HELPING CHILDREN WITH AUTISM

Adapted from HELPGUIDE.org

A parent’s guide to autism treatment and support

If you've recently learned that your child has or might have an autism spectrum disorder, you're probably wondering and worrying about what comes next. No parent is ever prepared to hear that a child is anything other than happy and healthy, and a diagnosis of autism can be particularly frightening. You may be unsure about how to best help your child or confused by conflicting treatment advice. Or you may have been told that autism is an incurable, lifelong condition, leaving you concerned that nothing you do will make a difference.

While it is true that autism is not something a person simply "grows out of," there are many treatments that can help children learn new skills and overcome a wide variety of developmental challenges. From free government services to in-home behavioral therapy and school-based programs, assistance is available to meet your child's special needs. With the right treatment plan, and a lot of love and support, your child can learn, grow, and thrive.

Don’t wait for a diagnosis

As the parent of a child with autism or related developmental delays, the best thing you can do is to start treatment right away. Seek help as soon as you suspect something’s wrong. Don't wait to see if your child will catch up later or outgrow the problem. Don't even wait for an official diagnosis. The earlier children with autism spectrum disorders get help, the greater their chance of treatment success. Early intervention is the most effective way to speed up your child's development and reduce the symptoms of autism.

When your child has autism: Tips for parents

• Learn about autism. The more you know about autism spectrum disorders, the better equipped you’ll be to make informed decisions for your child. Educate yourself about the treatment options, ask questions, and participate in all treatment decisions.
• Become an expert on your child. Figure out what triggers your kid’s “bad” or disruptive behaviors and what elicits a positive response. What does your autistic child find stressful? Calming? Uncomfortable? Enjoyable? If you understand what affects your child, you’ll be better at troubleshooting problems and preventing situations that cause difficulties.
• Accept your child, quirks and all. Rather than focusing on how your autistic child is different from other children and what he or she is “missing,” practice acceptance. Enjoy your kid’s special quirks, celebrate small successes, and stop comparing your child to others. Feeling unconditionally loved and accepted will help your child more than anything else.
• Don’t give up. It’s impossible to predict the course of an autism spectrum disorder. Don’t jump to conclusions about what life is going to be like for your child. Like everyone else, people with autism have an entire lifetime to grow and develop their abilities.

Helping children with autism tip 1: Provide structure and safety

Learning all you can about autism and getting involved in treatment will go a long way toward helping your child. Additionally, the following tips will make daily home life easier for both you and your autistic child:

• Be consistent. Children with autism have a hard time adapting what they’ve learned in one setting (such as the therapist’s office or school) to others, including the home. For example, your child may use sign language at school to communicate, but never think to do so at home. Creating consistency in your child’s environment is the best way to reinforce learning. Find out what your child’s therapists are doing and continue their techniques at home. Explore the possibility of having therapy take place in more than one place in order to encourage your child to transfer what he or she has learned from one environment to another. It’s also important to be consistent in the way you interact with your child and deal with challenging behaviors.
• Stick to a schedule. Children with autism tend to do best when they have a highly-structured schedule or routine. Again, this goes back to the consistency they both need and crave. Set up a schedule for your child, with regular times for meals, therapy, school, and bedtime. Try to keep disruptions to this routine to a minimum. If there is an unavoidable schedule change, prepare your child for it in advance.
• Reward good behavior. Positive reinforcement can go a long way with children with autism, so make an effort to “catch them doing something good.” Praise them when they act appropriately or learn a new skill, being very specific about what behavior they’re being praised for. Also look for other ways to reward them for good behavior, such as giving them a sticker or letting them play with a favorite toy.
• Create a home safety zone. Carve out a private space in your home where your child can relax, feel secure, and be safe. This will involve organizing and setting boundaries in ways your child can understand. Visual cues can be helpful (colored tape marking areas that are off limits, labeling items in the house with pictures). You may also need to safety proof the house, particularly if your child is prone to tantrums or other self-injurious behaviors.

Helping children with autism tip 2: Find nonverbal ways to connect

Connecting with a child with autism can be challenging, but you don’t need to talk in order to communicate and bond. You communicate by the way you look at your child, the way you touch him or her, and by the tone of your voice and your body language. Your child is also communicating with you, even if he or she never speaks. You just need to learn the language.

• Look for nonverbal cues. If you are observant and aware, you can learn to pick up on the nonverbal cues that children with autism use to communicate. Pay attention to the kinds of sounds they make, their facial expressions, and the gestures they use when they’re tired, hungry, or want something.

