How to Treat Autism

Funny Wiring Autism

Funny Wiring Autism

Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

Get My Free Ebook


How To Successfully Raise A Child Who Has Autism

This eBook guide will show you the ways to navigate the difficult path of raising a child with an autism spectrum disorder. Rob Marlow has complied his knowledge of children with autism to give you a complete guide to being able to meet both their needs and yours. The book teaches you how to add a sense of security to your child's life, how to deal with a runaway child, and how to find and avoid your child's triggers to give them a sense of safety. This also teaches you how to properly communicate with a child that cannot speak, and the best games for children, depending on their individual needs. You only have one chance in your life to raise your child Make sure that it best fits the child's life. Autism is not hopeless! There are ways to help autistic children, and give them a happy and safe childhood.

How To Successfully Raise A Child Who Has Autism Summary

Rating:

4.6 stars out of 11 votes

Contents: Ebook
Author: Rob Marlow
Price: $19.00

My How To Successfully Raise A Child Who Has Autism Review

Highly Recommended

Recently several visitors of blog have asked me about this manual, which is being advertised quite widely across the Internet. So I decided to buy a copy myself to find out what all the fuss was about.

All the modules inside this ebook are very detailed and explanatory, there is nothing as comprehensive as this guide.

Download Now

Learning from the autistics perception of autism

All over the world (my own home included) live people who have been diagnosed with 'autism continuum' (from low functioning to high functioning). Whether they were born with it or whether something 'caused' it, these people live in an 'autistic reality',11 which is the prime cause of their behaviour. People who behave in an autistic way need love, respect and help - in this order. After spending thousands of hours trying to relate to them, I came to believe that the only way in which we can truly understand that reality would be to experience it. Having said that, I also came to experience true friendship, fun and reassuring companionship, unconditional help and acceptance from my autistic friends, as well as enjoying meaningful communication, without actually experiencing the autistic reality.

Autism Society of America Foundation ASAF

A fund-raising organization founded in 1996 by the autism society of america, the largest and oldest organization representing people with autism. The ASAF was established to raise and allocate funds for research to address the many unanswered questions about autism. The ASAF has implemented action on several autism research priorities, such as developing up-to-date statistics developing a national registry of individuals and families with autism who are willing to participate in research studies and implementing a system to identify potential donors of autism brain tissue for research purposes and facilitating the donation process. In addition, the foundation contributes money for applied and biomedical research in the causes of and treatment approaches to autism. (For contact information, see Appendix I.)

Autism is not an impediment to sharing emotions or imagination

Autism is not an impediment to meaningful interaction As you read through this book, you will often come across the word interaction. What I am sharing in this book is not a therapy per se because I do not perceive autism as an illness or a disease.3 Autism is a way of being and learning which requires understanding. Your understanding of your child's way of being evolves with increased loving positive interaction. It wasn't Alexander's 'autism' that upset me nor did my 'non-autistic origin' cause my son to be upset. The lack of meaningful interaction between us caused us both a great deal of frustration, weariness and upset. My fear of dying with no one to look after him after my death caused me to cry for hundreds of hours. I believe you are probably reading this book because you are experiencing similar difficulties.

Autisms Clinical Course

Autism is usually detected in the third or fourth year of life. Early hallmarks include a failure to begin pointing, an apparent lack of interest in peers, a disinterest in playing with toys (or a disinterest in playing with them the same way that others of the same age do), and a delay in the development of speech for communicative purposes. Children with autism have a difficult time coordinating verbal and nonverbal forms of communication and therefore often do not mark acknowledgement of being spoken to with a gaze, do not mark their own communicative speech with eye contact directed at the listener, and do not coordinate body gesture with gaze and vocalization in such communicative efforts. Some children with autism develop single words slowly, but then lose these words, seldom use them, or seemingly plateau in language development. Others develop language for the first time around the third or fourth year of life or after initiation of speech therapy. Early language for a child...

High Functioning Autism

A child who is diagnosed with autistic disorder, the formal name given to autism in the DSM-IV, has difficulties in three areas social relating, communication, and behaviors and interests. In Table 1, we've listed the specific behaviors (or symptoms) of autism described in the DSM-IV. More detailed descriptions of these behaviors are provided in Chapter 1. To meet DSM-IV criteria for autism, your child must display at Table 1. DSM-IV Criteria for Autistic Disorder least six of the 12 symptoms listed. Your child may meet criteria for a specific symptom if he or she displays one or more of the behaviors associated with that symptom (listed in the right-hand column of Table 1).3 Children diagnosed with autism must experience at least two of the symptoms in the reciprocal social interaction domain, at least one symptom in the communication domain, and at least one symptom in the restricted, repetitive behaviors domain. At least one difficulty must have been present before age 3. If your...

Distinguishing High Functioning Autism from Asperger Syndrome Is There a Difference

The characteristics that may differentiate autism from Asperger syndrome are so tentative that they have not been included in the DSM-IV. There is, for example, no requirement in the DSM-IV that children with Asperger syndrome must be clumsy to meet criteria for the diagnosis. Likewise, there is nothing that says that everyone with autism must be good at puzzles (or that those with Asperger syndrome must be poor at puzzles). So how do we distinguish between the two Unfortunately, it's a very common experience for parents to receive different opinions, with one professional diagnosing Asperger syndrome and another telling you that it is actually high-functioning autism. Right now, the only reliable way to tell which condition your child has is to rule out the diagnosis of Asperger syndrome if he or she meets the criteria for autism. In the DSM-IV, the autism diagnosis always takes precedence over the Asperger syndrome diagnosis. This means that if your child meets autism criteria...

Causes of Autism Spectrum Disorders

Seth had experienced many, many ear infections and chest colds as an infant and young child. He seemed to be constantly sick and was in the pediatrician's office almost weekly. His mother has always wondered if this had anything to do with his autism. Scientists do not yet have complete answers to these questions, but very strong evidence suggests that the autism spectrum disorders are biological in origin and not caused by parenting or other psychosocial environmental causes. Differences in the size and organization of the brain, as well as in how it works, in individuals with autism spectrum disorders versus normal individuals have been found. Autism spectrum disorders and related difficulties also run in families, so we think that genetic factors also play a role. This chapter summarizes what we know so far about the causes of autism spectrum disorders. It's important to understand that most of the studies conducted to date were done on individuals with autism. The few studies...

In Autism Spectrum Disorders

Kanner first described autism in 1943, he wrote that children with the disorder were born with an innate, or inborn, difficulty bonding with people. In the mid-20th century, most doctors were trained in the psychoanalytic tradition, which attributed all behavioral and mental disorders to early childhood experiences. Thus autism was suspected to be caused by the social environment rather than by biology. Dr. Kanner was influenced by these ideas. Later he and others blamed autism on parents. They described refrigerator mothers who were so emotionally cold and rejecting that they caused their children to retreat into an autistic cocoon of safety. This view began to lose credibility in the 1960s, however, after Dr. Bernard Rimland published Infantile Autism The Syndrome and Its Implications for a Neural Theory of Behavior. In this 1964 book the author attacked parent causation theories and pointed out that there was absolutely no research data to support them. He was the first to...

Brain Changes in Asperger Syndrome

Very few studies have specifically examined brain differences in individuals with Asperger syndrome and how (or if) they differ from those of individuals with autism. In the amygdala study done by BaronCohen, no differences were found between adults with high-functioning autism and those with Asperger syndrome, suggesting that the amygdala may be a structure involved in all autism spectrum conditions. Other recent research has found abnormalities in the brains of individuals with Asperger syndrome that are similar to those reported in individuals with autism, including enlargement of the ventricles, decreased frontal activity, missing tissue in the frontal lobes, and smaller than normal medial temporal, limbic, and cerebellar structures. Most of these studies have been case reports of only one or two people with Asperger syndrome, so the numbers are very small and we cannot be certain how representative they are of most people with Asperger syndrome. As mentioned in Chapter 2, some...

In the Autism Spectrum Disorders

Even after the terribly wrong theories that parents caused autism had been put to rest, most scientists dismissed the idea that genetic factors might play any role in the development of autism. For one thing, it was extremely rare that a child with autism had a parent with autism, a pattern that we usually expect to see in a genetic condition. Occasionally, an autistic child would have a brother or sister who also had autism, but this again was considered too uncommon to support a genetic explanation. In the 1970s, two eminent psychiatrists questioned this logic. Sir Michael Rutter is a famous British child psychiatrist who was knighted by the queen of England for his important research contributions to the understanding of autism and other childhood disorders. Dr. Susan Folstein is a prominent child psychiatrist in the United States who has published many papers on the genetics of autism. Both scientists reasoned that since the social difficulties of autism remain in adulthood,...

The Anatomy Of Autism

People with autism show reduced mirror neuron activity in the inferior frontal gyrus, a part of the brain's premotor cortex, perhaps explaining their inability to assess the intentions of others. Dysfunctions of mirror neurons in the insula and anterior cingulate cortex may cause related symptoms, such as the absence of empathy, and deficits in the angular gyrus may result in language difficulties. People with autism also have structural changes in the cerebellum and brain stem. what has all this to do with autism In the late 1990s our group at U.C.S.D. noted that mirror neurons appear to be performing precisely the same functions that seem to be disrupted in autism. If the mirror neuron system is indeed involved in the interpretation of complex intentions, then a breakdown of this neural circuitry could explain the most striking deficit in people with autism, their lack of social skills. The other cardinal signs of the disorder absence of empathy, language deficits, poor imitation,...

