios create tension for the teen with Asperger’s or HFA – as well as his peers, who may be attempting to interact. Typically developing teens sometimes react harshly in these awkward moments.
In general, adolescents don’t exactly have the market cornered on emotional maturity. They’re still developing. So, odds are high that a young person on the autism spectrum has already had a number of uncomfortable peer-encounters by the time he reaches adolescence (e.g., teasing, bullying, peer-rejection, etc.). You can see why the critically important skill (i.e., the ability to engage in age-appropriate social interaction) needed in adolescence may be the one thing that a teen with Asperger’s or HFA associates with failure.
Parenting Out-of-Control Teens with Asperger's and High-Functioning Autism
15 crucial strategies that parents and teachers can employ in an effort to assist teens with Asperger's and HFA:
1. Adolescents with Asperger’s and HFA are challenged with self-esteem issues. Thus, it is important to help them feel important in matters that involve them. Get them to participate by giving them the choices available, as well as understanding of the consequences behind those choices.
2. Alternate preferred activities (e.g., computer games, TV viewing) and less-preferred activities (e.g., homework, chores). Teens on the spectrum are likely to put more intense – and more sustained – effort into challenging/non-preferred tasks when they know that they can take part in a fun or interesting activity at the end of it.
3. As the mother or father facing the often overwhelming task of parenting and disciplining an adolescent with Asperger’s or HFA, it may seem that you don’t have the time or patience for allowing her to have input into decisions that concern her. And it may even seem downright scary to consider allowing her to make her own decisions. Doing so would take more time and would definitely involve some risk. But, it becomes a significant issue when adolescents feel they are disregarded in matters that directly affect them. Adolescents with Asperger’s and HFA are no different in this regard. It’s a big deal when they are made to feel important despite their disorder. An important proactive step is letting the “special needs” adolescent know that, although her needs may be a challenge, there is nothing that can’t be overcome or managed more effectively.
4. Challenged by a particular developmental disorder or not, teens want to know they are loved, supported and have encouragement when needed. This is even more important for young people on the autism spectrum. When the disorder is allowed to overshadow the significance of a teenager, it hinders him or her greatly.
5. Check to be sure that you have your teen’s attention before giving directions. However, understand that young people on the spectrum may not always make eye contact, even when they are paying attention to you. Be on the lookout for other signs of attending (e.g., alert posture, orientation toward you, stopping other activities, verbalizations, etc.). Also, include essential information in your directions that will answer these four questions for your teen: When do I do the work? What is my payoff for doing the work? What exactly am I supposed to do? How much work is there to do in this task?
6. Create a plan to help your teen to generalize his learned social skills across settings and situations. Teens on the autism spectrum are likely to need explicit programming to generalize skills that they have learned in a particular setting to other settings or situations. Teach only a small number of “key” skills (e.g., how to start a conversation, how to ask for help) at one time so that you will have enough time to work with your child on generalizing each mastered skill. After he has mastered a skill in one setting, list other settings or situations in which you would like him to show the skill. Then create a training plan to help your teen to use the skill in these novel settings. If he has mastered the task of delivering appropriate social greetings at school, for example, you might take him to a church youth group, prompt him to greet his peers, and provide praise or rewards for his successful performance. This is an example of “hands-on” social skills training, which is greatly needed with these young people. Parents and teachers should “go the extra mile” like this.
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7. Create structured opportunities for your teen to participate in social interactions (e.g., allow him to invite a friend or two over for a movie or pizza party). Asperger’s and HFA teens are often excluded from social interactions with their typical peers at school, so parents can make up for this by providing social opportunities at home.
8. Help build your “special needs” teen’s self-esteem. List-making can be an effective method for accomplishing this goal. To begin, your adolescent can make a list of at least 5 things he admires or appreciates about himself. This list can include simple things (e.g., has a nice smile), or more significant things (e.g., earning good grades in school). Each day thereafter, he continues to make a new list. These lists can include his 5 greatest strengths, 5 greatest life achievements, 5 people who love and care about him, and his 5 favorite memories. Your adolescent can keep these lists in a special place and refer to them any time negative thoughts enter his mind.
