One of the primary tasks of childhood is to learn to regulate emotional responses. For many children with AS-HFA, the process of emotional self-regulation is delayed and they are likely to need extra help learning to deal with strong emotions appropriately. For example, while most toddlers and many preschoolers regularly have tantrums when they are frustrated or don't get their way, by the time they enter elementary school most typically developing children have few or no tantrums. Older children and even adolescents with high-functioning autism or Asperger syndrome, on the other hand, may continue to have tantrums because they have not yet learned how to regulate their emotions. Obviously, this kind of behavior does not help them fit in socially and can be one of the causes of social rejection and isolation.
The most important aspect of emotion regulation is being aware of your body's internal states and the cues indicative of emotional arousal. For example, when a person becomes frustrated, his or her muscles may tense up. He or she may feel a hot rush of blood to his or her face and a sudden surge of energy. Being aware of and interpreting these physiological effects of emotional arousal is difficult for many children with autism spectrum disorders.
Andy's brothers loved going to the neighborhood arcade and often pestered their mother to take them there. She felt torn because Andy, a young boy with high-functioning autism, had such a hard time at the arcade. He enjoyed the experience at first, but he became so caught up in the flashing lights and sounds that he soon was out of control. He would giggle uncontrollably, run around wildly, and tackle other children. The outing inevitably ended in tears and felt like a disaster to all involved. Andy's brothers pleaded with their mother to leave Andy at home next time.
Tim, an adolescent with Asperger's syndrome, was a gifted student. Despite the fact that his arithmetic scores far surpassed his grade level, he had received several failing grades. His frustration threshold was so low that he frequently snapped in class when his pencil needed sharpening or he could not get the teacher's help quickly. He seemed unable to monitor the increasing tension in his body until it overtook him in a physical outburst, at which point he would throw his books and papers to the floor, scream "I've had it!," and march out of the classroom. The other students stared, whispered, and began to snicker.
In both of these examples, we see children who fail to monitor their level of arousal and encounter social difficulties as a result. There are a few strategies parents can use to help children learn to regulate their emotions better. First, you can encourage your child to use words to express his or her feelings. It is precisely when preschoolers learn to verbalize that their tantrums precipitously decrease. Begin by teaching your child to notice when he or she is experiencing an emotion, such as joy, anger, or sadness. Then verbally label these emotional states for your child and encourage your child to express these feelings in words (for example, "I am feeling angry!"). If your child needs it, you can also provide visual cues, such as a sheet of paper with several emotions depicted on it, to help your child figure out his or her emotional state (see the Appendix for resources).
After your child has expressed his or her feelings in words or by using pictures, provide some ways of coping with the emotionally arousing situations. At first you can make suggestions, even perhaps a list of coping strategies. For example, you can say, "If you are frustrated, you can ask for help or ask for a break or go on to a new problem." Eventually, however, you will want to ask your child to come up with solutions by him- or herself. Prompt your child to think of further alternatives to the strategies you have provided ("What else could you do if you get frustrated?").
Sometimes, however, your child's emotional state will be so strong that he'll need techniques to calm himself before he can discuss his feelings and ways to cope with them. One technique that is often helpful is called progressive relaxation. While your child lies prone and breathes deeply, verbally walk him through tensing (while breathing in) and relaxing (while exhaling) muscle groups from toe to head. As he becomes more comfortable with the process, you can teach your child to tense and relax the entire body quickly and subtly for use in stressful circumstances. An added benefit of this rapid relaxation technique is that the teaching process helps children better recognize the body states associated with tension and relaxation. A second calming strategy for your child is to engage in a relaxing activity, such as listening to music (a portable CD player can be helpful), chewing gum, drawing, having a back rub, or thinking of something comforting, such as a soft blanket or the fur of a favorite pet. A less direct strategy is to teach your child to ask for help or to remove herself from the situation when she becomes aware of potential overarousal. Tim, described above, might benefit from having a teacher's permission to leave the room for 2 minutes if he is experiencing frustration. Parents and teachers can facilitate this by providing clear places and plans for children to take a breather and specific signals or "break cards" to let others know they need time alone. Just knowing that this option is available may be helpful for your child with AS-HFA. Most children will benefit from using a combination of these strategies for learning and maintaining emotional control.
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