Coping With Your Autistic Child
Definition
The medical definition of autism is: a condition which affects the processing, integration and organisation of information that significantly impacts communication, social interaction, functional skills and educational performance.
Age Of Onset
Due to the out-dated method of diagnosis which is based on a behavioural model taken from research performed by Leo Kanner in the 1940's, it is believed that children do not become autistic until the age of 2-4. The reason for this is because the signs and symptoms currently used to diagnose autism do not show themselves until that age – an age when these “behavioural” skills will emerge in your child. Autistic children though, are born with the condition and do not suddenly develop it because they have begun to talk or interact socially. Research conducted by Osnat and Philip Teitelbaum attest to this and they have proven that signs of autism can be detected in your child's infancy if you know what to look for.
Signs & Symptoms
It is important to understand that the diagnosis of autism can be a long and drawn out process which can be frustrating for a concerned and anxious parent. As there is no simple blood test through which autism can be detected, a doctor must observe the child over a period of time and usually in different situations. Another reason for the time-consuming diagnosis is that although there is a set of signs and symptoms to guide them, they appear differently in each child, making each case of autism as unique as a fingerprint.
· Expressive and receptive communication and social deficits
· Insistence on routine and resistance to change
· Appearing to be “off in their own world”
· Resistance to physical closeness such as hugging
· An attachment to odd toys such as kitchen utensils
· Lack of imagination during play and the tendency to play beside other children but not with them.
· Sudden and often unexplainable anger and tantrums
· Evidence of obsessive-compulsive disorder and repetitive behaviour
· Excelling at a particular skill above their IQ level
· Appearing to have sensory overload in normal environments.
Understanding & Coping With Communication Difficulties
Non-Verbal Communication
Verbal communication is noticeably reduced in children with autism, sometimes to the point of having no speech at all. It can be difficult enough conversing with a child who does understand what you are saying, and can speak themselves, but it is even more difficult to communicate when they can't speak or don't understand.
Coping
You may be surprised to learn that you already have the skills required to communicate with your autistic child. The way an adult communicates with a baby whether it be through unintelligible words or murmurings or even through humming, you are using tone and rhythm to relay messages to your infant. Sometimes you will use visual aids to show your baby what you are talking about. This is how your baby begins to learn how to communicate.
You then both learn reciprocal communication because you recognise from your baby's cries that they are hungry, uncomfortable, hurt etc. Through the different cries your baby has communicated to you their needs, and you have learned which cry means what.
Although as your child grows the messages they need to convey increase to include such things as, emotion and desires, and it is very difficult to do without language. But you have the foundations to still succeed at understanding your autistic child's needs and helping them to convey them in a way you will recognise by using and building upon the basics you used for them as baby's.
The most important thing to remember is that you must believe your child can learn these skills. You cannot afford to assume that just because your child is autistic it is inevitable that they can't and won't ever understand. They may not understand you completely, but something may get through to them giving you something to build on. When you speak to your autistic child, speak to them normally, as you would a non-autistic child. Speak to them at their level and try to encourage eye contact. Do not talk down to them or over their head, but position yourself so that your child can see your facial expressions and your body language. Use your tone of voice and visual aids to assist your child in understanding what you are trying to tell them.
At first your child may appear blank, seeming oblivious to your efforts, but sooner or later your child will realise that language is a useful tool and will attempt to understand it. Trust in yourself and your child and you will soon discover that more and more complex receptive language skills will develop.
Conceptual Thought or the lack thereof
A child with autism is incapable of thinking conceptually, which limits the child in many ways. What is meant by conceptual thinking is best explained by an example: Your child may associate leaving the house with putting on a pair of shoes. Now, if your child happens to be outside without their shoes on and they are walking through prickles or over very hot ground, they will not put their shoes on, even if they are holding onto them. The reason for this is their inability to “think outside the box”. They associate putting their shoes on with leaving the house, the concept of the shoes being used as a form of protection for the feet does not exist. Tiredness, hunger or quiet are also difficult concepts to grasp for your autistic child.
Coping
Time and experience is the only solution for your child learning “conceptual thought”. There is no sure way of teaching concept, but perseverance, speaking normally to your child and using visual aids when you can, can go a long way in speeding up the process.
Try to remain calm at all times as this lesson can be a very time-consuming and frustrating one to teach.
Echolalia
This is the immediate and involuntary repetition of words or phrases spoken by others. They are said without meaning and it is not understood by the autistic child exactly what it is they are saying, but it is often an attempt to understand. Sometimes, when you ask them a question they may either repeat the whole thing back to you in answer, or may only repeat the last word you said. For example, if you were to say to your child, “Is this your toy or is it Tommy's?” your child may say, “Tommy's”. This does not mean they are telling you the right answer, but if you are unsure reverse your words. If he repeats a different word you can be sure it's echolalia.
