Questions Surrounding Autism and Adolescents

My child always seems to react negatively to changes in his routine. How can I prevent this?

Since most children with Autism thrive on clear expectations and routines, there are many different methods a parent can use to help create smooth transitions.

1. Write schedules and time frames in a designated space (refrigerator or dry erase board), or use a picture schedule for non-readers.
2. Explain changes in the routine well in advance (e.g., “On Friday, you have an appointment with the dentist. That means, we will not be going home right after school, we will go to Dr. Smile’s office.”).
3. Tackle problem areas in advance when you have the time and energy to do so. For example, Justin (a child with autism) expected his mother to take the same route to Wal Mart every time and would become agitated if she deviated. In the beginning, it was not worth upsetting the routine, because mom had other problems that seemed more pressing, so she compliantly took the same route so as not to cause a fuss. Eventually, as other behaviors were dealt with, she began to tackle this one by letting Justin know ahead of time that they would be taking a different route, and eventually, she succeeded by just working through the tantrums and sticking to her guns.
4. Social Stories, developed by Carol Gray, work well for explaining changes ahead of time. Children with Autism also respond well to visuals and graphic models.

References:
Gray, C., Comic Strip Conversations, Future Horizons, Inc. Arlington, TX. 1994.
Gray, C. The Social Story Book, Future Horizons, Inc., Arlington, TX, 1994.
Reese, P. and Challenner, N., Autism & PDD: Social Skills Lessons, LinguiSystems, Inc., East Moline, IL, 1999.

How can I promote positive peer interactions for my child to help them gain social acceptance and develop friendships?

1. Help your child engage in successful conversations and reflection, with empathic peers, by using comic strips since the pictures, words, and symbols identify what the people say and do and emphasize what people may be thinking. Social stories which describe typical social situations and explain the meaning of various comments and identify appropriate responses are also good.
2. Direct your child to participate in activities or clubs in which their abilities might neutralize their social deficiencies (e.g., math groups). Make sure they are not involved in groups that are frequented by bullies.
3. Identify your child’s special gifts and teach him/her to share those gifts through tutoring, class presentations, or community service.

My child is developing new behavior problems that we didn’t face in elementary school. How do I handle these?

Below is a generic format for a functional behavior analysis (FBA). Your child’s school should provide assistance with this process when a parent requests, or when a teacher sees behaviors that interfere with academic learning and progress. You can use the same approach for problems at home.

1.Try to figure out the function of the behavior. Is it...

• Social Attention
• Escape/ avoidance
• Wants tangible item or activity
• Sensory Feedback

2. Gather Information

Antecedent : Does the behavior occur…

• When you are attending to other people in the room?

 Following a request to perform a difficult task? -

• When a request for an item or activity is denied?
• Repeatedly, in the same way, for long periods of time, even when no on is around?

Consequence: When the behavior occurs, do you or others….

• Attend to him/her?
• Leave him/her alone?
• Negotiate or give the desired item/activity
• Allow him/her to engage in inappropriate behavior?  

3. Plan an Intervention

Based on information gathered, determine how people should react to the challenging behavior each time it occurs.

• Plan to ignore.
• Plan to attend.
• Plan to remove privileges.
• Plan to redirect.

4. Identify a Replacement Behavior

What appropriate behavior is “functionally equivalent” to the challenging behavior?

• Teaching him/her to ask for a desired item or activity to replace tantrum/unwanted behaviors
• Teaching him/her to communicate his/her wants appropriately to replace escape/ avoidance behaviors

5.  Implement the plan

My child was diagnosed with Asperger’s Syndrome. How does this differ from Autism?

 Austrian Hans Asperger identified Asperger’s syndrome in 1944. Asperger’s is a neurologically based disorder on the autistic spectrum. It affects social perception, interactions, language and nonverbal communication. People with Asperger’s look typical, may have average to superior intelligence, but lack the social awareness and skills needed to connect with their world. There is a great debate as to where Asperger’s fits in the spectrum. According to Uta Firth in her book Autism and Asperger’s Syndrome, Asperger’s is described as being on the autism spectrum disorder. She describes Asperger’s Syndrome as “having a dash of Autism”. Others disagree and believe that Asperger’s Syndrome is a Nonverbal Learning Disability (NLD) or that Asperger’s Syndrome shares characteristics of Pervasive Developmental Disorder Not otherwise Specified (PDD-NOS), or as High Functioning Autism (HFA). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM- IV) a diagnosis of Asperger’s syndrome requires that four of the five listed criteria be present, including at least two indicators of a qualitative disability in social interactions, (e.g., serious impairments in peer relationships, social reciprocity, nonverbal behaviors, and empathy) and at least one in the category of restricted interest and stereotyped behaviors or rituals (e.g., rigid adherence to rules or routine, preoccupation with a narrow interest, parts or objects, repetitive motor movements). Many individuals who fall within the category of having Asperger’s Syndrome are often misdiagnosed with ADD, ADHD, schizophrenia, learning disabilities, bi-polar, receptive language, oppositional defiant and emotional disorders. Many children with Asperger’s are seen as being “bad kids.” Children with Asperger’s are not “bad kids” … yes, they have “bad” moments just like every other kid, and sometimes even more often than other kids, but Asperger’s is a true syndrome that can be improved through treatment and intervention.

Reference

Attwood, T. (1998). Asperger’s Syndrome: A guide for parents and professionals. London, UK: Jessica Kingsley Publishers.

Ehlers, S., Gillberg. C., & Wing, L. (1999). A screening questionnaire for Asperger’s Syndrome and other high-functioning autism spectrum disorders of school age children. Journal of Autism and Developmental Disorders, 29, 129-141

Klin, A., Volkmar, F. & Sparrow, S.S. (2002). Asperger Syndrome. New York: Guilford

Osonoff, S., Dawson, G. & McParland, J. (2002). A parent's guide to Asperger Syndrome and high-functioning autism. New York: Guilford.

Safran, S. P. (2001). Asperger’s Syndrome: The emerging Challenge to Special education. Exceptional Children, 67, 151-160