9. Helping your Asperger’s of HFA adolescent will be challenging at times, because with mood swings, meltdowns and hyperactivity, it seems you have no control – but neither does she! However, take a moment to realize that you can help her by controlling yourself. You really do your teen a great service by maintaining control, and by not allowing difficult situations to overwhelm you. Stress is contagious, so don’t spread it to your teenager.
10. Minimizing the disorder is NOT the point. Helping your adolescent to understand that he can accomplish things in spite of his disorder IS the point. Not only does this encourage self-esteem, it also provides motivation and hope.
11. Offer meaningful choices that give your teen some autonomy and control. For example, you may encourage her to select a few chores, and then allow her to decide what chore she will work on first. Also, you could allow her to choose when and where she will do her homework. Make an effort to build choices into home activities whenever possible.
12. Post a clear and predictable daily schedule. Children and teens with Asperger’s and HFA crave structure and predictability. But know that young people on the spectrum can sometimes react more strongly than their “typical” peers when faced with any unexpected change in their daily schedule. Thus, be as consistent as possible with the schedule.
13. Provide your teenager with simple strategies to engage others in social interactions. Demonstrate and model these strategies. Then give her an opportunity to try them out, and give her feedback and encouragement (e.g., role play how to approach a group and ask to join a game or other activity).
14. Use verbal prompts (i.e., pre-correction) before your teen engages in a task to promote success. Phrase your prompt to reflect what you would like to see your teen do (e.g., “Michael, please do your homework before dinner”), rather than what you would like him to stop doing (“Michael, you need to stop playing video games and get busy with your homework, because we are going to eat dinner soon”).
15. When a problem arises and you must confront your teen, keep your tone of voice calm and relaxed in spite of how you may be feeling. This “gentle” approach can diffuse a lot of situations that may otherwise be lost to conflict and anger. While every situation may not be diffused, disciplining in a gentle fashion is something that should be practice diligently with children and teens who are prone to meltdowns and feelings of frustration or anxiety.
Your adolescent with Asperger's or HFA will want friends, but may feel shy or intimidated when approaching his peers. He probably feels "different" from others. Although most “typical” adolescents place emphasis on being and looking "cool," young people on the autism spectrum may find it frustrating and emotionally draining to try to “fit in.” They may be immature for their age, and they may be naive and too trusting, which can lead to teasing and bullying.
All of these difficulties can cause these adolescents to become withdrawn and socially isolated – and to have depression or anxiety. However, with a little assistance from parents and other caring adults, even an Asperger’s or HFA teen can thrive and live a productive, happy life.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
“My teenage son with ASD (high functioning) is out of control, don't know what to do? I tried every option available to me with the exception of bootcamp. I just can't afford to put him in a bootcamp or military school. But that's the only solution that I see. He’s 17 and is on pot every day. He has a hair trigger and will go off big time whenever he is the least bit irritated over something… fits of rage over little things that most people would just ignore. Has threatened to kill himself when he’s upset. Please help!!!”
Emotional Dysregulation (ED) is often found in young people with Asperger’s (AS) and High-Functioning Autism (HFA), and is a term used in the mental health profession to refer to mood swings and emotional reactions that are significantly “out-of-control.” Examples of ED include destroying or throwing objects, angry outbursts, aggression towards self or others, a decreased ability to regulate emotions, an inability to express emotions in a positive way, smoking, drug and/or alcohol abuse, eating disorders, self-harm, and even threats to kill oneself or others.
These reactions usually occur in seconds to minutes – or hours. ED often leads to behavioral problems for the individual, which can interfere with his or her relationships at home, in school, or at place of employment.
ED in AS/HFA teens can be associated with “internalizing” behaviors, for example:
becoming avoidant or aggressive when dealing with negative emotions
being less able to calm themselves
difficulty calming down when upset
difficulty decreasing negative emotions
difficulty understanding emotional experiences
exhibiting emotions too intense for a situation
experiencing more negative emotions
ED can also be associated with “externalizing” behaviors, for example:
being impulsive
difficulty calming down when upset
difficulty controlling their attention
difficulty decreasing their negative emotions
difficulty identifying emotional cues
difficulty recognizing their own emotions
exhibiting more extreme emotions
focusing on the negative
ED in adolescents with AS and HFA can be made worse by difficulty in communicating feelings of annoyance, anxiety, depression, or worry. ED may be a common reaction experienced when coming to terms with problems in relationships, friendships, school, employment, and other areas in life affected by autism spectrum disorders.