Coping
When your child uses echolalia after your have asked a question, try to guide them to the correct answer, but don't worry too much if your child engages in this practice while playing alone. Also try to use visual stimulus or universal signs when talking to your child, much the same as you would a non-autistic child. For example, if you are trying to convey “big” spread your hands apart to show them “big”. To convey cold, shiver as if cold, etc. This gives your child clues to help link the word to an object or action and will eventually lead to more effective communication which makes sense.
Receptive Speech
While “speech” is a way of communicating ideas from one person's mind to another, receptive speech is the ability to decipher that spoken language into a mental picture which can be understood and used. Children with autism can hear the words spoken, but may be unable to form a mental picture that provides meaning for them. Some autistic children may have learned the appropriate use of words such as Mum, Dad, hungry etc, and are learning that these words have a use, and how that use applies to them. When a child will not turn their head when you call their name or cannot name certain objects after seeing them - usually because they don't think it applies to them - then they have a receptive speech problem.
Coping
While it may appear that the autistic child resists speech it is not the case, they just can't use it. A speech therapist as well as other therapists can help your child understand that language is useful. At home you can use flash cards or over-sized picture books to show your child exactly what things are. Use only nouns until their receptive skills have developed adequately otherwise they will become confused as to what you are teaching them. For example, show a picture of a dog, regardless of size, and tell them it's a dog, not that it's a big dog or a fluffy dog, just a dog. Also speak in the third person and use people's names when you are referring to them, and point to them if they are close by so that your child can associate the name with the person.
Understanding & Controlling Anger
The anger of your autistic child, although common, may be one of the most challenging elements of autism that you will encounter. Your child's anger is usually a direct result of the frustration they feel toward their inability to understand and clearly communicate with you. It can also be the same as any other child: a way to gain attention, to get their own way or what they want. It can also be due to a health issue such as a migraine, which hits them so suddenly and with such pain that it forces their behaviour to take a downward spiral. Being aware of the capability of extreme and sudden anger in your child and what you can do to control it may go a long way in helping you to cope with the outbursts.
Aggression can be a warning sign that an angry outburst is imminent. Anyone or anything in the path of an aggressive child is at risk of being targeted by that child's aggression, even a pet. Any display of aggression by your child is bound to be destructive and violent because of the level of frustration they feel, and this is their only way of venting.
Temper Tantrums
Whenever you hear that phrase, an instant picture pops into your mind of a child flinging themselves to the floor where they proceed to roll around, thrashing and screaming. To some parents it can be quite comical, especially when they know it's cause is just a simple case of being denied something, and usually only after the parent has become immune to the manipulative tactics used during these tantrums. A parent soon realises that their usage of such a simple word as “NO” has the power to unleash a monster in an otherwise pleasant child. The first one can be the most shocking, you were completely unaware that your child was capable of such theatrics and will do anything to make it stop, but after a while you learn that giving in isn't an option.
Not all children resort to such physical tactics as mentioned above. Some children will just hold their breath, hoping it will scare you into surrendering before they turn blue in the face. Others will pull on your heart strings by repeatedly screaming that they hate you. Then there's the quieter ones who will attempt to bribe or blackmail you into capitulation. Regardless of the nature of the manipulation tactic, it is a tantrum.
Here is a list of the features of a tantrum which will help you distinguish it from the meltdown mentioned later.
· The child will occasionally take a peek to see if their behaviour is being observed and gaining a reaction.
· Regardless of the ferocity of the tantrum the child will ensure they are not in danger of hurting themselves.
· A social situation will be used to this child's advantage.
· The tantrum will end as quickly as it began the moment a satisfactory solution has been established.
· The tantrum child is always in control and can stop whenever they want, although they don't want you to know that.
· A tantrum has one purpose and that is to gain what they want. The tantrum will end the minute their demands are met.
Coping
The best advice to give in situations like this is to gain a quick immunity to these sorts of theatrics, and remember that you are in control, not your child. Pandering to every whim or buying everything your child's heart desires only makes a “spoilt” child, their level of happiness is not affected to the point that they will be miserable for long. They will sulk for a bit, but they will get over it. Unfortunately there is no quick fix. Try not to let your child see they have gotten to you, dig your heels in and ride it out. Sooner or later they will realise it has no affect and will give up.
Meltdowns
By the time you have experienced your first meltdown, you will wish for the simplicity of the tantrum. A meltdown is an awesome display of your child's anger and manipulation at it's best. It packs as much power as a cyclone and is just as unpredictable. The biggest difference between a tantrum and a meltdown is the literal loss of control your child experiences. This loss of control overtakes the child and there is nothing they can do to get it back. They rely on you to recognise the signs and help them to regain their control. It is a very daunting and exhausting experience for even the most seasoned parent, and most times you will be at a loss as to what to do.
Here are the features of a meltdown.
· The child does not peek, nor care if they are being observed or getting a reaction.
· Safety is not considered by the child in the midst of a meltdown.
· They don't care where they are or in what social situation.
· Meltdowns move under their own power and wind down slowly.
· You child is not in control.
· Nothing will satisfy the child until the situation is over.
Coping
The best line of attack is to defuse the situation, but you need to choose your battles carefully using both yours and your child's personality as a guide. You will need to decide whether you want to “weather the storm” or, if in a public situation, leave the environment. The most important thing is to ensure that your child is in no danger of hurting themselves, as they do not care.
If your child is intelligent and understands exactly what they are doing, the situation can be stopped if you catch it in time. Be aware though that even the autistic child who understands will still reach the point of no return, so you need to catch it before then.
1. Recognise the signs that a meltdown is imminent.
2. A meltdown is always preceded by a trigger – determine what it is.
3. If the trigger is as insignificant as your child wanting a small toy, decide if it's worth it.
4. If the trigger is not so easily resolved, try to divert their attention with something else. If in a shop, move to a different part of the store.
5. Keep a special toy in your bag for whenever a meltdown is approaching. The more complex the toy, the more chance you will have of distracting the child.
6. While distracting your child, talk softly to them about their behaviour. They need to know that it is not acceptable and has to stop.
7. Use any calming techniques which you have found work for your child.
8. Remain calm at all times.
You will not always be able to defuse an impending meltdown if your child is determined to have one. Consider your options at the time it occurs and decide what course of action you feel is appropriate for the current situation.
It is a bit trickier to deal with a child who doesn't understand the correct behaviour. You will still have the same warning as you do under the above circumstance, but there will be little you can do to stop it's progression. Keep yourself calm and make sure that reflects in your voice. If you appear panicked or angry yourself it will communicate to your child and make matters worse. You will not be able to reason with your child so there is no point trying. Distraction and positive reinforcement are your best tools, and it may help you prevent future episodes. You need to be prepared for the distraction – keep items in a bag that is always with you that you can use when you feel a meltdown approaching. You will also need to be creative, find toys that you know your child enjoys and finds pleasure in.
You can also seek therapy for your child to help modify their behaviour, but you also need to instill discipline. All children need discipline regardless of whether they are autistic or not, the only difference is negative discipline doesn't work well with an autistic child. Positive reinforcement is your best line of defence.
Obsessive-Compulsive Behaviour
Many children with autism show obsessive-compulsive tendencies which are not to be mistaken for Obsessive-Compulsive Disorder (OCD). Below is a list of behaviours your child may exhibit:
· Places objects in lines
· Opening or closing doors
· Spinning or walking in circles
· Flapping of the hand or arm
· Rocking the body back and forth
· Repeatedly counting objects for no real reason
· Hiding or hoarding things
· Preoccupied with placing things in certain places
· Gestures and facial movements resembling Tourette's Syndrome
· Food selection may be based on shape or colour.
Lines
A child who constantly creates lines with objects is usually trying to put order to what they feel is an out-of-control and disorderly world. The will usually adapt this behaviour when the visual senses are in overload and they are trying to gain some sort of feeling of control.
The preoccupation and absorption of line creation can be a negative aspect. If this appears to become a problem try to divert the child's attention to a different activity that won't threaten their ability to create the lines. Most often this behaviour will dissipate as the child matures.
Routine
For an autistic child routine is extremely important. They rely on it to know what is going on around them, what is expected of them, and what they can expect from others. They become very resistant to change and although some changes are unexpected and can't be helped it is important to remember how upsetting it is for your autistic child. If possible distract them with with their favourite toy or a movie until the child has calmed. Unfortunately it is one of those things everyone has to adapt to, including the child, you will just have to ride it out.
Flapping
This is usually one of the first signs of autism and is linked to strong physical or emotional actions. It is a rapid and repetitive hand and/or lower arm movement that resembles waving. It will often be used by your child to express excitement. Flapping can become out of control and can often signal that a strong emotion such as anger may be building. You need to learn to watch for the signs. Most of the time though it is not harmful, just an expression of emotion.
It is not known why the autistic child engages in these behaviours, and most parents tend to just ignore it. Interrupting the behaviours will cause your child to become agitated and will only stress both yourself and your child. There are medications which can stop these behaviours but not all children respond to them. They are usually best left alone.
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