• Figure out the need behind the tantrum. It’s only natural to feel upset when you are misunderstood or ignored, and it’s no different for children with autism. When children with autism act out, it’s often because you’re not picking up on their nonverbal cues. Throwing a tantrum is their way communicating their frustration and getting your attention.
• Make time for fun. A child coping with autism is still a kid. For both children with autism and their parents, there needs to be more to life than therapy. Schedule playtime when your child is most alert and awake. Figure out ways to have fun together by thinking about the things that make your child smile, laugh, and come out of their shell. Your child is likely to enjoy these activities most if they don’t seem therapeutic or educational. There are tremendous benefits that result from your enjoyment of your child’s company and from your child’s enjoyment of spending unpressured time with you.  Play is an essential part of learning and shouldn’t feel like work.
• Pay attention to your child’s sensory sensitivities. Many children with autism are hypersensitive to light, sound, touch, taste, and smell. Other children with autism are “under-sensitive” to sensory stimuli. Figure out what sights, sounds, smells, movements, and tactile sensations trigger your kid’s “bad” or disruptive behaviors and what elicits a positive response. What does your autistic child find stressful? Calming? Uncomfortable? Enjoyable? If you understand what affects your child, you’ll be better at troubleshooting problems, preventing situations that cause difficulties, and creating successful experiences.

Helping children with autism tip 3: Create a personalized autism treatment plan

With so many different autism treatments available, and it can be tough to figure out which approach is right for your child. Making things more complicated, you may hear different or even conflicting recommendations from parents and doctors. When putting together an autism treatment plan for your child, keep in mind that there is no single treatment that will work for everyone. Each person on the autism spectrum is unique, with different strengths and weaknesses.

Your child’s treatment should be tailored according to his or her individual needs. You know your child best, so it’s up to you to make sure those needs are being met. You can do that by asking yourself the following questions:

A good autism treatment plan will:

• Build on your child's interests.
• Offer a predictable schedule.
• Teach tasks as a series of simple steps.
• Actively engage your child's attention in highly structured activities.
• Provide regular reinforcement of behavior.
  Involve the parents.

Source: National Institute of Mental Health

• What are my child’s strengths?
• What are my child’s weaknesses?
• What behaviors are causing the most problems?
• What important skills is my child lacking?
• How does my child learn best (through seeing, listening, or doing)?
• What does my child enjoy and how can those activities be used in treatment?

Finally, keep in mind that no matter what autism treatment plan is chosen, your involvement is vital to success. You can help your child get the most out of treatment by working hand-in-hand with the autism treatment team and following through with the therapy at home.

Choosing autism treatments

When it comes to autism treatment, there are a dizzying variety of therapies and approaches. Some autism therapies focus on reducing problematic behaviors and building communication and social skills, while others deal with sensory integration problems, motor skills, emotional issues, and food sensitivities.

With so many choices, it is extremely important to do your research, talk to autism treatment experts, and ask questions. But keep in mind that you don't have to choose just one type of therapy. The goal of autism treatment should be to treat all of your child's symptoms and needs. This often requires a combined treatment approach that takes advantage of many different types of therapy.

Common autism treatments include behavior therapy, speech-language therapy, play-based therapy, physical therapy, occupational therapy, and nutritional therapy.

Helping children with autism tip 4: Find help and support

Caring for a child with an autism spectrum disorder can demand a lot of energy and time. There may be days when you feel overwhelmed, stressed, or discouraged. Parenting isn’t ever easy, and raising a child with special needs is even more challenging. In order to be the best parent you can be, it’s essential that you take care of yourself.

Don’t try to do everything on your own. You don’t have to! There are many places that families of autistic kids can turn to for advice, a helping hand, advocacy, and support:

• Autism support groups – Joining an autism support group is a great way to meet other families dealing with the same challenges you are. Parents can share information, get advice, and lean on each other for emotional support. Just being around others in the same boat and sharing their experience can go a long way toward reducing the isolation many parents feel after receiving a child’s autism diagnosis.

• Respite care – Every parent needs a break now and again. And for parents coping with the added stress of autism, this is especially true. In respite care, another caregiver takes over temporarily, giving you a break for a few hours, days, or even weeks. To find respite care options in your area, see Resources section below.
• Individual, marital, or family counseling – If stress, anxiety, or depression is getting to you, you may want to see a therapist of your own. Therapy is a safe place where you can talk honestly about everything you’re feeling—the good, the bad, and the ugly. Marriage or family therapy can also help you work out problems that the challenges of life with an autistic child are causing in your spousal relationship or with other family members.

