I’m emailing with Kris Jones, an eloquent writer on Linkedin about his Asperger’s Syndrome. We’re talking about the stressors he experiences that can create extremely self-limiting anxiety. We’re going to use several blogs to talk about different stressors. Kris’s first stressor was his lack of self–fulfillment. One of the causes of this lack of self-fulfillment was Kris’ social anxiety.

Tony Attwood, expert on Asperger’s Syndrome, suggests that around 65% of adolescents with Asperger Syndrome have a secondary mood or affective disorder (such as depression or anxiety); most have anxiety.

anxiety/stress

Kris describes his thoughts and feelings which I’m calling social anxiety like so: “No one likes you. No one wants to know you. You are not interesting. Stay where you feel most comfortable – inside your house and away from others. You are not fit to be out there amongst the human race.” He says that this is representative of how he feels and it is what keeps him from going out and mingling with others his age. Even though he knows these thoughts about himself aren’t true, he can’t get past the anxiety.

Let’s break this down into parts. What causes this social anxiety?Continue Reading

Motivation is key when using reinforcement to change the behavior of individuals with Aspergers or HFA.

When you think about it, it makes sense that motivation is at the center of it all. If a child or individual is motivated, they are more willing to make certain changes in their behavior and do what you want.

Highway road going up

Using motivation as a behavioral tool for change occurs for neurotypicals as well. For example, if there is a position available at work that someone wants, the individual will modify their behavior to increase the chances of obtaining that position.  The specific change in behavior is a direct result of motivation (as in wanting the position).  If the position was not available, the person would less likely be engaging in the changed behaviors.

That said, there are two ways to manipulate motivation:

Deprivation

Deprivation means reducing the amount of access your child has to the reinforcer, also known as the item or activity that will be used to motivate the child to increase or decrease behavior. Deprivation increases the value of the reinforcer.

Example:  If a child absolutely loves Cheetos but has free access to them, a behavior analyst would use deprivation to increase the value of the Cheetos. Now the child can only access them if he or she performs as expected. Since the child has less access to the Cheetos but still loves them, the child is more willing to do what is asked to obtain the Cheetos—motivation.

Satiation

Satiation, on the other hand, means increasing the amount of access your child has to the reinforcer. Satiation is meant to decrease the value of the reinforcer, which is something to keep in mind when choosing a motivational tool.

Example: If a teenager receives an iPad, an object he is fascinated with, as a reinforcer and is the only reinforcer being used, it is likely that after a period of time the child will lose their interest in the iPad resulting in satiation (the iPad no longer has a strong value).

Behavior Analysts use deprivation to increase the value of the reinforcers to motivate the individual with Asperger’s or HFA, and are cautious of satiation to make sure the reinforcer does not lose its value. This encouragement can be used to help them to adapt in a situation or adjust behavior appropriately.

by Adriana Sanchez, MA, BCBA

Your Child's diagnosis, becoming an expert

The community I was from is set up for autistic people, people like me, to fail. One of the big issues in a minority community is that mental health is not addressed and no one believes in it. The resources are usually not available or difficult to find for people in minority communities. There are also long-standing traditions of mental health denial because of a “pull yourself up by your bootstraps” mentality. Because minority communities have often faced severe oppression and suffering in many ways, they have built an ideology about being strong and not helpless or weak. This has had many adverse effects on the mental wellbeing of the people within those communities.

Your Child's diagnosis, becoming an expert

Since mental health was somewhat of a myth to the community, it was a struggle I endured in my entire life.

I’m an African American male who comes from a community where if you displayed behavior that is associated with a mental illness, you were punished. African American communities often believe strongly in going to church, and they will tell you to pray about it and not seek help from a mental health professional. If you seek help from a mental health professional, you are viewed as weak. They tell your child to “man up, it’s all in your head, you’re making it up, etc.”

It’s hard to accept a mental health diagnosis in the Black community because of traditions we have been taught with.

Nobody in my community accepted my autism diagnosis, and I was ridiculed for seeking help. It was not until I was 22 years old, when I had my third suicide attempt, that I received help and support for my autism and other disabilities.