Autism is a complex genetic disorder

It is widely held that autism is largely genetic in origin several dozen autism susceptibility genes have been identified in the past decade, collectively accounting for about 20 of autistic cases. There is strong evidence from twin and family studies for the importance of complex genetic factors in the development of autism 12, 13 . Family studies have shown that a recurrence rate of autism in siblings of affected proband is as high as 8-10 12, 14 . Thus, the recurrence risk in siblings is roughly 100 times higher than that found in the general population. The substantial degree of familial clustering in ASD could reflect shared environmental factors, but twin studies strongly point to genetics. Several epidemiological studies among sex-matched twins have clearly demonstrated significant differences of concordance rates in the monozygotic (MZ) and dizygotic (DZ) twins. The largest of these studies 15 found that 60 of the MZ pairs were concordant for autism compared with none of the...

Genetic heterogeneity of autism

Although autism is highly heritable, the identification of candidate genes has been hindered by the heterogeneity of the disease. Autism genetics is highly complex, involving many genes loci and different genetic variations, including translocation, deletion, single nucleotide polymorphism (SNP) and copy number variation (CNV) 13, 19, 20 . The most obvious general conclusion from all of the published genetic studies is the extraordinary etiological heterogeneity of autism. No specific gene accounts for the majority of autism rather, even the most common genetic forms account for not more than 1-2 of cases 21 . Further, these genes, including those mentioned earlier, represent a diversity of molecular mechanisms that include cell adhesion, neurotransmission, synaptic structure, RNA processing splicing, and activity-dependent protein translation. Genetic heterogeneity of autistic cases has been documented by identification of single gene mutations and genomic variations including CNV....

Copy number variation CNV A paradigm shift in autism

The strong genetic contribution shown in family studies and the association of cytogenetic changes, but apparent lack of common risk factors in autism, led to a hypothesis that rare sub-microscopic unbalanced changes in the form of CNVs likely contribute to the autism phenotype. With the development of microarrays capable of scanning the genome at sub-microscopic resolution, there is accumulating evidence that multiple CNVs contribute to the genetic vulnerability to autism 80 . de novo CNV has been identified in up to 7-10 of sporadic autism 81, 82 , but are less frequent in multiplex families, in which CNV accounts only for about 2 of families screened 80, 83 . This could possibly suggest different genetic liabilities in simplex and multiplex autism. Recurrent CNVs at 15q11-13 (1-3 of autism patients), 16p11 (1 of autism patients), and 22q11-13 have been confirmed in multiple studies 80, 83-86 . This hypothesis also has been proven largely successful in identifying...

Converging molecular pathways of autism

Autism is a heterogeneous disorder with a fundamental question of whether autism represents an etiologically heterogeneous disorder in which a myriad of genetic or environmental risk factors perturb common underlying molecular pathways in the brain 110 . Two recent studies have suggested there could be convergence at the level of molecular mechanisms in autism. The first study on molecular convergence in autism identified protein interactors of known autism or autism-associated genes 111 . This interactome revealed several novel interactions, including between two autism candidate genes, SHANK3 and TSC1. The biological pathways identified in this study include synapse, cytoskeleton and GTPase signaling, demonstrating a remarkable overlap with those identified by the gene expression. The second, an analysis of gene expression in postmortem autism brain, provides strong evidence for a shared set of molecular alterations in a majority of cases of autism. This included disruption of the...

Evidence linking B 12 deficiency and autism

Autism is currently reaching epidemic proportions. In 2007, the Centers for Disease Control and Prevention reported, For decades, the best estimate for the prevalence of autism was four to five per 10,000 children. More recent studies from multiple countries using current diagnostic criteria conducted with different methods have indicated that there is a range of ASD prevalence between 1 in 500 children and 1 in 166 children. Rick Rollens, cofounder of the U.C. Davis M.I.N.D. Institute, reported in 2007, Twenty years ago in 1987 there were 2,273 persons with autism in California's system. Today, 20 years later, there are 32,809. In 2010, the prevalence is now reported to be 1 in 110 children.

Unanswered questions involving b12 deficiency and autism spectrum disorders

To fully elucidate the relationship between B12 deficiency and autism, the following questions must be answered 1. How many children diagnosed with autism spectrum disorders or pervasive developmental disorder actually suffer from an unidentified or misdiagnosed B12 deficiency 2. Can chronic sub-optimal B12 during fetal development and or infancy cause mild brain injury that manifests as high-functioning autism Can overt B12 deficiency in infancy cause moderate to low-functioning autism 3. What impact would the universal screening of children with developmental delay for B12 deficiency have on the identification of children with reversible symptoms that might otherwise be diagnosed as incurable autism 4. Would the screening of infants and toddlers as well as women in the prenatal, post-partum, and breastfeeding period for B12 deficiency significantly reduce the rates of autism and developmental delay 5. Would high-dose methyl-Bi2 therapy (1,000 mcg daily) taken by women before...

Autism speaks a universal language

Riding through a Mexican village, I watched a boy walking out of his garden into the middle of a mud road. He was gazing at the sun through a McDonald's straw. Whilst he was showing his excitement through flapping his arms, our eyes met for a brief second. My elder son, who watched me from a distance, tapped my shoulder and reminded me that we were on holiday. I doubt that his parents knew that their 12-year-old child had what we call autism, or that they were worried over their child not being 'an active contributor to society'. I knew there was no school in the village and most people did not know how to read or write. I do believe however that his parents felt just as much pain as any parent in the world for not being able to

Web Sites for Asperger Syndrome and Autism Resources

Asperger Syndrome Coalition of the United States http www.asperger.org Asperger Syndrome Web Ring http aspie.freeservers.com main.html Autism Related Resources Autism Research Institute http www.autism.com ari Autism Resource Network http www.autismbooks.com Autism-Resources http www.autism-resources.com Autism Resources http www.unc.edu cory autism-info Autism Society of America http www.autism-society.org Autism Society of North Carolina Bookstore http www.autismsociety-nc.org Autism Today http www.autismtoday.com Center for the Study of Autism, Asperger Syndrome http www.autism.org Families for Early Autism Treatment http www.feat.org http www.futurehorizons-autism.com National Alliance for Autism Research http www.naar.org Online Asperger Syndrome Information and Support (O.A.S.I.S.) http www.udel.edu bkirby asperger Pervasive Developmental Disorders Web Site University of Washington Autism Homepage

Autism is not an appendage

Autism isn't something a person has, or a 'shell' that a person is trapped inside. There's no normal child hidden behind the autism. Autism is a way of being. It is pervasive it colours every experience, every sensation, perception, thought, emotion, and encounter, every aspect of existence. It is not possible to separate the autism from the person - and if it were possible, the person you'd have left would not be the same person you started with. This is important, so take a moment to consider it Autism is a way of being. It is not possible to separate the person from the autism. Therefore, when parents say, 'I wish my child did not have autism', what they're really saying is, 'I wish the autistic child I have did not exist, and I had a different (non-autistic) child instead.'

Autism is not an impenetrable wall

You try to relate to your autistic child, and the child doesn't respond. He doesn't see you you can't reach her there's no getting through. That's the hardest thing to deal with, isn't it The only thing is, it isn't true. It takes more work to communicate with someone whose native language isn't the same as yours. And autism goes deeper than language and culture autistic people are 'foreigners' in any society. You're going to have to give up your assumptions about shared meanings. You're going to have to learn to back up to levels more basic than you've probably thought about before, to translate, and to check to make sure your translations are understood. You're going to have to give up the certainty that comes of being on your own familiar territory, of knowing you're in charge, and let your child teach you a little of her language, guide you a little way into his world. And the outcome, if you succeed, still will not be a normal parent-child relationship. Your autistic child may...

Autism vs B12 Deficiency Acquired Brain Injury BABI

Centers for Disease Control and Prevention reports that one in 110 children have autism. As we discussed in Chapter 12, B12 deficiency in infants and children can easily be mistaken for autism. It is unknown how many children labeled as autistic have B12 Deficiency Acquired Brain Injury (BABI), but our guess is that the number is high. Identifying such children before they suffer brain injury would prevent many tragedies, and it would do so while creating a huge savings in healthcare dollars. Michael Ganz, Assistant Professor of Society, Human Development, and Health at Harvard School of Public Health, puts the lifetime cost of caring for an autistic child at around 3.2 million. But Ganz believes this is likely an underestimate because this consists only of medical costs, such as visits to doctors' offices, medications, and therapies, and non-medical costs, such as adult care, childcare, and special education, and does not include costs due to lost parental income and income...

