How to cope with Anxiety and Fear

Anxiety symptoms and reactions are very common in individuals with autism spectrum disorder (ASD). They can interfere with functioning across home, community and school settings. Scientific studies have found that from 11 to 84 percent of youth with autism suffer from anxiety symptoms – intense fear, trouble concentrating, rapid heartbeat, tension, restlessness or sleeplessness. Lisa Rogers with Educating Diverse Learners answers a reader’s question about helping her son overcome his daily stressor. 

Q: Dear Lisa,

My son has fears. One thought gives him daily anxiety: that of his pants not staying up. We tried belts that he buckles too tightly. He still fears the pants will fall and the buckle gives extra sensory problems. We tried sweatpants that he ties tightly, still fearful. All day he hikes his pants up. I tried to show him the pants can’t fall down but this doesn’t help. He also insists on wearing underwear two sizes too big. He is 8 and diagnosed as PDD-NOS. Could you direct me to any information to help him? This fear is causing multiple meltdowns daily. I don’t know what to do.

Thank you.

-Anonymous

A: Dear Mom or Dad,

Multiple meltdowns each day can certainly take its toll on your son and your family. I understand how critical this issue is for you and will do my best to provide helpful information for you to consider.

In order to be most helpful, I do need to ask a few questions first.

  • Is your son able to explain in any way what is causing or contributing to this fear? You mention that this is a current situation and so any insight about the reason for this development will be helpful. As you know, children on the autism spectrum are often rule-driven and literal in their interpretation of language. Perhaps something an adult said with good intentions about the importance of keeping your pants up or a scene from a movie could be a root cause? On the surface this might seem silly, but this can help in better understanding your son and his very real fear.
  • If your son is able to communicate through words or pictures, you might try cartooning as a way to acquire insight. When he is calm and all is well, you can sit together and draw a cartoon where you ask him to describe his thoughts while he is walking with his pants snug and tight around his waist. If not too stressful for him, you could even draw a picture with pants falling down on a stick figure and ask him to describe his ideas/feelings about this.
  • Have you already tried suspenders or even overalls to provide a sense of security beyond a belt or tie? It sounds like there are compounding sensory issues and so these might not be feasible options.

For now, here are a few ideas to consider . . .

I. Due to neurological differences, individuals with autism often experience a higher level of stress and anxiety. Structure, however, makes events predictable and helps to reduces stress, confusion, and anxiety.

So while you want an answer to your immediate problem, adding structure may be a critical preventive key to decrease anxiety which may be contributing to the presenting problem. A few ways to add structure at both school and home include the following:

  • Establish set routines at school and at home
  • Create daily schedules, weekly calendars and lists
  • Use visual cues like checklists with photos
  • Establish clear visual cues so that they can understand what work is expected, how much work is required, and how they know when they are finished the work
  • Make transitions predictable and regular
  • Provide tools, such as “surprise cards” to help deal with unanticipated or even planned changes in the routine

Here are a couple of resources for building structure at home:

http://www.freeprintablebehaviorcharts.com/autism_and_routines.htm
http://asdteacher.com/picturechoiceboard/

II. Does your son have any favorite characters or things? If so, these special interests can be used to help him deal with his anxiety/fear about his pants falling down. Power Cards have been found to be effective for some children with special interests.

A Power Card involves including special interests with visual aids to teach and reinforce academic, behavioral and social skills to individuals with Autism Spectrum Disorders. By using their special interest, the individual is motivated to use the strategy presented in the scenario and on the Power Card. It’s a positive strategy that is often entertaining as well as inexpensive and simple to develop.

It can be used when an individual lacks the understanding of his/her expectations, to clarify choices, to teach cause and effect between a specific behavior and its consequence, to teach another’s perspective, to aide in generalization, or as a visual reminder of appropriate behavioral expectations of a situation.

Resources for Depression and ASD: Now that we know, what do we do?