Today, to help others avoid this struggle, I have composed a list of ways you can accept your child’s diagnosis no matter how severe it is. Remember, you can be victorious and become an expert and advocate for your child.

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During the summer of 2017 Aspergers101 hosted a free informational series on Aspergers at the San Antonio Public Library. We have recorded each of these valuable sessions in video and powerpoint format so that you can have access to them at any time. Below, watch the second workshop from our Informational Summer Series on Aspergers focusing on social development.

First, Jennifer and Sam Allen discuss important strategies for parents, professionals, and peers to utilize when socializing with those with Aspergers. Next, Louise O’Donnell, Ph.D. Neuropsychologist and Assistant Professor at UT Health Departments of Psychiatry and Pediatrics talks about the neurological aspects of social development for those with Aspergers and Autism.

The following are excerpts from Jennifer and Sam Allen’s powerpoint presentation on social development.

Remember when communicating with someone diagnosed with ASD:

  • They know what they want and don’t want.
  • They know what they want to get across.
  • They know what they feel.
  • What they may find challenging is finding a way to let us know what those thoughts and feelings are.

Strategies for Improving Social Integration

1. Opportunities to interact with neuro-typical children

The first strategy is to ensure the child has opportunities to observe and interact with mainstreamed children at their school. This is to ensure that their peers not only demonstrate appropriate social/emotional behavior but also are sufficiently skilled socially to know how to modify their social behavior in order to accommodate and support the child with Asperger’s Syndrome. Some children with Asperger’s Syndrome attend schools for emotionally disturbed children; such circumstances may not provide an appropriate peer group.

2. Knowledge of the nature of Asperger’s Syndrome

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As most teens and adults with Asperger syndrome know, people with Asperger syndrome can be significantly depressed. The rates of diagnoses of depression vary among studies, from 18% to 22%. The most commonly quoted rate of a depression in the general population of the US  is 6.7%. Most of the research shows both genders have these high rates of depression.

Studies focused on males and females and not those who are transgender. There are more people who identify as transgender in the AS population than in the general population and transgender people have a higher rate of depression. One would guess that someone who is both AS and transgender might have a high tendency towards depression.

Interestingly, non-autistic full siblings and half-siblings of individuals with ASD (not just Asperger syndrome) also had higher rates of depression than the general population, although at half the rate of those with ASD. Studies of suicide attempts are also very troubling. In studies of suicide, the rate of suicidal thoughts and attempts are prevalent, especially in adolescence and young adulthood.

It’s critical to identify depression, since it can be treated.

It’s obviously important to understand why rates of depression and suicidal thoughts are so high. One factor, given the findings in siblings, is that there is an increased genetic vulnerability to depression, although large studies haven’t supported a common genetic overlap. We have to look to other factors to account for these high rates of depression.

It’s important to diagnose clinical depression for anyone for a simple reason – depression is treatable with a variety of modalities:

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Your child may not know how to use language appropriately in social situations. This undeveloped social skill can cause your child to unintentionally say harmful or rude comments to others. Even when able to say words clearly in complex sentences with correct grammar, a child still may have a communication problem – if they have not mastered the rules for social language known as pragmatics.

Speaking head

Pragmatics includes three major communication skills:

  1. Using language for different purposes

    • greeting (e.g., Hello, goodnight)
    • informing (e.g., I’m going to go to bed now.)
    • demanding (e.g., Turn out the lights, please.)
    • promising (e.g., I’m going to wake up early and make waffles.)
    • requesting (e.g., I would like an extra blanket.)

  2. Changing language according to the needs of a listener or situation

    • speaking differently to a toddler than to an adult, or with a sibling vs. a teacher
    • sharing background information with an unfamiliar listener
    • speaking differently in a movie theater than on a playground

  3. Following rules for conversations

    • turn taking
    • introducing a topic of conversation
    • staying on topic
    • rephrasing when misunderstood
    • using verbal and nonverbal signals
    • knowing how closely to stand to others
    • using appropriate facial expressions and eye contact

Remember: It is important to understand the rules of your communicative situation.

An individual with pragmatic problems may:

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Our bodies take in information from the world around us through our sensory systems. As this information comes in, our brain filters and processes it for use. This process, called “sensory processing”, all happens automatically and simultaneously without us realizing that it.Depositphotos_37852017_sWhen all of these systems work correctly, we are able to perform our daily activities smoothly and without a problem. When these systems don’t work as well as they should a person may be disorganized, clumsy, have attention difficulties, and become over responsive or under responsive. Individuals with this issue might just have trouble functioning day to day as well as they should.

This is called Sensory Processing Disorder (SPD).

Sensory Processing Disorder can be seen in typically developing children and adults at an estimated rate of 15%. But individuals with autism and Aspergers are far more likely to be affected. It is estimated that 80% of children with ASD have sensory processing difficulties.

Some signs of SPD include:

  • Oversensitive to touch, sound, smell, lights and other visual input
  • Distractibility
  • Clumsiness
  • Decreased play skills
  • Resistance to being touched by others
  • Picky about clothing textures and tags
  • Toe walking and/or hand flapping
  • Picky eating

If you would like to learn more about SPD, visit the SPD Foundation website. If you know your child has sensory issues, you can also find a SIPT Certified Therapists in your area.  

Do you see some of these sign in your child?  How do you handle the difficulties that arise from them? 

By Gayla A. Aguilar, OTR, OTD

Sources

Ayres, A. J. (1972). Sensory integration and learning disorders.  Los Angeles: Western Psychological Services

Tomchek, S.D., Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the Short Sensory Profile. American Journal of Occupational Therapy, 61, 190-200

Since feeding involves all sensory systems (sight, smell, sound, touch, and taste), eating is the most difficult sensory task that children face. Feeding issues are especially common in children with autism, including those with Aspergers, because of difficulties with sensory processing. In many cases, this leads to eating challenges at mealtimes.

Little girl eating

“Food chaining,” from the book by the same name, is based on the child’s natural preferences and successful eating experiences—specifically the idea that we eat what we like. Food chaining introduces new foods that have the same flavors or sensory features as foods that are already preferred by the child, increasing the likelihood that the child will like the food.

A food chain consists of four levels that build upon one another. By following the levels of the food chain, the child will be able to build upon success with small changes.

For example, if your child’s accepted food is chicken nuggets, a sample food chain might look like this:

Level I Level II Level III Level IV
Maintain & Expand Current Taste & Texture Vary Taste & Maintain Texture Maintain Taste & Vary Texture Vary Taste & Texture
Other brands and sizes of chicken nuggets (i.e., strips/popcorn/bites, both fast food & home-prepared); fried chicken patties cut into pieces (fast food & home prepared) Different flavored chicken nuggets (barbeque, honey mustard, hickory smoked, etc.) Use sauces/dips to vary tastes. Chicken strips (not breaded); chicken leg/drumstick; chicken breast; ground chicken patties Breaded seafood (scallops, shrimp); breaded fish (fast food & home-prepared); breaded turkey breast; breaded vegetables; breaded baked chicken; crusted/breaded pork tenderloin; ground meats

Here are some other food chaining tips:

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Fidgeting is a common result of excess energy in children and can interfere with positive behaviors. Excess energy and fidgeting can be distracting and disrupt learning. According to an article on Autism Speaks, by Geraldine Dawson and Michael Rosanoff, “Increased aerobic exercise can significantly decrease the frequency of negative, self-stimulating behaviors that are common among individuals with autism, while not decreasing other positive behaviors.” Exercise is a positive outlet for children exhibiting these behaviors.

Physical activity will release some of this energy and in turn, promote positive behavior. Lack of time is a common barrier to fitness with therapy sessions, school, and doctor visits. To help facilitate this we have come up with some ideas for fun exercising regardless of a busy schedule. We have provided different options based on various children’s interests, in order to keep them fully engaged, as well as different variations depending on the level of comprehension in each child.

For those children interested in sports, you can set up “routes” or “bases” with cones for the children to run around.

At the end of each course, you can leave a football, baseball, or soccer ball for them to throw or kick to you. If your child comprehends and reads numbers well, you can label each cone and call out which number for them to run to.

Otherwise, you can use flashcards to label each cone, and you can hold up the matching card that you want them to run to. This will add some cognitive thinking to the exercise. Have them run these routes for about 30 minutes or until you feel they have released all their excess energy.

