When dealing with a child on spectrum, the presence of sudden or chronic behaviours that are aggressive, odd, or socially inappropriate can present challenges one may feel ill-equipped to understand and deal with. Being prepared ahead of time can help a great deal in managing these issues in the calm, logical way. The following questions and answers cover some of the most common problems that arise with the behaviour of children (and some adults) who have Autism Spectrum Disorder (ASD):
My child’s behaviour has changed suddenly; what should I do?
First off, have the child seen by a doctor. Children with ASD sometimes can’t identify and/or vocalize their feelings, so may not be able to express the pain caused by a medical condition that has arisen quickly, making it important to rule such out.
Once medical issues have been found absent, assess whether or not changes to the child’s routine or environment have happened recently. Remember that even small changes, such as re-arranging a room or changing lighting or shampoo brands, may upset someone with ASD and bring out “coping behaviours”.
My child doesn’t understand physical boundaries and tries to hug strangers; what should I do?
Remember that social boundaries are very challenging for someone with ASD to grasp; they quickly assume what is okay at home or with friends is okay as a general rule.
To combat this, try writing a “social story” (with pictures if possible) explaining why people hug friends and family, but not strangers. A comic strip style of format is often ideal for these.
Try to teach more appropriate ways of showing affection to strangers rather than just limiting the problem behaviour, as those with ASD should be encouraged to interact socially as much as possible/enjoyable. Suggest waving to strangers instead, for example, or holding the door open for them. Reward the child for practicing these alternate skills.
Consider conducting a general social skills “training course” for the child, explaining in story form why people greet each other in the ways they do, part as they do, etc.
My child gets very anxious during breaks and at lunch hour; how do I help her deal with this?
School break times often stress those with ASD because they are both unstructured time and often involve sensory overload (noise from many children playing, lots of movement).
Consider having a support worker stay with your child during these times and structure the break time around certain games each day to create a routine.
You can also look for special support groups at the school for those with ASD that focus on teaching children social skills in a way they can handle. This way the child both develops a peer network and receives structure and support, with someone on hand to help her troubleshoot her particular issues with social interaction.
Give your child methods for indicating her distress to staff if she can’t easily vocalize it, such as stress scales, so that staff know when it’s time for a “time out” from social situations. Likewise, teach your child healthy relaxation techniques to use during these breaks, such as listening to soft music or practicing deep breathing.
If breaks are still simply too overwhelming, seek permission from the school for your child to spend them in the library or computer room.
For many people with an Autism Spectrum Disorder (ASD), obsessions, repetitive behaviours, and routines that might appear overly rigid or unhealthy to neurotypical individuals are actually a source of comfort and self regulation. Like all things, however, when used too much, these behaviours may detract from other things or cause distress to the person with ASD, so understanding these needs and knowing where to draw a line is important. To help a person with ASD learn how to manage these issues, it’s vital to understand the behaviours’ function and how to respond to them.
Why People with ASD Develop Obsessions and Repetitive Behaviour
People with an ASD may have any number of obsessions (some of them as common as certain TV shows), but often they center around a “technical”, academic, or mechanical skill-set, such as computers, trains, historical dates or events, or science. Obsessions can become quite odd and particular, however, involving specifics about numbers or certain shapes (things like car registration numbers, for example, or bus or train timetables, and the shapes of body parts or stones). People with ASD can feel quite strongly about these things, no matter how mundane they may seem to others.
Children with ASD develop obsessions as they help to give them a sense of structure, order, and predictability, which counterbalances the chaos they may feel is inherent in the world around them. They also give a solid, sure base on which to begin conversations and break the ice with others. For these reasons, it’s vital to not label these obsessions as unhealthy by default, but rather to allow the child with ASD to explore them. One should try to understand the function of the behaviour and remain observant for signs of things going too far. Such signs include the seeming distressed while partaking in their chosen hobby, signs they wish to resist engaging in it but cannot (it’s become a compulsion), or signs it is making the child withdraw socially more than he or she normally would. Similarly, it may need to be managed if it becomes seriously disruptive to others.
Repetitive behaviour (such as hand-flapping, finger-flicking, rocking, jumping, etc.) develop quite early and may likewise appear unhealthy or troubling, but serves a therapeutic role for the child with ASD. Many suffer from sensory distortions (over or under sensitive senses), so may need the stimulation or distraction this kind of activity provides.
Understanding Routines and Resistance to Change
Those with ASD often feel confused and frightened by the complexity of life around them, due to their susceptibility to sensory overload and difficulty with understanding complex social dynamics. Developing set routines, times, particular routes, and rituals to handle daily life helps the person with ASD moderate their confusion and anxiety by making the world feel like a more predictable place; as such, people with ASD develop a strong attachment to routines and sameness.