Depression is more frequent in those with AS than the general population, and the struggles of those with AS often contribute to the development of depression. The obvious question is, what resources are available and what do we do? First, we should not accept depression as just a normal part of AS, especially if it’s interfering with everyday life. Secondly, we need to recognize the symptoms to help as early as possible. And lastly, we need to research the supports that are available – how you can help yourself or others right now – and what resources still need much improvement so that you can call upon action in your community.

Being aware of the symptoms of depression is critical:

  • sleep difficulties, either sleeping more or less (insomnia, early morning waking);
  • changes in appetite (either more or less hunger);
  • weight gain or loss;
  • a failure to enjoy normal sources of pleasure;
  • difficulty concentrating;
  • sadness, guilt or hopelessness;
  • crying or unusual irritability.

Someone who is clinically depressed sees the world in the above ways each day. It’s important for the individual or those around to seek professional help.

Medication can help many with depression, as can Cognitive Behavioral Therapy. Although CBT is a slower process with AS individuals and needs to be adapted to their thought process. Some studies suggest neurobiofeedback can be helpful with depression and there are a few early studies of its use with ASD patients. For those who prefer to avoid medication, this is certainly worth exploring. It is best to come to your medical sessions with the knowledge of various treatments so that you can be prepared to discuss what is best for you.

It’s important to think about addressing the factors that can result in depression.

Transitioning to Middle School

Q&A with Lisa Rogers

 

Q: Dear Lisa,

My son has High functioning Autism and is in general education classes in public school. He will be going to Middle School next year and I was wondering how should I prepare the teachers for him, and him for the teachers? This will be different as he no longer has just one teacher but will have many. We have had our ARD and I know the school does so much but I’m nervous and wanted to know what I can do as his parent.

-Sharon Kaiser/Plano, TX

Middle School

A: Dear Sharon,

I’m so glad to have this question. Too often, April or May rolls around and then we begin to have a conversation about transitioning to a new school in the following Fall Semester. By planning ahead, parents and teachers can alleviate the anxiety associated with such a big change and increase success from Day 1 of school. Of course, each person on the spectrum responds to and deals with change in their own way. By including your son in the process, you can make decisions that are tailored to his needs.

Possible activities to consider include the following:

  • Determine the point of contact[s] at the new school
  • Plan a visit to the new campus; coordinate with a small group of friends if possible
  • Set up a Circle of Friends or buddy/social coach
  • Provide a map of the new campus
  • Build a schedule that includes student interests
  • Build a schedule that will meet sensory needs
  • Write a social story about the new campus and new staff. You can find a sample social story in video format at the following link: https://www.youtube.com/watch?v=qk0Nag4zvJk
  • Consider beginning to switch several classrooms at the elementary campus to practice this new aspect of Middle School life in a safe environment
  • Ensure the new staff have training in autism to build common understanding
  • Ensure that visual supports are in place to prevent stress. Signs on the first week of school can help navigate a new environment [e.g. schedule, scripts, narratives, etc.]
  • Discuss whether or not the student will benefit from a “Home Base”. A “Home Base” is a predetermined location for the student to regain composure or work through a problem.
  • Develop a plan for communication between home and school

In addition, I strongly recommend creating a portfolio of your child’s strengths, needs and interests.

Asperger Syndrome From Diagnosis to Independence Part 2: Social Development

San Antonio Public Library Informational Summer Series

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

Using Graphic Organizers to Improve Your Child’s Academic Success

Continuing with instructional supports, this week’s blog will focus on a simple, yet powerful strategy: graphic organizers.

Graphic organizers are tools that help your brain think.”

– Kylene Beers

Most teachers use graphic organizers but might not be fully aware of the comprehensive benefits of this visual support. Graphic organizers can accomplish the following key elements toward instructional success:

Child, Graphic Organizer

  • understand important data with very little reading involved
  • think logically
  • identify main concepts
  • assign specific labels to concepts
  • sort relevant and non-relevant details
  • make predictions
  • identify cause and effect
  • identify and understand consequences
  • organize and sequence data
  • understand time lines
  • visualize and understand abstract content

Researchers found that when content is illustrated with diagrams, the information can be maintained by students over a longer period of time.

Graphic organizers portray knowledge in a meaningful way which helps bring clarity to ideas as connections are made.