For more information. please visit:

http://www.helpguide.org/articles/autism/helping-children-with-autism.htm

Parents and Adult Children React to My Descriptions of Borderline Family Dynamics

Parents and Adult Children React to My Descriptions of Borderline Family Dynamics

In my post about the family dynamics of Borderline Personality Disorder (BPD), I describe the role of the spoiler. A child or adult child of a family that exhibits the family patterns described in my posts on this subject begins to behave in ways which turns things around. The child invalidates the parents' efforts to "help" or "take care of them" in nasty ways. He or she essentially responds to invalidation by making comments that invalidate the parent right back. 

The reason the children do this is because they believe the parents need a child to be a target for their anger, and volunteer for the gig. They give the parents just cause by behaving in unreasonable and infuriating ways.

When it comes to the people who make comments on my posts on this and similar subjects, it always fascinates me how parents usually think I am putting all the blame on them for the family problems, while the adult children with the disorder react to the exact same post by thinking I am putting all the blame on them! 

Family systems therapists used the term punctuation to describe these types of reactions. People take something that is an ongoing problem created by continual reactions to feedback from two people with each other, and look at just one isolated segment of it - thereby breaking up a process artificially into misleading cause and effect relationships. They then react accordingly.

Of course, there are readers who do see the whole of the patterns in their lives but still do not know how to put a stop to them. In many cases the problems continue in spite of honest declarations of personal responsibility and even apologies -because there continue to be underlying issues that remain unaddressed.

I have reproduced two comments and my replies which illustrate these phenomena quite well. The first comment doubles as a description of spoiling behavior which illustrates it far better than I ever have.

The Blame Game

Submitted by A Mother of a Possibly BPD Child on November 6, 2016 - 11:39am

Regarding blaming the parents for "invalidating" feelings: I think it's a dangerous idea that all feelings are valid. Does anyone truly believe this?

When you are dealing with someone whose thinking is so distorted that they misperceive all your motives and react to your natural withdrawal as abandonment after they have been screaming abuse at you for an hour, you will just distort your own thoughts if you try to get into their head. If I say to my daughter "When you told me X it hurt my feelings," she often perceives that as an attack and starts to mock me: "Oh did that hurt your feelings? POOR YOU!" This can often escalate, and soon she is telling me what a horrible parent I am. That she is in so much pain that she'd lash out at me like this (again) does *not* mean I was abusive to her. She did not learn how to talk that way from us. We would never say something like that, even though she tells other people that's how we talk to her, and she probably believes we do. We did not cause that pain. Her mind did.

And this is the crux of the matter: just because someone perceives something as hurtful does not necessarily mean it's time to blame someone for hurting them. If someone trips and falls on you, and you scream, and they get mad at you for hurting their ears and making them feel ashamed with your tears of pain, should you feel sorry for them, since they honestly feel hurt by what you did? Should you feel mortified at yourself for inflicting such a nasty guilt trip on them with your tears? Some feelings *are* invalid! We invalidate our own feelings all the time. We *have to* if we don't want to be complete narcissists. A non-BPD person might feel a flash of anger at the ear-pain, but they would quell it, and then feel sorry they fell on you, sorry they hurt you accidentally. And if the screamer is non-BPD, they will probably be furious for a second at being fallen on, but then accept the apology and understand that it was an accident, perhaps even apologize for the loud sound they made - and everything will be fine afterward.

But if it isn't like this, the non-BPD screamer might reflect that they shouldn't have screamed and they certainly shouldn't have cried, since that just escalated things with the BPD person. But they were just behaving the way they would to anyone who fell on them. The reason they might think they shouldn't have screamed though, was because it made things into a conflict they didn't want, and they knew they could have avoided it.

This is CRAZY-MAKING.

And here's something else that's important: if (in the scenario with the falling person being BPD) the screamer pretends nothing bad happened afterward and tries to be loving again as if the falling person had been apologetic and understanding, are they *enabling* this bad behavior? Spoiling a tantrum-thrower? And if the falling person is the screamer's child, is the screamer not providing a terrible role model for the child? Should the *child* learn to tolerate this kind of behavior in other people? Should they not stand up for themselves and have high standards for their own behavior and that of other people?

Parents want to teach natural consequences, encourage empathy, and model the way one should behave in certain situations. BPD totally warps this. You start to think it's impossible to teach anything useful. You start to think that *ANY* response you have is doing irreparable harm to the BPD person. Walking on eggs to reduce conflict, or refusing to tolerate bad behavior - it's all bad. So what would be *good* for a BPD person? How would we recognize it?

As parents, we are not mind-readers. However we respond to behavior, it should teach something (how to respond, how not to respond, natural consequences, etc.) If the behavior is terrible and entirely lacking in empathy and remorse (just self-loathing, which doesn't do a darned thing to enact change), and if normal parenting only makes it worse, that cannot be - and is not - our fault for not knowing what would set the kid off this time. Of course we guess, of course we suspect - but we don't *know*. If we knew, we would necessarily be mentally ill too!

If we as parents caused this escalation by "invalidating" some feelings that originated in a distorted version of reality, or if we offended the child by refusing to be her punching-bag, that means LIFE itself would have provoked the same outburst. We just happen to be here trying to get her to have some self-knowledge and resilience. We are trying to help her learn how to deal with the real world. The real world will never be as careful as we are trying to be. The real world will never ask itself "Should I try not to take this personally, since she's clearly in so much pain she doesn't know what she's saying, or should I just react the way I normally react, since those are the natural consequences??"

The real world will react to BEHAVIOR. Often wrongly, often nonsensically, often (sad to say) maliciously. We are supposed to prepare kids for this! And as parents, we are supposed to train our kids to control their behavior and take responsibility for their actions. But what if, despite our best efforts, they don't learn this?

Many of the families that seem to shun someone who stops behaving so abusively were probably put through hell and just can't take any more. It's like they were holding up the car out of sheer adrenaline, and now the car is gone, they are burned out and need a break. Castigating them for shunning the person is asking way too much of them. Those were the natural consequences. Natural consequences usually teach non-BPD people how to control themselves and take responsibility for their actions. But what works with BPD people?

Parents of BPD kids need support and skills, not blame. They need tools to cope with a situation that is literally crazy - and quite possibly crazy-making.

·report

blame game - my response

Submitted by David M. Allen M.D. on November 6, 2016 - 4:21pm

Hi A Mother of a Possibly BPD Child,

"Blaming" and finger pointing are counterproductive, but all adults - both parents and adult children alike - have to take responsibility for their part in the family dynamics if these dysfunctional patterns are ever going to stop.

What you have written is a beautiful description of spoiling behavior by a child (or an adult child) with borderline personality disorder. It is designed on purpose to invalidate YOU. The child thinks for various reasons that you need them to do that, believe it or not.

For an explanation of how this seemingly crazy situation may arise in families even if there is no obvious abuse, see the posts

http://www.psychologytoday.com/blog/matter-personality/201109/the-family-dynamics-patients...

http://www.psychologytoday.com/blog/matter-personality/201205/borderline-personality-disor...,

and

http://www.psychologytoday.com/blog/matter-personality/201205/borderline-personality-disor...

Communication to Estranged Children

Submitted by Ria on November 12, 2016 - 2:10pm

I am so grateful for the comments of adult children on this page. It gave me insight in the feelings and minds of adult children who cut off parents. My daughter has cut me off a year ago - it happened a few times before she had children, I always reached out and tried to mend the relationship, but now the grandchildren are used as pawns. Although I am broken with the loss of my daughter as well as grand children, I have decided it is final this time. I was not the perfect mother, not even a good one. At 64, after many years of therapy, after two marriages, I understand that. 

I know my daughter is angry and anxious and use this cut-off defense after irrational anger outbursts - this time in front of the kids, which was the final straw for me. But you cannot cut off love and wipe out precious memories. I wonder all the time if she is happier without me in her life. Perhaps she has a better chance of growth, sorting out her own anger and pain without me. I want her to be happy and content within herself. It saddens me even more when I read of the bitterness and pain adult children express here and I cannot help to think: is there anything more I can do for her? Can I help her? Or is letting go the better option? I know no one can really answer, but let's talk about this. I know there are really evil people, but many parents were simply damaged as children. When they have children, usually when they are very young, they have no skills or boundaries or knowledge of parenting to care emotionally for their young, especially 38 years ago when information and education was not a given. The result is emotional abuse, neglect, and / or physical abuse. The horrible old cycle - how do we break it?

Communication - my response

Submitted by David M. Allen M.D. on November 12, 2016 - 2:42pm

Hi Ria,

Of course I can't say anything about your situation in particular, but in general, of course it is best for parents to acknowledge their problematic behavior in the past, explain what they had experienced with their own parents, and apologize.

However, if the parent then goes on to continue to feel too guilty and beat themselves up for their past flaws, that may backfire. The adult child may then start to think that the parent is better off without them - just as you say you wonder about your kids being better off without you - because the child sees that his or her presence makes the parent feel really bad. In response, they may continue to avoid the parent so as not to add to the parent's burden. 

Additional point not in my original reply: Alternatively, they may act nasty to feed the parent's guilt because they think the parent wants to be punished for various sins - or they may go back and forth between the two depending on whether the parent seems to need to be punished or then starts to feel too guilty.