How attached the person is, and how much distress is caused by a breach in these routines, varies with the individual; he or she may be upset by minor breaks (even as small as changing activities, or the layout of a room being changed), or need a larger, more chaotic upset, such as the disruption and stress of the holiday season. As a general rule, the more unexpected the change, the more upsetting it will be; warning those with ASD about upcoming changes and keeping calendars and timetables is often helpful.
Likewise, one should expect those with ASD to rely even more heavily on their routines during times of change or stress; as with obsessive behaviours, this reliance should be allowed, but managed so it does not become unhealthy.
Behavioural difficulties are common in children who have ASD, but with the right strategies and support, they can often be mitigated through effective management. There are myriad reasons for these difficulties, such as issues with communication, sensory processing, social interaction, and balance issues which affect active play. It’s vital that parents and caregivers understand these behaviours are not their “fault”, they are merely symptoms of the underlying difficulties the child with ASD is facing.
Understanding the Causes
The root causes of behavioural difficulties are generally as follows:
Difficulties with communication: Children with ASD typically struggle with expressive language, understanding what is being said to them, and picking up on non-verbal communication cues. This can, understandably, become quite frustrating and provoke problem behaviours.
Difficulties with social situations: The difficulties presented by social situations for a person with ASD go beyond just communication; people with ASD also struggle to understand other’s points of view (inflexible in their opinions), and grasp the “unspoken rules” of social interaction that state when to, for example, end a conversation. Due to all of this, children with ASD may shun social contact, and they are more likely to experience bullying.
Difficulties with unstructured time: People with ASD have a hard time dealing with situations where there is no set schedule, as their brains have a hard time sequencing activities on their own. For this reason, children with ASD are more likely to act out during recess or other break times, as they feel confused and frustrated.
Difficulties processing sensory information: Those with ASD often have over or under-sensitive senses, leading to a tendency to get overwhelmed or to seek stimulation to a problematic degree. They may react strongly to touch, be very picky eaters, get overwhelmed by loud noises (or be unable to concentrate over background noise), etc.
Additionally, one should always remember that people with ASD do not easily adapt to change; always be on the lookout for things in their environment or schedule that have been altered, as this may trigger problem behaviours. Illness (especially seizures, which ASD individuals may be prone to) can also trigger acting out, as the child with ASD cannot easily vocalize his or her pain. Consider using diagrams to help children express where they are feeling pain.
People with Autism Spectrum Disorder (ASD) typically have difficulty processing sensory information such as sounds, sights, and smells. This is usually referred to as having issues with “sensory integration”, or having sensory sensitivity, and is caused by differences in how the brain of a person with ASD understands and prioritizes the sensory information picked up by the body’s many sensory receptors. When this breakdown in communication becomes too intense, the person with ASD may become overwhelmed, anxious, or even feel physical pain. When this occurs, some with ASD may act out.
The over and under-sensitivity ASD people experience may affect some or all of the following seven senses:
Including seeing objects as darker than they really are, blurred central vision, having poor depth perception (resulting in clumsiness), and distorted or fragmented images.
Imbalanced hearing (hearing sounds only in one ear), may either enjoy loud noises or be very agitated by them, may have difficulty cutting out background noise (affecting concentration), sounds may be distorted. These difficulties may also contribute to balance issues.
A person with ASD may either crave touch (and not know how much to apply, such as holding a person too tightly) and have a high pain threshold, or shun touch (even common gestures of affection, such as hugs) and struggle with certain sensations, such as those produced by rough fabrics, hair brushing, etc.
Some with ASD may crave strong tasting foods (such as very spicy foods) or even go so far as to try to eat non-edible substances like Play Dough, while those who are hypersensitive to taste will shun all but the blandest foods, and may dislike foods with anything but a smooth texture.
Some people with ASD may have no sense of smell and remain unaware of strong odours (leading them to rely on oral cues; they may taste things to get a better sense of them), while others may find common smells (such as from deodorants, lotions, shampoos, and perfumes) too strong to bear. For this reason, they may be extremely averse to going to the bathroom.
People with ASD may rock back and forth so as to get enough input on where they are situated, as they lack a sense of balance. They may have difficulties with sports, particularly anything gymnastic where the head is removed from an upright position. They may be more prone to car sickness than those who lack ASD.
Body awareness (‘proprioception’)
As people with ASD struggle to orient their bodies properly in space, they may stand too close to others, have a hard time navigating rooms or moving around obstructions (including people), experience difficulties with fine motor skills, or experience Synaesthesia (a condition where senses are “confused”, i.e. one will hear or taste a colour).