Speculation Is there an autismB connection

Children with autism, a once-rare developmental disorder that is now becoming alarmingly common, exhibit severe speech and language problems, aloofness or abnormal social interaction, repetitive and ritualistic behavior (such as obsessively lining up toys), and in many cases self-injurious or aggressive behavior. Some cases of autism have known causes for instance, prenatal rubella infection, meningitis during early development, or specific genetic disorders. In general, however, autism is simply a description rather than an actual diagnosis, because the cause of a child's autistic symptoms is rarely identified. In fact, autism appears to have multiple causes, and preliminary Vitamin B12 is vital for proper brain function, growth and development. Classic B12 deficiency in infants and young children frequently causes symptoms similar to those seen in autism, including aloofness, loss of speech and social skills, and movement abnormalities (see Chapter 12). Increasingly, doctors are...

Epigenetics plays an important role in autism

In addition to structural genetic factors that play causative roles for autism, environmental factors also play an important role in autism by influencing fetal or early postnatal brain development, directly or via epigenetic modifications. Epigenetic modifications include cytosine methylation, post-translational modification of histones, small interfering RNA and genomic imprinting. Involvement of epigenetic factors in autism is demonstrated by the central role of epigenetic regulatory mechanisms in the pathogenesis of Rett syndrome and fragile X syndrome (FXS), both are the monogenic disorders resulted from single gene defects and commonly associated with autism 38-40 . FXS is a result of a triplet expansion of CGG repeats at the 5' untranslated region of FMR1 gene, which encodes the FMRP (fragile X mental retardation protein). FMRP is proposed to act as a translation regulator of specific mRNAs in the brain and involved in synaptic development and maturation, through its...

Who Is Qualified to Diagnose Autism Spectrum Conditions

The types of professionals most often making such diagnoses are psychologists and psychiatrists, particularly those trained in childhood disorders. Other types of doctors, such as neurologists, pediatricians, and general practitioners (sometimes called family practice doctors), may also see your child for a diagnostic evaluation. Additionally, social workers are trained in the diagnostic process and how to use the DSM-IV, so they are qualified to make diagnoses. Other professionals, such as teachers, speech-language pathologists, and occupational therapists, may have some knowledge of autism and may well be the ones who first alert you to the possibility, but they are not trained in the diagnostic process. Since teachers and therapists often have experience with other children like your son or daughter, even though they cannot make a formal diagnosis, you would be wise to listen to their concerns and ask for a referral to a qualified professional. At some agencies, your child will be...

Treatments for Asperger Syndrome and High Functioning Autism

As Seth's parents heard the psychologist say autism, they were engulfed in despair. But, the psychologist continued, there are some very good programs that have been developed to treat the exact kinds of problems Seth has. She handed them a slip of paper with a phone number written on it and encouraged them to call that very afternoon, saying, They will take care of you and Seth. Seth enrolled in this special education preschool just for children with autism that fall. He stayed in this program for 2 years, until he was eligible for kindergarten. His parents asked his teachers what type of intervention he should have next, and were startled by their reply There are no specific schools for someone like Seth after this. While Seth had made rapid progress in preschool and could now talk very well, he still had many difficulties, and his parents knew that his need for treatment was far from over. Thus began their long search for therapies, programs, and classes that would help their...

Prevalence of Autism

There is much controversy concerning the prevalence of autism. DSM-IV notes a prevalence rate of 4 to 5 cases per 10,000 in the United States, though these data are based on diagnostic criteria from the third edition of the DSM, criteria that have been shown to be diagnostically more restrictive. Many investigators have suggested a prevalence rate for PDD of around 1 in 800 cases in the United States, but no definitive prevalence data exist for DSM-IV criteria. It is clear, however, that more cases are being diagnosed. Several possible influences include earlier detection, diagnosis of more mildly affected individuals, the use of autism rather than mental retardation as the primary diagnosis in cases of more severe mental retardation, and the preference for this diagnosis in geographic regions where it is associated with higher intensity delivery of services. According to DSM-IV, approximately 70 percent of individuals diagnosed with autism have also been diagnosed with mild to severe...

Treatment for Autism

Treatment for autism is mostly based on methods of changing maladaptive behavior and developing Treatment for autism is primarily based on methods of changing maladaptive behavior and developing learning and communication skills. This line drawing was created by an autistic child, who has identified both himself (Mike) and his brother (Kevin) as passengers in the same car. (Gladys Agell and Vermont College of Norwich University) Treatment for autism is primarily based on methods of changing maladaptive behavior and developing learning and communication skills. This line drawing was created by an autistic child, who has identified both himself (Mike) and his brother (Kevin) as passengers in the same car. (Gladys Agell and Vermont College of Norwich University) learning skills. Behavior modification approaches, educationally based approaches, speech therapy, parent skill training, and adaptive skill training are generally part of an individualized multimodal treatment plan. The...

Autism

The following visual analogy is designed to introduce you to new meanings of the words child with autism, autism autistic and communication problems. Place three identical tablemats on the table. One represents your child at a stage when he feels tense around other people. One represents autism autistic. The third represents communication problems. Autism autistic At this stage, before you learn how to make sense of your child's behaviour and before he can make sense of what you want from him, all tablemats are equal in size. Depending on your understanding of autism in general, you might feel inclined to believe autism autistic as a separable entity from your child's personality. Place the tablemat representing autism on top of the one representing your child. Try blending in your mind the image of your child - his puzzling behaviour, including his perception of our world - with the tablemat representing autism autistic. Therefore your child and autism autistic are perceived as one...

Asperger Syndrome

Its symptoms are identical to those listed in Table 1 for autistic disorder, except that there is no requirement that the child demonstrate significant difficulties in the second category communication. In other words, individuals with Asperger syndrome have the same types of reciprocal social interaction deficits and restricted, repetitive behaviors as individuals with autism but don't display the same language difficulties. No matter how old they are, their language ability is about what would be expected for their age, especially in the areas of grammar, vocabulary, or pronunciation. It is, in fact, a specific requirement of the Asperger diagnosis that language develop at the normal time, with the child saying words by age 2 and using simple phrases (Go bye-bye, My ball) by age 3. Sometimes language may even be precocious in its development. Some of the children described by Dr. Asperger talked before they walked. Many, like Joseph, completely bypass baby...

Atheory Ofautism

Studies of the mirror neuron system may reveal clues to the causes of autism and help researchers develop new ways to diagnose and treat the disorder By Vilayanur S. Ramachandran and Lindsay M. Oberman CHILDREN WITH AUTISM may struggle with social interaction because their mirror neuron systems are not functioning properly. At first glance you might not notice anything odd on meeting a young boy with autism. But if you try to talk to him, it will quickly become obvious that something is seriously wrong. He may not make eye contact with you instead he may avoid your gaze and fidget, rock his body to and fro, or bang his head against the wall. More disconcerting, he may not be able to conduct anything remotely resembling a normal conversation. Even though he can experience emotions such as fear, rage and pleasure, he may lack genuine empathy for other people and be oblivious to subtle social cues that most children would pick up effortlessly. order, which afflicts about 0.5 percent of...

Autism is not death

Granted, autism isn't what most parents expect or look forward to when they anticipate the arrival of a child. What they expect is a child who will be like them, who will share their world and relate to them without requiring intensive on-the-job training in alien contact. Even if their child has some disability other than autism, parents expect to be able to relate to that child on the terms that seem normal to them and in most cases, even allowing for the limitations of various disabilities, it is possible to form the kind ofbond the parents had been looking forward to. But not when the child is autistic. Much of the grieving parents do is over the non-occurrence of the expected relationship with an expected normal child. This grief is very real, and it needs to be expected and worked through so people can get on with their lives - but it has nothing to do with autism. This is the same thing that parents experience when a child is stillborn, or when they have their baby to hold for...

Problems with Social Interaction Active but

The essence of AS-HFA is difficulty with social interactions, although the striking social impairments of more classic autism, such as extreme remoteness and persistent avoidance of others, rarely appear. Some children, like Lauren, don't go out of their way to start conversations or interact with others but do respond if other people approach them. Other individuals show interest in people and enjoy their company they may even want to join groups and make friends. However, their ability to do so successfully is limited by their difficulty knowing what to do or say in social situations. They may be awkward and unsure during interactions. They may give the impression that they are not interested in the person they are talking to because they don't follow the

Few Key Termsand What They Mean

Pervasive developmental disorders (PDDs) a group of disorders characterized by delayed or abnormal development in many (pervasive) aspects of development social, communication, behavior, cognition, sometimes even motor skills. This term is synonymous with autism spectrum disorders. pervasive developmental disorder not otherwise specified (PDDNOS) The child has some autistic-like behaviors, but does not meet the definition of either high-functioning autism or Asperger syndrome. autism the most common and typical of the PDDs, ranging in severity from those who are very handicapped (nonverbal, totally aloof, and highly repetitive) to those who are only mildly socially awkward, are slightly unusual in their conversational style, and have special interests. The high-functioning autism spectrum disorders include high-functioning autism The child fits the definition of autism but has normal cognitive and learning abilities. The child may initially have had difficulty acquiring language, but...