Especially in the summertime, some children might enjoy water sports or games. Water gun tag is an easy way to get the children involved in playtime outside to shed some energy. You can utilize a similar labeling system as the sport ideas mentioned above, but feel free to switch it up a bit and use some pool noodles or other water toys for them to run to.

You can incorporate colors to help the children engage in their visual senses. Motivate the kids to run to the next cone or noodle so they can get a nice and refreshing spray of water or spray you and any siblings with water. Again, play for around 30 minutes or until fatigued.

For children who enjoy a challenge, you can set up a fun obstacle course for them to run through.

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The summer of 2017 Aspergers101 hosted a free informational series on Aspergers at the San Antonio Public Library. We have recorded each of these valuable sessions in video and powerpoint format so that you can have access to them at any time. Below, watch the first workshop from our Informational Summer Series on Aspergers focusing on diagnosis in childhood. First, Jennifer and Sam Allen discuss the initial steps of recognizing signs of Autism in a child and seeking a diagnosis. Next, Berenice de la Cruz, Ph.D., BCBA-D and COO of Autism Community Network, gives details on the diagnosis process and the medical terminology behind Autism and Aspergers.

The following checklist for Autism and Asperger behavioral signs comes from Jennifer and Sam’s powerpoint. This checklist is not meant to be used as a professional or standalone diagnosis, but rather as a helpful guide that can support you in your journey of diagnosis for your child.

Informal Childhood Developmental Checklist

Social Interactions

 The child prefers to play alone

 The child is rarely invited by others to play in the neighborhood or to participate in activities outside of school

 The child’s social interactions and responses are immature, not keeping with his/her age or his/her cognitive abilities in other areas

 The child has difficulty interacting in group settings

 The child does not play with other children as expected: he/she may not appear interested in their games, or may not know how to join in

 The child appears to be vulnerable to teasing, bullying and being taken advantage of by others

Behavioral Observations

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Once a child is becomes more competent in his or her ability to think multi-causally, the next focus of higher level social-emotional thinking is the capacity to understand the gray areas of life. Adolescents and young adults with Aspergers or HFA are especially prone to hitting an emotional rut when speaking in terms of “never” and “always”—hallmark terms associated with “black and white” thinking.

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“He never calls on me during class” or “She always gets to play the game first” are common phrases that parents or peers hear when the speaker’s ability to think and feel in more varied degrees is constricted. Not only is this harder to negotiate socially for the partner, but it’s not a very fun state for the black and white thinker either. Such polarized patterns of thinking can lead to social isolation brought on by the extremity of the speaker’s emotional response.

Getting unstuck can be supported through Floortime, where the parent or the therapist can spotlight the child or adolescent’s black and white ideation.

For example, Jason is a young teen with Aspergers who states that he never gets to play his media after school. Jason becomes agitated when discussing this with his mother and his therapist, flooded by feelings of anger and sadness that he has difficulty modulating.

The role of Floortime therapist or supported parent in this dynamic might be to:

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Some individuals with Aspergers or HFA may engage in crisis behavior that interferes with their learning, puts themselves or others at risk, prevents them from participating in various activities, or impedes the development of relationships. Crisis behavior can range in severity from low productivity to meltdowns that involve aggression, self-injury, or property destruction. Many individuals unfamiliar with Aspergers may believe these types of behaviors are intentional and malicious. However, it has become well known that problem behaviors often serve a function for the individual engaging in the behaviors. Additionally, deficits in the areas characterized by Aspergers may impact behavior.

Stressed teen girl screaming, shouting

Characteristics associated with Aspergers and how it may lead to crisis behavior:

Cognition

Asperger’s Syndrome is a neurological disorder that impacts the way that individuals think, feel, and react. Individuals with Aspergers are believed to react “emotionally” rather than “logically” during stressful situations and are unable to maintain self-control.

Generalization

Some individuals with Aspergers or HFA may have difficulty applying information and skills across settings, individuals, materials, and situations. Even though socially appropriate alternative strategies have been learned, the individual may be unable to “recall” the strategies while stressed.Continue Reading