Autism is a very diverse condition, and as such, it is often referred to as being a “spectrum” disorder which encompasses many different types of disability, all of which can affect unique individuals differently. When it comes to distinguishing the various forms of “high functioning” autism, one can encounter challenges, as the level of disability is itself less obvious, and its impacts are therefore more subtle and hard to differentiate.
In particular, high-functioning autism (HFA) and Asperger’s syndrome (AS) may present quite similarly to an untrained eye, but retain important differences that are still being researched today; below, the difference between the two conditions is explained:
The primary difference between the two conditions is generally found in the area of language development (notably, those with Asperger’s syndrome usually do not experience delayed language development while young) but the differences go beyond this one area, and have been subject to a certain amount of debate and controversy over the decades.
History of the Autism Diagnosis
The term “autism” was originally coined in 1911 by psychiatrist Eugen Bleuler, and was at first meant to denote the social withdrawal and detachment that often accompanies schizophrenia (indeed, the word “autism” translates to “selfism”). Later, in the 1940s, when both American Leo Kanner and Austrian Hans Asperger were working on defining the childhood disorders they were treating, they came across the concept of autism in their research, and decided it was an apt description for the various symptoms they had been attempting to treat in children. Over time, Kanner realized these children were not actually experiencing schizophrenia, but rather something else, which he dubbed “infantile autism”. Asperger added onto this body of knowledge by ascertaining that some of the children referred to his child psychiatry clinic were suffering from a condition that had not been hitherto properly described, but which loosely fit what Bleuler had defined as autism (and which lacked the acute psychosis of schizophrenia). Kanner’s work was highly accurate and detailed for its time, and formed the cornerstone of future research into autism, particularly after his paper (published in the UK in 1943) gained widespread recognition in the English-speaking world.
Following Kanner’s paper, the diagnosis of ‘infantile autism’ came into popular use as the 1950s and 60s progressed, and Kanner’s work largely overshadowed Asperger’s, who remained mostly unknown outside Europe.
Over time, academics, along with Asperger himself, noted that Asperger’s and Kanner’s autism bore striking similarities. Judith Gould and Lorna Wing, in particular, contributed by conducting a revolutionary study in the late 1970s that demonstrated autism existed on a continuum. It was during this course of this study that the phrase “Asperger’s syndrome” was first used to describe a higher-functioning sub-group of the autism patients surveyed. Asperger’s came to be seen as a more “positive” diagnosis, with less social stigma attached to it, creating some controversy around the prevalence with which it was thereafter used.
Some debate still exists today around the four main areas of difference that separate Asperger’s syndrome from high-functioning autism:
Most of us desire to make the best first impression possible when entering into any important social situation; being able to do so is vital to thriving in our society, as it facilitates us effectively applying for jobs and resolving difficult conflicts around us. In order to do this, we have to be able to calculate our responses to people using observations about their facial expressions, tone of voice, and body language. Through doing so, we can determine if our actions are making them happy, sad, angry, etc.
Now, imagine having an illness that affected your ability to read all of those vital social cues; how hard would it be to effectively communicate with others? Such is the struggle faced by those with Asperger’s syndrome, one of Autism Spectrum Disorders (ASD).
What is Asperger’s syndrome?
This mental health disorder is named after Austrian pediatrician Dr. Hans Asperger, who was the first to research and describe this disorder in 1940s. As mentioned prior, Asperger’s syndrome is a less severe form of autism, a disability one is born with and which presently has no cure (nor known cause). This disability affects cognitive functioning, namely how an individual processes information about the world and other people around them. Asperger’s is often said to be on the “autism spectrum”, as autism is highly variable, affecting different individuals in many different ways, and with many different degrees of severity. Asperger’s is relatively common, affecting around 1 in 165 people in Canada. According to Asperger’s Society of Ontario, more than 70000 people in the province live with Asperger’s syndrome. This disorder can affect people from all walks of life, but is more frequently seen in males than females (it’s not yet understood why this is the case).
Asperger’s is typically considered to be an invisible disability, as it is not immediately apparent. As one gets to know someone with Asperger’s, however, one will typically see them struggle with the following:
- social communication;
- social interaction;
- social imagination.
Asperger’s syndrome does not, however, necessarily affect intelligence; many who have the disability demonstrate IQs that higher than average — unlike autism, which frequently causes learning disabilities (though it should be noted that people with Asperger’s are prone to ADHD, dyslexia, and dyspraxia, and in extreme cases, may also have epilepsy). Moreover, Asperger’s syndrome is often confused with giftedness, thus resulting in gifted children being diagnosed with Asperger’s and vice versa.
As those with Asperger’s are not severely impaired, they often go on to lead happy and successful lives, if they have access to adequate support; there are many forms of social, behavioural, and communications-based therapy that can help a person with Asperger’s.