Are You and Your Child Alone in This

As you search for answers about how and why your child is so different, you may feel tremendously alone. You may have spent years feeling that no one else has a child just like yours. In fact you may never have heard of high-functioning autism or Asperger syndrome before your doctor or someone else raised it. Actually, you're not nearly as alone as you may now feel. Prevalence estimates vary widely, with numbers as high as 1 of the school-age population occasionally suggested for the whole autism spectrum and between 0.2 and 0.5 (or 2 to 5 individuals in 1,000) with Asperger syndrome alone. Many researchers believe these numbers are high, but even more conservative estimates suggest that autism spectrum disorders are much more common than we ini tially thought. As recently as 10-15 years ago, we estimated only 2-4 of every 10,000 individuals had an autism-related condition. But a very recent (2001) study published in the prestigious Journal of the American Medical Association found a...

The Diagnostic Bible DSMIV

The diagnostic process varies from agency to agency and from professional to professional. Some evaluations are comprehensive and lengthy, others relatively quick. Some professionals will use special tests, while others will talk with you and play with your child in a seemingly informal manner. But all will be collecting specific information about your child's early development and current strengths and weaknesses in the three areas relevant to autism spectrum disorders. As we outlined in Chapter 1, these areas are your child's social interaction skills, ability to communicate with others, and special interests or unusual behaviors. Once this information is collected, a decision is made about whether your child meets criteria for an autism spectrum disorder and, if so, which one. To do this, professionals use the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (or DSM), which outlines the specific behaviors and problems associated with each...

Childhood Disintegrative Disorder

Like Rett's disorder, childhood disintegrative disorder involves a period of normal development followed by a loss of skills, resulting in severe impairments in cognitive, self-help, and other skills. The pattern is somewhat different from Rett's, however, and the two are easily distinguished. Childhood disintegrative disorder can occur in either boys or girls but is much more common in boys. The hand movements so typical of Rett's are not seen in childhood disintegrative disorder. Also, the period of normal development is longer than in Rett's the regression occurs after at least 2 (and up to 10) years of normal development. Prior to the regression, the child appears perfectly normal, interacting with others, talking, playing, and taking care of him- or herself at the level appropriate for his or her age (for example, using the toilet and eating independently). There is then a loss of skills, with the child withdrawing, no longer talking, losing thinking skills, bowel control, and...

How Can Different Evaluators Arrive at Different Diagnoses

This is a very common occurrence (although no less frustrating because it is common). It comes about because professionals vary as to how strictly they adhere to the diagnostic rules outlined in the DSM-IV. Psychologists and psychiatrists who conduct research on autism spectrum disorders usually go by the book most carefully, as the seemingly minor differences between high-functioning autism and Asperger syn drome may be important to their investigations. Other professionals use the DSM criteria a bit more loosely. For example, some professionals diagnose any child with autistic-like behaviors who developed language by age 2 with Asperger syndrome, regardless of whether the other criteria for the disorder are met. Others steer away from the Asperger and PDDNOS labels, fearing they are less familiar to parents, the educational system, and insurance companies, possibly negatively affecting the services, resources, and benefits the child will be offered. One mother vented her...

How Can We Be Sure Our Child Has ASHFA and Not ADHD or OCD or Something Else

Estimates of the prevalence of autism spectrum disorders have soared during the past two decades. Although it is still unclear what has caused this rapid rise, one factor that has certainly contributed is that as professionals and the general public have become more familiar with the autism spectrum disorders, the number of children diagnosed with them has soared. And as their diagnosis has become more prevalent, misdiagnosis is also more likely. Sometimes a proper assessment by a specialist reveals that this diagnosis is wrong. It's been our experience that in earlier years almost all children referred to our specialty clinics for a diagnostic evaluation did in fact meet criteria for an autism spectrum disorder. In the last year alone, however, one-quarter of the diagnostic evaluations performed in our clinics overturned previously suggested diagnoses of either high-functioning autism or Asperger syndrome.5 Almost all the children had multiple serious behavioral difficulties. It was...

Is It Possible That My Child Has Something Else in Addition to ASHFA

Although we strive to achieve simplicity in diagnosis, it is not always possible or accurate to diagnose a child with AS-HFA alone. Having multiple psychiatric conditions is called comorbidity, which is very important to detect, because if they are left untreated, these coexisting disorders can lead to an overall worsening in your child's functioning. Research has repeatedly shown that individuals with AS-HFA are at higher risk than other individuals for the conditions listed in Table 3, for reasons not fully understood yet. A study by Dr. Janet Lainhart, a child psychiatrist at the University of Utah, found that close to half of the adults with autism spectrum disorders she studied have one or more of these comorbid conditions. No studies on their prevalence in children have yet been conducted, but they are thought to be relatively common, especially by adolescence. in your child, which indicates the possibility of comorbidity. Autism does not cause bad moods, so if your previously...

Are You Getting the Expert Help You Need for a Good Diagnosis

Many different types of professionals are qualified to diagnose autism spectrum disorders. In our experience, expertise in the area of autism spectrum disorders is much more important to a thorough, accurate diagnosis than particular credentials. It can be difficult to know whether you have found the best person to evaluate your child, however, until you go through the process. Here are some questions to ask yourself as the evaluation proceeds. Any no answers should prompt you to ask the professional for an explanation, more information, or further evaluation. If you're not satisfied by the explanation, or you get a number of no answers, consider seeking another professional for a second opinion once the assessment is finished. ents, tell the professionals in detail what your child is like at home, on a day-to-day basis, since some of both her strengths and her difficulties might not be apparent during the observation period. Autism spectrum disorders involve two different kinds of...

Observation of Your Child

The professional will also observe your child and interact with her for some period of time, making note of the same types of symptoms he or she asked you about in the interview. The examiner might set up specific situations to make sure that certain symptoms, if present, are evident during the observation period. Eye contact, for example, is often poor in children with autism spectrum conditions. To be certain that your child's eye contact is limited with the examiner because of an autism spectrum disorder and not just due to shyness or lack of opportunity, the examiner might set up explicit scenarios that powerfully pull for eye contact, such as making it necessary that your child ask for help. In such situations, typical children almost always make eye contact. Similarly, the examiner might ask your child to tell a familiar story, because most typical children will periodically make eye contact to be sure that you are following them or are interested in what they are saying. An...

Medical Tests Informative but Not Usually Diagnostic

A related question you may have is whether specific medical tests might be helpful in your child's evaluation, even though they might not be critical to making the actual diagnosis. The answer to this question varies from child to child. Some children have certain risk factors or events in their history that make a full medical work-up highly desirable. For example, approximately 25 of children with autism spectrum disorders also have seizures, which can range from short blackouts to violent convulsions of the entire body. Seizures are most common in more classically autistic children, but can also occur in individuals with AS-HFA. The most common periods in which seizures start are preschool and adolescence. If your child has ever displayed behaviors indicative of potential seizures, then neurological testing, such as an electroencephalogram (EEG) and or an MRI (brain scan), may be ordered by your doctor. If your child went through a stage of development in which he or she lost...

Structural Imaging Studies

This research method has found a wide variety of abnormalities. In all brains (autistic and nonautistic) there are spaces, known as ventricles, that contain fluid instead of brain tissue. Some studies have found that the ventricles are larger than normal in some people with autism, which may mean that brain tissue around the ventricles has been lost. This finding is not specific to autism, however it has been found in a variety of other syndromes. It appears to be a marker for an abnormal brain, rather than specific to autism. Dr. Eric Courchesne, a prominent neuroscientist at the University of California at San Diego, reported in the late 1980s that a very specific part of the cerebellum (called the vermis, which is the Latin word for worm, because of its shape) was smaller in many people with autism. Some more recent studies have confirmed this finding, while others have not. Recent investigations have shown that this part of the cerebellum is abnormal in people without autism too....

Functional Imaging and Other Studies of How the Brain Works

Two specific areas of the brain have been the focus of investigations into whether the brains of those with autism spectrum disorders work differently from the brains of those without autism spectrum disorders. Since autism spectrum disorders always involve social deficits and repetitive behaviors, the areas of the brain that control these functions have been a focus of neuroimaging studies. In the late 1970s, two American neurologists, Drs. Antonio Damasio and Ralph Maurer, published a paper that pointed out behavioral similarities between people with autism and patients with damage to their frontal lobes (the region in the front of the brain, just behind our eyes and forehead). Both groups had difficulty controlling their emotions, would get very upset by small changes, were compulsive (wanting things just so), and were rigid in their solutions to problems, seeing things in a concrete, black-and-white manner. This led to a theory, still influential today, that if the frontal lobes...

Seeing Other Minds Darkly

Some letters, though, catch me completely unprepared. One letter was written by an adult who wondered if people ever recovered from autism or AS. Sharon's letter began I would like to make an appointment for an assessment. Obviously, I cannot really be autistic, or even have Asperger syndrome since I have a husband, a child, and a career. But since I first heard of autism I have thought of it as 'my problem,' and this conviction only deepens as I learn more, and as I fail to change myself despite my best efforts. While professional diagnosis might be a comfort, professional denigration would be painful, which is why I have avoided exposing myself to anyone qualified to deny my self-diagnosis. What intrigued me about the possibility that Sharon had AS was not only the types of social difficulties she described but also that she was an architect. This obviously required a high degree of perceptual skill and a penchant for seeing visual nuance and detail. In the letter, she wrote that...