There can be an “on-off” quality to these strong emotional reactions, where the affected individual is calm minutes later, while those around are stunned and may feel hurt or shocked for hours – if not days – afterward. Moms and dads struggle to understand the out-of-control behavior of their “special needs” teenager, with disappointment and resentment often building up over time. Once they understand that their teen has trouble controlling his emotions or understanding its effects on others, they can begin to respond in ways that will help manage these flare-ups.
In some cases, AS/HFA adolescents may not acknowledge they have trouble controlling their negative emotions, and will blame others for provoking them. Again, this can create enormous conflict within the family. It may take carefully phrased feedback and plenty of time for these adolescents to gradually realize they have a problem with how they express themselves.
As previously mentioned, many individuals with ED have an autism spectrum disorder. But, when the typical problems associated with adolescence are added to the equation, parents have a real challenge on their hands. Here are just a few of the struggles associated with being a teen on the spectrum:
• The teen years are more emotional for everyone. Yet the hormonal changes of adolescence, coupled with the problems associated with AS and HFA, might mean that the adolescent becomes emotionally overwhelmed. Childish tantrums reappear. Males may act out by physically attacking a peer or teacher. They may experience "meltdowns" at home after another day filled with harassment, bullying, pressure to conform, and rejection. Drug addiction becomes a real concern at this age (most notably, marijuana use).
• Teens with AS and HFA - with their distractibility and difficulty organizing materials - face similar academic problems as students with ADHD. A high school term paper or a science fair project becomes impossible to manage, because no one has taught the AS or HFA teenager how to break it up into a series of small steps. Even though the academic stress on an AS/HFA adolescent can be overwhelming, school administrators may be reluctant to enroll him in special education at this late point in his educational career.
• Some teens with AS and HFA remain stuck in grammar school clothes and hobbies instead of moving into adolescent concerns (e.g., dating). AS/HFA males often have no motor coordination. This leaves them out of high school sports (typically an essential area of male bonding and friendship).
• Many teens with AS and HFA - with their average to above average IQs - can sail through grammar school, and yet hit academic problems in middle and high school. They now have to deal with 4 to 6 teachers, instead of just 1. The likelihood that at least one teacher will be indifferent - or even hostile - toward making special accommodations is certain. The AS/HFA student now has to face a series of classroom environments with different classmates, odors, distractions, noise levels, and sets of expectations.
• Many AS/HFA adolescents are stiff and rule-oriented and act like little adults, which is a deadly trait in any teen popularity contest. Friendship and all its nuances of reciprocity can be exhausting for an AS or HFA teenager, even though she wants it more than anything else.
• In their overwhelming need to fit in and make friends, some teens on the spectrum fall into the wrong high school crowds. Adolescents who abuse substances may use the AS or HFA teen’s naivety to get him to buy or carry drugs and liquor for their group.
• In the teen world where everyone feels insecure, adolescents that appear different are voted off the island. Teens with AS and HFA often have odd mannerisms. One adolescent talks in a loud un-modulated voice, avoids eye contact, interrupts others, violates others’ physical space, and steers the conversation to his favorite odd topic. Another appears willful, selfish and aloof, mostly because he is unable to share his thoughts and feelings with others. Isolated and alone, many autistic teens are too anxious to initiate social contact.
• AS/HFA is characterized by poor social skills. These include a lack of eye contact during conversation and body language that conveys a lack of interest. The teen years revolve around social interaction, and an adolescent on the spectrum may be ostracized and mocked by his class mates because of his lack of social skills.
• AS and HFA adolescents are often more immature than their peers and may be naive when it comes to puberty and sexuality. If they have not been taught about sex, they may pick up information from pornographic material. This can lead to inappropriate behavior and touching that could land them in trouble.
• Fashion is important to “typical” teens (especially girls), but teens with AS and HFA have little dress sense. If they do not attempt to conform to their peers' standards, they will often be mocked and left out of social events.
• Depression often results from the social skills deficits that adolescents with AS and HFA commonly experience. They may feel worthless, and in extreme cases, may consider suicide as an option.
• Bullying is a big challenge in the lives of many autistic teens. Because of their unusual behavior, they tend to attract bullies and are less likely to report this than their peers. In some cases, the AS or HFA teen may respond with violence and end up in trouble at school.