Supports for Sensory Processing Disorder and Issues with Touch

As with the senses of sight and hearing, sometimes one or more of the senses are either over- or under-reactive to stimulation. This is also true for the sense of touch. For some persons with an Autism Spectrum Disorder, certain textures feel uncomfortable or even painful. For these individuals, the idea of a hug or even accidentally brushing up against something may be highly stressful. In order to prevent this negative tactile experience, much energy and focus is spent avoiding situations that increase the likelihood of such events.

Painted hands for a border

Imagine lining up where there are others in front of you and behind you. The chances of being accidentally touched by either person may cause the simple act of lining up to be highly stressful and anxiety provoking. For individuals that do not like the feel of certain textures or things, parents and teachers may consider the following types of supports:

Q&A With Lisa: How do I get my child qualified for special ed?

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Q:

Dear Lisa,

“I suspect my child has autism or some related disability. He is in the early elementary years. How do I get my child qualified for Special Education services in public school and what do they offer?”

-Confused and Concerned in Texas

A:

Dear Confused and Concerned in Texas,

Thank you for asking this question that many others surely have as well. I will do my best to clarify the referral process from a parent’s perspective and possible services. However, you are always welcome to contact the campus Principal and/or the special education department of your current campus/district and present your question to them directly. Their response will give you an overview of the process which I will outline in this article through multiple resources and a flowchart.

Since you have mentioned that you suspect autism or some related disability, I have also included a resource that might help you to clarify your concerns in those terms if/when you do make the phone call to the local special education office.

What Happens to Adults with Asperger’s Syndrome? (Kids Grow Up)

Resources for Adults with AS

Adults with Asperger’s find that the accommodations and supports available for kids aren’t there for them. It’s increasingly recognized that children have sensory issues and supports are often made in schools to support social issues and social anxiety. Some accommodations are made for emotional reactivity and problems with becoming overwhelmed. Adults don’t grow out of these problems; in fact, some make the transition to college or try to find jobs and find little understanding and no support.

Group of business people assembling jigsaw puzzle and represent

Social challenges may be confounding and complicate relationships with friends, work colleagues and partners. Accommodations in school may have helped with inflexibility, concrete thinking and difficulty with changes in routine, but these considerations aren’t typically made in work situations. Many parents of young adults with AS fear that their over-reactivity and poor social judgment may get them into serious trouble in the community.

Hygiene and Social Skills: Mom seeking help towards a diagnosis

Q&A with LisaRogers

Q&A with Lisa Rogers

Q: Dear Lisa,

We think our daughter has Asperger’s. It’s all only her way and she bursts out laughing at very awkward times. She has no friends and doesn’t’ seem to care about her hygiene or people skills. I’m not sure where to go or what to do. We live in a rural area in Tennessee. Does the school or doctor’s office help? I’m reading online and found aspergers101 and it seems the closest to finding what is wrong.

-Mary Andrews, Greenbrier Tennessee

A: Dear Mary,

While I live in Texas, there are some federal guidelines that mandate certain functions at the state level that should provide some guidance to you and your family. Go to the following link for some initial information:

How can I help my adult son with Asperger’s?

Q&A with Ken Kellam

Q: “Many people see children with Asperger’s and they don’t understand that their needs are lifelong. They don’t see that even if you watch your child succeed at a young age, there will be new territory to navigate as they get older and new situations arise.” This is so true, my son was diagnosed with Aspergers in the 90’s when there was not a lot of “buzz” about it. He did okay, but now as an adult he seems to be having difficulty especially with anxiety and confidence. I am worried for him, and keep directing him towards counseling, but he hasn’t yet. Any suggestions?

-Angela

adulthood

Angela,

I can completely relate to this. Near the end of my high school days, I garnered several accomplishments and awards, but college was a completely different ballgame, especially since I was four hours away from home. Once I got out of college and moved back home, the working world was a completely different situation as well, and I struggled mightily at times. Each new job, new relationship, and new situation is a challenge, but an opportunity as well. Fortunately, my family could not have been more supportive of me over the years.