Applied Behavior Analysis

The applied behavior analysis (ABA) model for treating young children with autism was developed by a psychologist named Dr. Ivar Lovaas, a faculty member at the University of California at Los Angeles (UCLA), in the 1960s. The treatment program uses general principles of behavioral therapy to build the skills that children with autism lack, such as language, play, self-help, social, academic, and attentional skills. In addition, the program tries to minimize the unusual behaviors of children with au- May be helpful for attention or activity level problems, depression, anxiety, anger, but does not treat core symptoms of autism tism spectrum disorders. The treatment is typically delivered in the child's home by a team of trained staff. Between 30 and 40 hours of treatment are provided weekly, making the ABA model the most intensive program for autism and related conditions. Since the time that Lovaas published his original study on the effectiveness of ABA for the treatment of autism,...

Other Preschool Possibilities

Several other treatment approaches have been gaining popularity for young children with autism spectrum disorders, including the Denver Treatment Model, developed by Dr. Sally Rogers at the University of Colorado Health Sciences Center, and the Greenspan model, developed by Dr. Stanley Greenspan of George Washington University Medical Center. These approaches emphasize play, positive social relationships, child-centered control of interactions, and sharing emotions with others. The importance of following the child's lead, tempting him or her to communicate and relate by entering the child's world, and allowing the child to exert control over interactions is stressed by these models. One goal of these therapies a goal that is emphasized much more than in either the ABA or TEACCH models is to foster warmth, pleasure, and reciprocity in relationships. These models also incorporate structured teaching sessions and behavioral and visual principles to address academic and other skills, and...

Interventions for Preschool and Beyond

Some of these interventions use the same principles as the preschool programs just reviewed, so your child may still benefit from the use of behavioral or visual techniques, at a level appropriate for his or her age and intelligence. The two most common needs of children with high-functioning autism and Asperger syndrome are social skills training and educational assistance. There is a wide variety of different interventions for each, so we have devoted a separate chapter to each of these topics and will mention them only briefly here.

Educational Assistance

In Chapter 7, we describe in detail the kinds of educational structure that appear most useful for students with Asperger syndrome and high-functioning autism. Many of the accommodations we suggest capitalize on your child's good visual skills and memory, using these strengths to make up for weaknesses in organization, planning, attention, and flexibility. The most essential part of educational programming is adapting the curriculum to your child's individual problems and unique abilities (more on this in Chapter 5 as well). At this point we will only say that, in addition to finding social skills training for your child, you will probably want to contact your school district to discuss the most appropriate ways to deliver educational support to your child.

Language Communication Therapy

By definition, those with high-functioning autism and Asperger syndrome have relatively well-developed language abilities. They can speak fluently, in full sentences, with few or no grammatical errors. Yet they most likely exhibit some difficulty using language in a social context to exchange ideas and information with others. They usually have trouble with abstract or complex language concepts. When what we say isn't exactly what we mean (such as when we are sarcastic, joking, or using metaphors or other figures of speech), the child with AS-HFA may misunderstand. All these difficulties are collectively referred to as deficits in the pragmatics of language. There are rules that underlie conversation that the rest of us learn naturally and know implicitly. These include taking turns, providing enough information to be clear without being verbose, and contributing relevant information. We know Much of this can be addressed in a good social skills group. (After all, how do we separate...

Behavioral Interventions

Children and adolescents with autism spectrum disorders can demonstrate some unusual and problematic behaviors that require specific management. Your child may at times have temper outbursts, possibly including being aggressive toward others or destroying things. When another teen called Josh, a 15-year-old with high-functioning autism, fatso, he shoved his face into a water fountain, causing serious injury to the boy's nose. Or maybe your child is impulsive and distractible, shouting out in class, grabbing things from other people, or having trouble sitting and focusing on work. Perhaps your child is very rigid about routines, the order in which things are done, or where favorite objects are placed. One young boy named Mark insisted that boxes of cereal be eaten in order by weight that is, if the Cheerios box weighed more than the Rice Krispies box, it had to be completely consumed before the next box of cereal could be opened. Mark also refused to eat food that was cut or broken for...

Parents as Treatment Managers

Besides this day-to-day management, you will need to be aware of the changes in your child's and your family's needs over time. No treatment plan will be adequate forever. Some challenges will diminish with time and intervention others may emerge as new developmental stages are reached and the skills needed to negotiate them change. It will likely be necessary to have your child reevaluated by a professional who knows both your child and autism spectrum disorders every few years to be sure that the treatment package continues to be useful. diagnosis of AS-HFA, you do not want to learn to live with it as a chronic condition. You want to cure it You want back the child you expected, the child with a life ahead of him or her without the difficulties associated with AS-HFA. Often this quest involves trying emerging interventions that appear to show promise but have not yet been thoroughly researched. For some parents, the need to leave no stone unturned, to try anything that might be...

Channeling Your Childs Strengths A Guiding Principle

Barbara and Eugene held hands as they drove home from Albert's school, where their son was enrolled in first grade. Their hearts felt heavy. Albert had been diagnosed with Asperger syndrome during the summer, and now his teacher was reporting that he was having a very difficult time with both peers and adults in school. He wasn't interested in playing with the other children, and he often refused to follow the rules. Despite being very intelligent, he rarely did his work, preferring to draw pictures of his favorite computer game characters. If this pattern continued, he might not be promoted to second grade. sions, but obviously he had noticed the type of pen she used, remembered the single occasion she had mentioned her music tastes, and registered which snacks she occasionally left sitting on her desk. There in the bag, which he had taped closed and labeled JA in black marker, were her favorite model of pen, filled with ink in her favorite color a bag of her favorite type of potato...

That Can Become Strengths

There are other characteristics associated with the high-functioning autism spectrum disorders that can similarly be used to your child's advantage. Sadly, however, you may be more used to hearing these characteristics identified as deficits. Problems that children with AS-HFA have in school and the social world are often related to their inflexibility, single-mindedness, and difficulty relating to peers. But there's an

Passion and Conviction

Parents of children with high-functioning autism spectrum disorders often lament their child's single-mindedness about certain subjects or Darcy was diagnosed with PDDNOS in preschool, after her parents noticed she was exhibiting tendencies similar to those of her older brother with classic autism. Later her diagnosis was changed to Asperger syndrome. One of Darcy's special interests was computer games, which she enjoyed so much that she taught herself how to program her own games, earning her high status among kids in her neighborhood and at school. In junior high, she started a business making personalized screensavers for her parents' friends, earning her some much-desired pocket money. In her sophomore year of high school, Darcy volunteered in the computer science department of the large state university in her city, where she distinguished herself so much that she was offered a paying job the next summer. Darcy is now enrolled at the Massachusetts Institute of Technology (MIT),...

Comfort and Compatibility with Adults

Adults are usually more consistent and more accommodating than peers, so many youngsters with autism spectrum disorders prefer the company of adults. The fact that children with AS-HFA are sophisticated in their language use and interests makes adults enjoy their company as well.

The Foundation Consistency

As you've read throughout this book, and no doubt experienced in your own home, most children with AS-HFA have a difficult time when their world is not consistent, routine, and predictable. As parents, therefore, you should always make consistency a priority, in both your overall approach to parenting and through the establishment of family routines and schedules. Making things consistent, routine, and predictable at home will reduce your child's confusion and anxiety and help promote positive behavior. In turn, this will help turn your home into more of the haven that it should be for the whole family. As we discussed in Chapter 5, many children with high-functioning autism or Asperger syndrome have very strong memory and rule-following capabilities, which usually make them quite good at remembering and applying routines. This is a perfect opportunity to take advantage of your child's strengths on the home front.

Understanding Challenging Behavior

Some children with Asperger syndrome and high-functioning autism occasionally display challenging behaviors, such as hitting, screaming, throwing tantrums, repetitive arguing, or even self-injury (such as slapping their own face or biting their hand). For many parents, particularly when you are in the midst of a spirited episode with your child, these problem behaviors seem like an end in and of themselves. You may get caught up in the moment, focusing on the idea that your child's objective is to engage in the challenging behavior and your goal is to squelch it. Obviously, you do need to deal with the immediate problem. However, it is important to remember that challenging behavior is not just random and almost always has a function or purpose. Most often, the child is trying to communicate his or her needs and wishes to others. So, if you want to discourage the challenging behavior, you need to determine what your child is trying to convey through it. Once you understand what he or...

Maintaining a Healthy Family Attitude Siblings

Working to ensure the psychological well-being of the siblings of children with autism spectrum disorders is one of the most valuable investments parents can make. With a healthy attitude, siblings can be a parent's greatest allies in caring for a child with AS-HFA. They can also be great friends to and serve as role models for children with AS-HFA, particularly for helping them to understand the social world. Finally, of course, when they are happy and feel supported, siblings contribute to the overall well-being of the whole family. The most important principles in dealing with siblings of children with AS-HFA are honesty, education, and open-mindedness. Your typically developing child will likely have myriad questions about his or her sibling. Why doesn't he talk to me Why does she do those weird things How come he won't play with me Does she hate me Can I catch autism Does my brother have Asperger syndrome because I wrestled too hard with him when he was a baby The more your...