Common causes of ED in autistic adolescents include other people’s behavior (e.g., teasing, bullying, insensitive comments, being ignored, etc.), intolerance of imperfections in others, having routines and order disrupted, difficulties with academics despite being intelligent in many areas, peer-relationship problems, a build-up of stress, and being swamped with sensory stimulation or multiple tasks.
Identifying the cause of ED can be a challenge. It is important for parents and teachers to consider all possible influences relating to the environment (e.g., too much stimulation, lack of structure, change of routine, etc.), the adolescent’s physical state (e.g., pain, tiredness, etc.), his or her mental state (e.g., existing frustration, confusion, etc.), and how well he or she is treated by peers.
The first step is for the AS or HFA adolescent to learn emotion-management skills. A good place to start is identifying a pattern in how the strong reactions are related to specific frustrations. Such triggers may originate from the environment, specific individuals, or internal thoughts.
Steps to successful emotion-management include the following:
• Self-awareness— The AS/HFA adolescent can be instructed to become more aware of personal thoughts, behaviors, and physical states which are associated with ED. This awareness is important for the adolescent in order for him to notice the early signs of losing control of his emotions. He should be encouraged to write down a list of changes he notices as he begins to feel the need to over-react to something.
• Levels of anger and coping strategies— As the adolescent becomes more aware of situations associated with ED, she can be instructed to keep a record of events, triggers, and associated levels of frustration. Different levels of disturbance can be explored (e.g. mildly annoyed, irritated, very frustrated, angry, a sense of rage).
• Develop an emotion-management record— The adolescent may keep a diary or chart of situations that trigger strong reactions. List the situation, the level of frustration on a scale of 1 to 10, and the coping strategies that help to overcome or reduce feelings of frustration.
• Becoming motivated— Parents and teachers can help the AS or HFA adolescent to identify why he would like to manage his emotions more successfully. He identifies what benefits he expects in everyday living from improving his coping skills.
• Awareness of situations— The adolescent is taught to become more aware of the situations that are associated with outbursts. She may want to ask other people who know her to describe situations and behaviors they have noticed.
Self-Help Strategies—
The “stop – think” technique:
As the adolescent notices the troubling thoughts running through his mind, he can learn to (a) stop and think before reacting to the situation (e.g., “Are these thoughts accurate or helpful?”), (b) challenge the inaccurate or unhelpful thoughts, and (c) create a new thought.
The personal safety plan:
A personal safety plan can also be developed to help the adolescent avoid becoming upset when she plans to enter into a situation that has a history of triggering strong reactions. Here is a real life example of a plan used by a 17-year-old girl with Asperger’s for using the “stop – think” technique when approaching a shopping center situation that is known to trigger frustration:
My goal: To improve my ability to cope with frustration when I am waiting in long lines.
Typical angry thoughts: “The service here is so slow. Why can’t they hurry it up? I'm going to lose my mind any moment now.” – Stop thinking this!
New calmer and helpful thoughts: “Everyone is probably frustrated by the long line – even the person serving us. I could come back another time, or I can wait here and think about pleasant things such as going to see a movie.”
Possible steps in a personal plan can include the following:
Plan ways to become distracted from the stressful situation (e.g., watch a YouTube video or read an e-book on my cell phone, carry a magazine)
Phone my friend to talk about the cause of frustration
Make changes to routines and surroundings (e.g., avoid certain people that are prone to teasing me)
Leave the situation if possible
Explain to another person how he or she can help me solve the problem
Avoid situations that are associated with a high risk of becoming frustrated
Other possible components to a personal plan can include the following:
Use visual imagery (e.g., jumping into a cool stream takes the heat of anger away)
Self-talk methods
Relaxation techniques
Anger-control classes in my area
Creative destruction or physical activity techniques to reduce anger
Dealing with the emotional problems in teens with AS and HFA is not easy for parents, and it can be hard to trace back the original causes of problematic behaviors. If parents are concerned about their child’s anger, rage or aggression, they should seek advice from a professional. Oftentimes, young people on the autism spectrum who demonstrate emotional problems simply need help developing some coping, social and communicating skills.
Resources for parents of children and teens on the autism spectrum:
