Caring For Someone With ASD

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• QWhat special ed options exist for preschoolers with autism?

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  A Dr. Sara Wiemer , Pediatrics, answered on behalf of NorthShore University HealthSystem

  For children under age 3 years, you should contact your local early intervention services. For children over age 3, contact the child's local public elementary school. There are, of course, private preschool options for children with autism and disabilities, and the preference between public and private school is entirely up to the parents.

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• QWhy does my child with autism repeat dialogue from TV and video games?

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  A Chantal Sicile-Kira , Mental Retardation & Developmental Disabilities, answered on behalf of Top 10 Social HealthMakers

  For a young child, the fact that he is quoting dialogue from films or video games is a good sign in terms of his verbal abilities. He may be repeating them because he likes the sound, or he is understanding those words and phrases form listening to them over and over. Pay attention to whether or not he is repeating bits of dialogue at appropriate times, which would show that he is understanding the meaning or intent. For example, my son used to repeat certain lines form Sesame Street that had to do with eating cookies when that is what he wanted to eat. When he slips on the stairs, he says “Whoops! Sorry!” in the same voice he has heard in a favorite video. This is a good sign. 
  I would suggest you get him interested in communicating with you by getting to know the movies and games he is quoting from, and then dialogue and connect with him by repeating them as well. He will be more interested in you if you take an interest in what he is into. You can repeat the bits of dialogue at appropriate moments. Then, use the characters from the movies and write social stories about what they would do in certain real life situations, getting him to help more and more, gradually getting him into talking about the here and now and not so much the pretend world. Using his interest to connect with him and to teach him how to connect with others is an important first step.

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• QHow can I prepare for a vacation with my child with autism?

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  A Chantal Sicile-Kira , Mental Retardation & Developmental Disabilities, answered

  Leaving the security of home for a new place can be off putting for children with autism. How you prepare the person on the spectrum depends on his or her age and ability level. Here are some tips:

  • Think of the individual’s daily routine and the items he or she likes or needs and bring them along to make him feel more at home. Bring whatever foods and drinks will keep him happy on the trip, especially if there are dietary restrictions.
  • Buy some small, inexpensive toys or books that he or she can play with during the journey and that if you lose it will not be the end of the world. If he only plays with one favorite item, try to find a duplicate and see if you can “break it in” before the trip.
  • Do not wash any items (including plush toys) before the trip as the individual may feel comfort in the “home” smell of his cherished item.
  • Put up a monthly calendar with the departure date clearly marked, and have the person check off every day until departure. Bring the calendar with you and mark off number of days in one place or on the trip, always having the return date indicated
  • Put together a picture and word “travel book” of what means of transport you are going to be using to, who you are going to see, where you will sleep, and what you will do or see at your destination. Go over this with the person, like you would a storybook as often as you like in preparation for the trip. Use a three-ring binder so you can add extra pages or insert the calendar mentioned above for use on the trip.
  • Put together a picture or word schedule of the actual journey to take with you on your trip.  This can be done with an ipad or iphone app, or add a page with a velco strip to your travel book.  For example, a picture to represent the car ride to the airport, going through security, getting on the airplane, etc. For car trips, pictures representing different stops on the trip and number of miles to be driven can be used.
  • Taking a short trip before attempting long voyages, if possible, is recommended. This will help the person get used to traveling and give you the opportunity to see plan ahead for possible areas of difficulty. Also, if you use the travel book system, it will help the person make a connection between the travel book and any impending travel in the future.
• QHow can I teach my autistic daughter how to deal with changes?

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  A Chantal Sicile-Kira , Mental Retardation & Developmental Disabilities, answered

  Adults on the autism spectrum that I interviewed for my book Autism Life Skills related that one of the hardest aspects of growing up was transitions: transitions from one place to another, one task to another, one person to another and other types of changes. They related this as being due to their sensory processing challenges. When asked what was one  strategy  that was the most helpful for handling transitions while growing up, they all answered variations of: telling me what was going to happen next so I could mentally prepare for it.
  Behavior therapy can help  to control a child's behaviors during difficlut transition moments. However, avoiding the behaviors to begin with is even better. One way to teach your child about transitions is to prepare them by having schedules and social stories about what is going to happen next. Having a visual as well as an auditory explanation is helpful as  they have different learning styles (visual, auditory, kinesthetic). Eventually over time, the child will learn to understand what, fr example, "going to the store" entails and he will be more prepared for the transition. Even if your child is non-verbal, and you do not know how much he understands, take the time to do this.  Over time he will understand.

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• QWhy does my autistic child want to spend so much time with animals?

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  A William Stillman , Health Education, answered

  Individuals with autism can be acutely sensitive, vibrating with a frequency that supersedes those who are “neuro-typical,” especially as it relates to all the senses. It is not uncommon for children and adults with autism to have unique, unspoken bonds with all kinds of animals. Remember St. Francis? He could communicate with animals of all species, even fish; and I’ve documented similar instances of conjoining between people with autism and domestic and wild animals. In her book, Animals in Translation, renown autistic author Temple Grandin compares her picture-thinking aptitude (how I also think) with that of animals. It is through the exchange of mental imagery that some children and adults with autism communicate with animals. If you’re familiar with how animal communicators or animal “psychics” work, you’ll know that the premise of image-swapping is similar.
  
  I hope that helps explain things a bit. Pay careful attention to the manner in which other animals are drawn to your child -- house pets, birds, butterflies, and squirrels for example. I’ll bet, if you hadn’t noticed it before, that you’ll see an interaction occurring during those times.
• QHow can having a passionate interest benefit people with autism?

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  A William Stillman , Health Education, answered

  For the person with autism, passions may be a bridge to enhancing relationships, decoding mystifying educational curriculum, or developing a viable vocation. Such individuals oftentimes possess encyclopedic knowledge pertaining to their special interests, or can lend insights unique to the autistic way of thinking when it comes time to problem-solve. For those fortunate to hold dear a passion that is not mislabeled as an “obsession,” social acceptance may by acknowledged by virtue of their place in the community and the manner in which they are revered for what it is they have to offer.
• QWhy doesn't my child with autism tell me when he is hurt?

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  A William Stillman , Health Education, answered

  The issue of pain, and pain that goes undetected, undiagnosed and untreated properly is an important one for us all; but, perhaps, it becomes even more complicated when discussing autism because of all the variables that may come to bear upon any single child’s pain experience.Your child may not have reported his pain because:
  

  • He either isn’t neurologically wired for speech, or -- even if he
         does speak -- he may not have a way to describe or put
         language to what he’s experiencing in the moment.
  • He may have a flat affect -- that is, an expressionless facial
         appearance that doesn’t seem to register much of any
         emotion, making him tough to “read.”
  • His brain may not be properly registering the pain signals his body
         is sending it because of neurological crossed wires, so to
         speak; or there may be a higher pain threshold or a delay in
         processing pain.
  • He may not know there’s a parental expectation that he tells
         someone if he’s in pain (you may have to teach this concept
         to him).
  • He may not know how much pain he should feel before telling
         someone.
  • He may have an extreme fear of doctors, especially if he’s been
         treated roughly or insensitively in ways that were not
         respecting of his personhood. This makes allowing the pain to
         go unreported the lesser of the two evils.
  • Similarly, he may have had an adverse reaction when previously
         given pain medication, so he chooses to say nothing to avoid
         repeat circumstances.
  • He may not realize that what he’s experiencing is anything
         different from anyone else (like the boy with autism who only
         got relief from mild asthma at age eight and exclaimed, “I 
         didn’t know it wasn’t supposed to hurt when I breathe!”).
  • He’s trying to manage the pain independently but it’s looking like
         self-injurious activity (such as head-banging); he’s creating
         another pain as a diversion to the initial pain felt.
• QHow can I cope with my nonverbal autistic child's extreme behavior?

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  A William Stillman , Health Education, answered

  Strive to address the issues as separate from, or adjunct to, your child’s autism instead of believing these behaviors are a function of autism. That is, your child’s behaviors are really communications. He has good reasons for doing what he’s doing, and he’s doing the best that he knows how to in the moment.
  
  Whenever I am faced with supporting someone with autism who is challenging to serve, I use the following paradigm in an attempt to deconstruct and decode the true issues. Are the child’s “behaviors” a function of one or a combination of the following three contentions:
  

  • The inability to communicate in ways that are effective, reliable and universally understandable
  • The inability to communicate physical pain and discomfort in ways that are effective, reliable and universally understandable
  • The inability to communicate mental health symptoms in ways that are effective, reliable and universally understandable

  I suggest pursuing these points simultaneously. First, we already know your child is limited in what he can communicate because he doesn’t talk. Pictures and some signs are good for laying a basic foundation of communication, but these modes are limiting and ultimately not boundless. Has he been assessed for a communication device, speech therapy, music therapy, and/or computer keyboarding?
  
  Second, can you attest that your child is not experiencing any kind of physical ailment that has gone undetected, undiagnosed, and untreated? Common culprits of pain in people with autism are gastrointestinal issues and allergies of all kinds --research these, please, as related to your child. Can you detect any such symptoms that have perhaps become chronic?
  
  Third, many autistic individuals are vulnerable to mental health issues due to their exquisitely sensitive nature. If depression, alcoholism and other addictions, suicide attempts and other related issues prevail in family history on either side, your child may be predisposed to such mental health concerns. In my experience and in my opinion, the most common mental health experiences in people with autism are anxiety, depression, bipolar disorder (depression cycling with mania), and post-traumatic stress disorder. Begin by researching the symptoms for each; gather information about symptoms, not behaviors; and discuss your findings with your child’s pediatrician.