The Cognitive and Academic Profile of Individuals with ASHFA

Chapter 5 reviewed the cognitive talents that are often part of high-functioning autism and Asperger syndrome, and Chapter 2 introduced the cognitive challenges that are part of the diagnostic profile for autism spectrum disorders. Joseph exemplifies a typical (although not universal) pattern, in which some of his academic skills are highly advanced, others are age-appropriate, and still others are truly deficient. Joseph can sound out almost any word he is shown, but he doesn't always know what it means. This indicates a dissociation between his reading decoding and reading comprehension skills. Similarly, in math he understands the rules of addition and subtraction and is even beginning to memorize the multiplication tables, but he has trouble applying

Learning Disabilities and ASHFA

The fact that there are major distinctions between the cognitive challenges posed by autism spectrum disorders and those posed by learning disabilities does not preclude the possibility that a child will have both. While it is relatively uncommon for children with autism spectrum disorders to have dyslexia too, it does occasionally happen. If your child is experiencing trouble with phonics, by all means have him or her evaluated for dyslexia. Most school psychologists and many clinical psychologists in the community are trained to perform these specialized evaluations. One learning disability is actually somewhat common among children with autism spectrum disorders. It is known as nonverbal learning disability, or NLD. As discussed in Chapter 2, children with NLD expe rience selective difficulty with mathematics, visual-spatial skills (for example, completing puzzles, mazes, drawing), and handwriting, but function fine when the activity relies primarily on language skills (for...

Educational Placement

One of the first questions raised by parents of children who have been diagnosed with Asperger syndrome or high-functioning autism involves school placement. Would their child be better off in a regular or in a special education classroom Are classrooms for children with autism spectrum disorders better than those for children with more general learning or behavior problems Should they investigate private schools The answers to these questions depend on the individual child there is no placement that is universally successful for all children with AS-HFA. The rule of thumb is that a child who is performing at or close to grade level and displays relatively few challenging behaviors (for example, outbursts, aggression, interrupting) can benefit from education in a regular classroom. However, even when these conditions are met, there is some risk that these children will fall between

Public or Private School

Parents sometimes ask where the best schools for children with autism spectrum disorders are located in the country, expressing a willingness to move if their child's needs could be better met elsewhere. The simple answer is that there aren't any or at least any that advertise themselves as national schools just or primarily for students with AS-HFA. And, as this and other chapters should make clear, it might not be such a good thing to have your child segregated not only in a special class but also in a special school, with no typical peers available to serve as models and potential friends. If you do find a special school of this type in the future, be sure that it provides opportunities for inclusion and education with nondisabled students as well. The principle of the least restrictive environment is not just legal policy but is also good for your child's social development.

Some Concluding Thoughts

To access such services, however, you must make the specific nature of your child's academic needs known. This includes sharing diagnostic information and other test results that may be relevant. It may also mean steering interested educators and administrators to resources and information about Asperger syndrome and high-functioning autism. The Appendix at the end of this book includes some resources specific to the educational needs of students with AS-HFA that may be helpful to share with school personnel.

What Your Childs Therapist Can Offer

Your family may have adapted to your AS-HFA child's social deficits, and therefore you might not consider the problem an enormous one at home in your daily activities. But social difficulties tend to be more pronounced in groups and with peers. So social problems may in fact be fairly significant for your child at school, at the local playground, or in a scout troop. We know that people with AS-HFA have trouble generalizing from one situation to another, so it's important to teach social skills in settings that are similar to those in which the children experience difficulty. When teaching social behavior to a child with high-functioning autism or Asperger syndrome, the therapist or teacher may be impressed by how fast the child learns new skills, only to be surprised later at how poorly these skills are used with peers. Thus, teaching in a group context is essential. general behavior or learning disorders do exist and can be helpful starting places for teachers or therapists wishing...

Your Childs Ability to Handle Emotion

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...

The Good News about Growing Older

Perhaps the most important advantage of maturity in adolescents with AS-HFA (as well as many typical teenagers) is that increased autonomy brings a greater opportunity to shape their own experience and seek a niche in the world that is more compatible with their own strengths and interests. Robin, a young woman with Asperger syndrome, was frustrated throughout childhood by others' lack of appreciation of her interest in photography. Her parents and teachers would continually try to get her to set aside this fascination to do schoolwork, and kids were always trying to escape her long speeches on photographic techniques. But in high school Robin gained both social stature and self-esteem when she joined the yearbook staff and found everyone hounding her for a chance to occupy some space in her viewfinder.

Critical Issues during Adolescence and Adulthood

Teenagers and adults with high-functioning autism and Asperger syndrome face many of the same challenges that they had to deal with in childhood. For parents, this means that the ideas you've been using to help your son or daughter will still help. Many, perhaps even most, people with AS-HFA continue to need support later in life, although the amount needed may well diminish over time. As you did when your child was younger, you should continue to play to his or her strengths whenever possible, capitalizing on excellent memory or visualization But, you may say, my child has just gone through a huge hormonal shift. She now has a job. The rest of the world's expectations are higher now that she is older. Can we really go on as if nothing has changed In fact, some things do change for people with high-functioning autism and Asperger syndrome as they mature. You'll need to emphasize independence and functionality more than ever. You have to learn how to negotiate a new set of situations...

Depression and Anxiety

Science has not yet clarified whether these mood problems result from the natural psychological consequences of managing AS-HFA or if they represent a biological disposition that is related to autism spectrum disorders. It may well be a combination of the stress of chronically trying to fit in, the pain of rejection, and a biological vulnerability to mood problems. Some research suggests that mood disorders run in the families of people with autism. Depression and anxiety disorders in family members usually appear well before the birth of the child with autism or Asperger syndrome, so they do not appear to be simply a re action to the stress of raising a special needs child. Another piece of evidence is that the neurotransmitter serotonin (a brain chemical that helps brain cells communicate with each other) appears to be altered in individuals with autism spectrum disorders and individuals with depression. So AS-HFA and depression may co-occur so often for many reasons. Thus, you will...

Promoting Social Opportunities

College will provide your adult child with numerous opportunities to further develop his or her social skills. There are many settings in college where social skills are taught at a more academic level. For example, classes in speech communication and drama emphasize how best to communicate, how to convey emotion, and how to read other people's response to you. Sociology and psychology classes can provide insight into the way others work and the rules underlying human behavior. An abundance of special interest groups, ranging from rock group fan clubs to star-gazing societies, provide opportunities for socialization within the comfort of an area of interest. Responding to the increasing presence of students with AS-HFA on college campuses, the administrative offices or student bodies of many colleges are developing autism spectrum disorder friendship or support groups.

Supervised Group Living

Another residential option that provides more support than independent living is supervised group living. One type of supervised group living is a group home, which is a residential facility for several individuals with disabilities. Group homes are usually houses in residential neighborhoods staffed by trained professionals who assist residents in areas like personal care, cooking, and housekeeping. Since group homes may serve individuals with various disabilities, it may be advantageous to seek one that specializes in autism spectrum disorders.

Hello Friend Now Go Away

Everyone diagnosed with an autism spectrum disorder has trouble with social interchange, specifically with what we call reciprocity, the back-and-forth interactions that make up all social encounters. In the very remote, nonverbal children who have classic autism, reciprocity difficulties are obvious. In high-functioning children and adolescents with AS-HFA, however, reciprocity problems may be more subtle. Parents often describe a feeling of one-sidedness in interactions with their child. Sometimes parents feel as if they must carry the whole relationship, supporting and scaffolding the interaction to establish some meaningful connection. If they don't start the conversation or ask the specific questions, the child may have very little to say or appear totally content on his own. Other parents describe their child as having his or her own agenda the child either tells the parents what to do or talks on and on without paying much attention to the parents or altering his or her...

Chores and Household Responsibilities

Encouraging children to help around the home is a challenge for every parent, including those parenting children with AS-HFA. It is typical for children to dislike chores and to try their best to shirk these responsibilities in lieu of something more fun. To make chores more tolerable for a child with an autism spectrum disorder, embed them in a daily or weekly routine. This consistency will help your child know what needs to be done and prevent a chore from being an unwelcome surprise. Likewise, try to routinize the steps in the chore. Capitalizing on their typical visual strengths, many children will be helped by creating a written checklist or set of pictures that outlines the steps involved in the task. For example, to help a child with taking out the garbage, show pictures of a person removing the garbage bag, tying it, placing it in the can in the garage, and then putting in a new bag. Work through the list with your child several times to help him or her learn the steps...

Listening to the Architecture of the World

I often notice Justin pacing back and forth in the hallway while he waits for his appointment. Through the window he flits in and out of view as he goes up and down the corridor. He's always listening to his portable radio, just like any teenage boy. But Justin is thirty years old, and he lumbers rather than walks, humming a tune from the radio under his breath. I've known him for almost twenty years. He was one of the first people with autism I met, and for that reason he will always hold a special place in my heart. I've learned a great deal from Justin, and if he has benefited from my interventions, it will have been a fair trade. He has been through a great deal, and his parents, Mark and Vera, have weathered many crises over the years. Justin has the capacity to hear things that I am incapable of hearing naturally. It is this attention to perceptual detail that is so remarkable. But in a more general sense, it's the pleasure that the intricacy of detail brings to people with ASD...

Classroom Accommodationsand What Is a 504 Plan

At first, this law was interpreted as an obligation to provide physical access to education for people with disabilities (for example, curb cuts and elevators for students in wheelchairs, sign language interpreters for deaf students, and the like). More recently, however, the meaning of access to an appropriate education has been expanded. Section 504 has increasingly been used to secure services for children with disabilities who don't qualify for special education but still have educational needs (or, in the language of the law, limits in learning). All school districts have a designated 504 coordinator who helps put together services for children qualified under Section 504. In brief, a 504 Plan is a written document that lays out a variety of modifications that a child needs to be successful in a regular education environment. Usually these accommodations are somewhat less time-consuming and require less intensive intervention and fewer trained staff to implement them than those...

The Salience Landscape Theory

Stimulus Salience

To account for some of the secondary symptoms of autism hypersensitivity, avoidance of eye contact, aversion to certain sounds, and so on researchers have developed the salience landscape theory. In a typical child, sensory information is relayed to the amygdala, the gateway to the emotion-regulating limbic system. Using input from stored knowledge, the amygdala determines how the child should respond emotionally to each stimulus, creating a salience landscape of the child's environment. In children with autism, though, the connections between the sensory areas and the amygdala may be altered, resulting in extreme emotional responses to trivial events and objects. ficulty understanding metaphors, just like people with autism. These results suggest that cross-domain mapping may have originally developed to aid primates in complex motor tasks such as grasping tree branches (which requires the rapid assimilation of visual, auditory and touch information) but eventually evolved into an...

Learning and Forgetting at School

Frankie's situation was becoming desperate. His parents came to see me, hoping I could find a way to improve his behavior and his learning at school. To teach him at home would mean depriving him of the opportunity to interact with other children and so perhaps improve his social interactions. Frankie had enjoyed his first school years and had made some friends who came to the house to play and invited him to their birthday parties in return. The more time Frankie spent with other children, the less he seemed to pursue his eccentric interests at home. Now he wanted to play with other children, not just on his own. His parents thought this positive change was a product of their determination that he go to the local school rather than to a special school for children with autism. But now he was clearly unhappy in school he was bored and uninterested in the regular school subjects and was interested only in flags. He was making little progress in reading and arithmetic. He showed no...

Recognizing Order and Following Rules

Denise is a young adult with Asperger syndrome who graduated from college and works as a medical transcriptionist in a hospital. In explaining her success, she divulged her secret of closely watching others to formulate rules of social behavior. Even when she was a child, she noted, she had observed peers for clues about appropriate conduct or comments. I watched what they did or said in a certain situation and then memorized that rule in case it ever happened to me. And I was always so happy when someone would just tell me the rule I remember being so relieved when my mother said that I should look at someone and give a wave if they said 'Hi' to me in the hall, Denise explained. The same tendency can lead many children with high-functioning autism or Asperger syndrome to enthusiastically embrace existing rules and become great law-abiding citizens. The rules must, however, be clear, explicit, and consistent, or the AS-HFA child is likely to chal You can also use your child's...

Self Awareness Self Esteem and Identity Development

Due to the close link between perceived attractiveness and social mastery and popularity. Among boys, physical prowess composes an important aspect of self-concept. Again, this presents a challenge for children with AS-HFA because of the common link between autism spectrum disorders and motor coordination problems (see Chapters 2 and 3). Morality is another facet of adolescent identity development that is often problematic for children with AS-HFA. Although moral rigidity and righteousness can be a notable strength for children with AS-HFA, it can also cause some social difficulties. Superficially clear-cut moral guidelines can lead children to make poor judgments in adolescence, when interactions become more sophisticated and complex. Like many adolescents, children with AS-HFA may develop strong religious or political beliefs in response to these ambiguities. After reading a book on the meat-packing industry, one young woman with high-functioning autism decided that eating meat was...

The Strengths That Accompany the Challenges

Having Asperger syndrome or high-functioning autism is not all bad. There are special gifts, talents, and inclinations that come along with the challenges and make your child a very special, unique, and interesting person. Many children and teens with these conditions have excellent memories. They remember details of family trips, routes around their city, or spelling lists effortlessly. Many also excel in reading. Like Joseph, they may teach themselves to read at an early age and later be able to read words aloud and spell well above grade level. Others are very advanced in visual-spatial skills, putting together complex jigsaw puzzles, reading maps, or working electronic equipment far better than their peers. If you can find some practical way to apply your child's special interests to the real world, then his or her incredible abilities to focus, memorize, and spend long hours immersed in a topic become invaluable strengths. You may have heard of Dr. Temple Grandin, a professor of...

Communication Eloquent but Inarticulate

In addition to social difficulties, autism spectrum disorders usually involve communication problems. In fact, the most prominent feature of classic autism, at least in the minds of most people, is the inability to speak. What is less well understood is that even those with Asperger syndrome and high-functioning autism experience some difficulties with communication. This, it turns out, is one of the most confusing parts of the diagnostic puzzle and often leads to misdiagnoses when the child is young. You may have had autism raised as a possibility at some point in your child's life, only to have it ruled out or be told later that he or she couldn't possibly be autistic because the child speaks so well. Indeed, it is part of the definition of Asperger syndrome that language be fluent, not only at the age the child is seen for evaluation, but even at ages 2 and 3. A smaller, but not insignificant, number of children with high-functioning autism begin talking early and soon speak...

Individual Psychotherapy

Traditional psychotherapy can help some, but in our opinion a limited number of, individuals with AS-HFA. Generally, individual psychotherapy involves discussion of emotions and gaining insight into behavior patterns or interpersonal issues. Since most AS-HFA children, adolescents, and even adults have limited self-awareness, do not naturally make social comparisons, and often show little insight into the nature and reasons for their difficulties, this form of psychotherapy is often not very helpful for them. Additionally, the realm in which the majority of problems arise for those with AS-HFA, social situations, are best dealt with in larger group formats, rather than in individual therapy sessions. One of the chief difficulties encountered in autism is the lack of automatic generalization, from one situation to another, from one interaction to another, from one setting to another, from one person to another. It is therefore unlikely that work done in a one-to-one setting with an...

What about [Fill in the Blank Other Possible Causes

Over the years, a number of other causes of autism have been suggested. There is some evidence, although it is controversial, that infections during pregnancy or in the first years of life may contribute to the development of autism in a very small number of children. For example, studies in the 1960s and '70s found that approximately 10 of children exposed to the rubella virus in utero developed autism. Other studies found that infections with the herpes simplex virus, which can cause brain swelling and brain damage, can in very rare cases lead to autism in a previously healthy person. More recently, the late Dr. Reed Warren, an internationally renowned immunologist from Utah, speculated that some cases of autism might result from an inherited immune system deficiency that makes children more susceptible to viral or bacterial infections. Unable to clear the organism quickly, the fetus or infant is at increased risk that the infection might damage the brain directly. Another possible...

Medical Centers UniversitiesClinics

Autism Asperger Resource Center 4001 HC Miller Building 3901 Rainbow Boulevard Kansas City, KS 66160 Phone (913) 588-5988 Fax (913) 588-5942 Emory Autism Resource Center Emory University 718 Gatewood Road Atlanta, GA 30322 Phone (404) 727-8350 Indiana Resource Center for Autism Judevine Center for Autism 9455 Rott Road St. Louis, MO 63127 Phone (314) 849-4440 Fax (314) 849-2721 Kentucky Autism Training Center Weisskopf Center for the Evaluation of Children 911 South Brook Street Louisville, KY 40203 UCLA Autism Clinic 300 Medical Plaza, Suite 1100 Los Angeles, CA 90024 Phone (310) 825-0458 University of Miami Center for Autism and Related Disabilities Phone (305) 284-6564 (800) 9-AUTISM ext. 2 University of Utah Autism Program University of Washington Autism Center Center on Human Development and Disability Box 357920

Strategies for Positive Discipline

As you may have experienced with your own child, many standard disciplinary methods don't work well with children who have autism spectrum disorders. Children with Asperger syndrome or high-functioning autism may not have good self-monitoring skills and may lack the ability to judge whether their behavior is appropriate. They may not pick up on cues that normally would signal that their behavior does not fit in, and they may not feel the embarrassment or shame that many children experience when they have behaved inappropriately. Nor are they always motivated by a desire to please their parents and other adults by behaving well. When 10-year-old Ronald had his friends over, they would try to talk with Ronald's 14-year-old brother Peter to ask him about a video game that he had mastered. Peter had no interest in talking with his brother's friends, but because he had Asperger syndrome, he didn't know how to communicate his feelings appropriately and would simply shove Ronald and his...

Accepting the Enigma Moving Beyond the Cause

The parents tell me the children are triplets. The girls, Sally and Ann, are identical twins, and the boy, Danny, is a fraternal twin. The mother, Joan, used to be a shop assistant she is dressed in white jeans and a sweater and wears glasses. She looks completely and utterly exhausted. The father, Dave, is a machinist who works the midnight shift. He has just woken up to drive everybody to the appointment. Both parents are very worried about the children's development and wonder whether they might have autism. They have no other children at home. They look at me anxiously as if I might give them an immediate and perhaps reassuring answer. Instead I gather some information to understand what might have happened and whether it is true that lightning has struck three times in the same family at the same instant. They had regular appointments with the family doctor and the pediatrician and followed all directions meticulously. Joan and Dave became concerned with the children's...

Unusual Interests and Behaviors

The third area in which people with high-functioning autism spectrum disorders differ is behavior. You will probably have noticed that your child's range of activities is relatively focused and that he or she can do the same thing over and over again without getting bored. Among those with Asperger syndrome and high-functioning autism, these traits usually show up as very specific interests that verge on obsessions. These kids have the favorite pastimes that many children have computers, video games, dinosaurs, astronomy but pursue them to the exclusion of almost everything else. Many parents report that their child will stay at the computer for hours, not breaking to go to the toilet, to eat, or to sleep unless pressured, and even then with much resistance. The intensity of the child's interests seems odd to others and may contribute to the child's social isolation. So does the child's choice of interests. Few typical children (or adults) appreciate the intricacies of the stock...

Strategies for Teaching Social Skills Outside the Clinic

Earlier we stressed the importance of addressing social issues in a group setting, since this is where social problems usually arise, and thus this is where your child needs to practice social behavior. We also emphasized that you should practice and support your child's emerging social abilities at home whenever possible and that social skills training in a clinic alone would not do much good. In the following sections, we describe a variety of resources and techniques for working on social skills that can be used by anyone, across a variety of settings. These techniques will help your child improve his or her social behavior even when he or she is not within the four walls of the clinic or school, with a trained professional there to assist him. You are a key player in this endeavor. The following approaches do not require a professional degree to implement, just an interest in trying, a willingness to keep trying, flexibility, and a sense of humor. It is often helpful to initiate...

Sensory Integration Therapy

Some children with high-functioning autism and Asperger syndrome are overly sensitive to and easily overwhelmed by everyday sensations, such as certain sounds, tastes, textures, or smells, or by being touched. Their distress when encountering these sensations can be very intense. Parents sometimes describe the phenomenon as sensory overload. One young woman said that when she was bombarded by unwanted sounds, smells, and sights, her body would shut down. She described feeling completely detached, almost as if her body belonged to someone else or was a piece of furniture. One boy with Asperger syndrome was so sensitive to smells that his mother called doctors in advance of his appointments to remind them not to wear perfume or scented antiperspirant. During one visit, he told his doctor pointedly that she had bad breath and threatened to leave unless she gargled with mouthwash. Many children with AS-HFA find loud noises intolerable and will cover their ears when exposed to them. Some...

Dealing with Teasing and Bullying

Many children and teens with AS-HFA are teased, belittled, or bullied in school. The peer mediation approaches described above appear to foster greater peer acceptance, which may reduce the frequency of victimization by peers that can be a common part of the life of a child with AS-HFA. Peer buddies are especially useful to the child with high-functioning autism or Asperger syndrome during unstructured times of the school day, such as lunch or recess. It is well established that bul There are several other techniques that have shown promise in reducing the likelihood that teasing or bullying will occur. Many approaches involve similar ingredients to those used in peer mediation programs, including providing information about autism to classmates and creating regular opportunities for interaction between children with AS-HFA and typical peers. Other programs involve assertiveness training and teaching the child specific techniques for standing up to bullies asking for help, seeking out...

Additional Tests

That looks at memory, fine motor skills, spatial processing, and the like a nutritional evaluation and many other things, depending on how comprehensive the team conducting the evaluation is. All these areas are of some interest in that they produce the most complete picture of your child, but parents and professionals sometimes have to weigh the desire to be comprehensive with practical constraints, such as finances. If the professional is appropriately trained, a relatively quick evaluation that includes only a parent interview and an observation of your child and contains none of these extras can still provide an accurate diagnosis. The signs of autism spectrum disorders are readily discernable to the experienced professional who has asked the right questions and noticed the right aspects of behavior, without any additional intellectual, neurological, or educational testing. Be sure to ask the doctor or team assessing your child how many children with autism they see. Or call your...

Autopsy Studies

Only a few investigations of this type have been done, since they are so difficult to perform and since it is uncommon both for individuals with autism spectrum disorders to die prematurely (thankfully) and for their survivors to donate their brains to science. The few studies that have been done have found two types of brain abnormalities. First, they have found that there are too many brain cells (neurons) in a region known as the limbic system, which lies deep in the center of the brain and is important to social and emotional behavior. Moreover, the cells are smaller and more tightly packed together than they are supposed to be. This may mean that they do not have the correct shape and or enough room to make the connections with other brain cells that allow them to function as they should. Autopsy investigations have also revealed significantly fewer brain cells in another part of the brain called the cerebellum, which is important in both motor coordination and cognitive...

So Now What

The rest of this book covers methods of treating and managing the difficulties associated with Asperger syndrome and high-functioning autism. This chapter presents an overview of the different treatment options available in many communities and, when known, their relative benefits and risks. As discussed in Chapter 1, the range of outcomes seen in adolescents and adults with autism spectrum disorders is wide. Some people improve a great deal and their difficulties become less apparent over time. They function fairly well in a variety of different roles and settings typical for their age college student, employee, roommate, friend, neighbor with few apparent impairments. In this chapter you'll learn which currently available treatments seem to maximize the likelihood of these best outcomes. We hope that as more children are diagnosed and treated early, more will function well in adolescence and adulthood perhaps a lot more. Very little research has...

Social Interventions

Your area may not have a group of this type exclusively for children with AS-HFA, but there may well be one for children with attentional or other behavior problems. The child or adolescent with AS-HFA often benefits from the opportunity to meet other kids with autism spectrum disorders who share similar interests, personality styles, temperaments, and challenges. But as long as the group addresses many of the issues listed above and you feel that there is a good fit between the therapeutic goals of the group and your child's needs, it is not necessary that all or even most of the participants have AS-HFA. You should also check with your school district, since often social skills groups are offered through schools.

Medication

The use of medications to treat people with AS-HFA has increased in recent years, due in part to increasing recognition of the neurological basis of the disorder. Research studies have shown that levels of certain brain chemicals (neurotransmitters) are different in people with autism, sometimes higher than they should be and sometimes lower. Although there are no medications that can cure autism, appropriate use of medication can often increase the quality of life for both the child A wide range of medications have been used for autism spectrum disorders over the years. However, as yet no medication that alters the core social and communication deficits of AS-HFA has been found. The drugs that are commonly used with the AS-HFA population address noncore symptoms and comorbid conditions, such as attention and activity level problems, depression, anxiety, aggression, repetitive thoughts or behaviors, sleep difficulties, tics, and seizures. The most commonly prescribed medications for...

Dietary Treatments

Some professionals have advocated the use of special diets, vitamin supplements, or both to manage some symptoms associated with autism spectrum disorders. In recent years, a theory has been formed that some cases of autism are caused by food allergies, specifically severe allergic reactions to gluten, a protein found in flour, and casein, a protein found in milk products, that irritate or damage the brain and lead to the unusual behaviors associated with the autism spectrum disorders. So far this hypothesis is based on clinical observations and parent reports rather than well-controlled scientific studies. As with understanding the potential risks and benefits associated with medications, future research investigations are very much needed. Some parents report improvement of their child's behavior when certain prod Another form of dietary treatment for AS-HFA is vitamin supplements. Dr. Bernard Rimland, who was one of the first professionals to propose a biological cause for autism,...

Family Support

To the extent that significant difficulties remain for members of the family, however, additional support may be necessary. Most urban areas have support or self-help groups for parents and families of people with AS-HFA. These are often associated with your state's local chapter of the Autism Society of America. In some areas, there are even regular meetings for families of children with high-functioning autism or Asperger syndrome, so that the topics of focus are specifically relevant for those with milder or higher functioning symptoms. If this is not available in your area, don't despair, because most support groups will still make a strong effort to have some of their meetings centered on higher-functioning individuals. You just may need to call ahead and get a schedule of topics to know when it will be most relevant for you to attend. Parents often find it useful to talk with other parents, who understand better than professionals what you are going...

Mealtimes

It is also essential to keep in mind that parents don't always get an accurate impression of what their child eats. The mother of Sandra, an 8-year-old girl with high-functioning autism, was under the impression that her daughter ate nothing but pretzels and cheese. After consulting with the doctor and finding out that her height and weight parameters were appropriate, she asked Sandra's teacher about her eating habits at school. She learned that Sandra regularly ate the entire school lunch, including vegetables and milk.

Bedtime

Another challenging transition, bedtime can be a daunting endeavor, especially since studies have shown that autism is often associated with sleep difficulties. Bedtime routines, such as going to bed at the same time and engaging in the same prebedtime tasks, are helpful for all children, but especially for those with Asperger syndrome or high-functioning autism. Give your child plenty of advance warning and a countdown (30 minutes, 20 minutes, and so on) as bedtime approaches. To help your child wind down, make sure he or she engages in a quiet activity, like reading or playing a mellow game, before bedtime. An

More Products

Autism Support Program
autismsupportprogram.com