Archive for April, 2009
School for the Asperger’s Child
By: Kara T. Tamanini M.S., LMHC
The school environment often presents a unique challenge for the child with Asperger’s syndrome. School is truly a balance between learning in class, class assignments, homework, and children socializing with each other. How teachers communicate information to them is of extreme importance, as is the school environment itself. The best way for a child with Asperger’s to learn is by breaking down assignments visually and structuring the classroom environment both aesthetically and by the way that assignments are presented to him/her. Understanding that communicating needs easily (especially when your child does not understand what is being taught) is often difficult for the child with Asperger’s.
Making sure that your child’s teacher understands the unique way that your child learns, whether it is through visual or verbal instruction in the classroom is of extreme importance to your child’s success in school. If your child’s teacher understands what your child’s individual strengths are in as far as learning and retaining information, then his/her teacher can build on that in the classroom. Often seen in children with Asperger’s syndrome is that they do better with instruction that is very concrete and literal rather than with concepts that are abstract in nature. Often when information is presented with visual aides and when the information is broken down in smaller pieces, the tasks seem less daunting.
Homework and class assignments can often be a source of extreme anxiety and frustration to a child with Asperger’s syndrome. In an effort to please and have everything “perfect”, they become anxiety-ridden in their attempt to complete assignments and homework without error. They will often also become anxious when a number of assignments are given to them and they are unsure of what and where to start first. Utilize your child’s teacher by having him/her break down the tasks on a chart and map out the times that assignments are due in class and also at home when homework is given. For example,
9:00-9:30- work on math problems in class
9:30-10:00-read over vocabulary words and memorize for test tomorrow
3:30-4:00-write down spelling words in agenda and study for spelling test
When class assignments and homework are marked down and they are able to see the work visually in their own “special folder”, the tasks become structured and the work and amount become less daunting.
The school itself for the Asperger’s child is often a big source of their anxiety. All schools for children with Asperger’s are filled with SENSORY experiences that will often put the child into “overload” by the end of the school day. This is often a common complaint reported by parents with children with Asperger’s syndrome. Often seen in Asperger’s children as well as children with Autism, is that they have significant sensitivities to noises, being touched by other students or by teachers, certain smells at school, and visuals. By the end of the school day, the actual combination of trying to conform to all of the social rules (remember they are very often “people pleasers”), complete class work, and the sensory overload often puts the child into meltdown mode.
There are a number of strategies or interventions that can be used that are highly effective if conveyed properly to your child’s school and teacher/s.
- 1.) Visual aides of the social rules or mores in the classroom are often helpful ie… respect each other, wait your turn, do not tease or make fun of others
- 2.) Students in class are given a written schedule of the day’s assignments and any changes to the schedule are conveyed to them in advance
- 3.) Keep the classroom door shut to cut down on the amount of noise in the classroom (remember children with Asperger’s are often very sensitive to loud noises
- 4.) Organize the classroom to be less cluttered so there are less distractions
- 5.) Have the intercom, phones, class bell in class turned down to a lower volume
Above all, keeping a structured environment whenever possible will provide your child with Asperger’s with the least amount of stress to bring about school success.
After I sat down at my desk, the teacher asked us to get our math books, which unfortunately I had left at home with the rest of my stuff. So I just sat there for a few minutes until I got bored and I started talking to two girls in front of me while they were doing their math work. Would you believe that my teacher yelled at me again for talking and she told me I was disrupting the class!! I just can’t say anything without getting into trouble!!
I got into trouble again after lunch, because I raised my hand to go to the bathroom. I really just wanted to get up and walk around. I was sick of sitting in that desk. Would you know it, my teacher yelled at me again when I started talking to the kid next to me when she was up in front of the class by the chalkboard talking to everyone about our homework assignments for tomorrow.
When school was over for the day, I pushed the girl in front of me and my teacher started yelling at me again. I think that the teacher just loves to yell at only me!! She told me I can’t seem to keep my hands to myself. I know when I get hom from school Mom will ask me what happened at school and I will tell her “nothing”. No one seems to understand me. I don’t get why everyone is always screaming at me.
Understanding what your child goes through on a daily basis goes a long way with being patient with them. They are also struggling each day to pay attention and remember that they are not doing this on purpose!! Try to put yourself in their shoes and see what they go through in a day. This story was adapted from a child I see in therapy as he related his day at school to me in session!!
Hi!! My name is Tommy and I am 10 years old! My mom and dad told me a few weeks ago that I have ADHD. Whatever that means!! All I know is that I am in trouble all the time and everybody I know is always yelling at me. It is not my fault that I am in trouble all the time. I don’t understand why they are always so mad at me anyway. My teacher really seems to be mad at me almost every single day. I don’t think I am all that bad. Let me tell you about what happened yesterday and you will see what I mean.
My day started with my mom screaming at me to get out of bed. So what if I didn’t get up until 7:30 and the bus leaves at 7:40. She came into my room like four times to get me out of bed and then finally starts screaming at me. I had to eat breakfast on the bus, because I didn’t have time for my mom to make me breakfast, which really seemed to upset her. I realized half way to the school that I had forgotten my backpack!! That means I also wasn’t going to be able to turn in my homework again. I just don’t get why mom got so mad about that. Really, I should be the one who is mad because I am failing in a few of my classes. Gee!!
When I got to class, my teacher asked for us to turn in our homework and my teacher got really sore with me when I told her that I left my backpack at home. Her face even turned red when I told her, “it is no big deal, I will just give it to you tomorrow.” What difference does it make when I turn in my homework. She asked me to sit down and I walked by Lucas, my friend, in class and thumped him on the head like I always do and she got even madder at me and yelled, “keep your hands to yourself already.”
MORE ON TOMMY TOMORROW!!
A common problem also seen in children with Asperger’s as well as seen with children with Autism are sensitivity to sensory experiences. A child with Asperger’s is often very sensitive to loud noises such as an airplane or an ambulance going by and they will often cover their ears. Some very common sensitivities seen in children are in smell, taste, sound, visual, and in touch.
A child with Asperger’s will often cry when they hear very loud sounds, certain smells will make them sick to their stomach, and they often become overwhelmed when they are trying to process too much visual information such as seen when they go on a shopping trip. Children with Asperger’s often are very sensitive to a lot of light and they often do not want to be touched and a hug or being patted on the head or on the back is often aversive to them.
A child with Asperger’s may also have difficulty making friends as they often miss social cues that are often inherent in children who do not have ADHD. They do not seem to understand nonverbal communications such as another child’s facial expression or the body language of the children around them. Social skills are often lacking and other children will often perceive them as abrupt and insensitive to others feeling. In addition, they are often very passionate about one or more particular areas, however can not relate when children talk about something that does not interest them. They do not accept change well and often seem inflexible to those around them.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM IV (4th ed., text, revision), Washington, D.C.: American Psychiatric Association.
Asperger’s syndrome, which is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), under the Pervasive Developmental Disorders differs from Autism in the following ways.
1.) There are no significant delays in language
2.) There are no delays in their cognitive development
3.) No clinically significant delays in development in self-help skills
4.) No clinically significant delays in adaptive behaviors
5.) No delays in curiosity about the environment in childhood
The diagnostic criteria for Asperger’s syndrome are that the child must demonstrate impairment in social interaction as shown by at least two of the following:
- Impairment in the use of nonverbal behaviors(such as eye contact, facial expressions, and gestures) during social interaction
- Lack of development of relationships with their peers
- Failure to seek enjoyment, interests, or achievements with other people (ie.. a lack of showing, bringing, or pointing out objects of interest to other people
- Failure to reciprocate emotions or social gestures
The child must also demonstrate restricted repetitive and stereotyped patterns of behavior, interests, or activities, as manifested by at least one of the following:
- Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal in intensity or focus
- Apparently inflexible adherence to specific, nonfunctional routines or rituals
- Stereotyped and repetitive motor mannerisms (ie.. hand flapping or twisting, or complex whole-body movements
- Persistent preoccupation with parts of objects
Be consistent in disciplining your child. If you reward or punish your child use the same reward or punishment every time!! Parents become so frustrated with their child’s behavior that they punish a behavior and because their child becomes angry or throws a temper tantrum they “cave in” and let them have their way. What I often hear is that a parent gets tired of saying the same thing over and over and “gives up” and lets the child have their way. (For example, your child refuses to do their homework and you tell them if they finish their homework they can watch their favorite television program when they are done. Halfway through completing their homework, your child throws a temper tantrum and tells you they are not going to do it. You as the parent let them watch television because you are tired of fighting with them and you try to get them to finish their homework later. However, what you have done here is reward noncompliance with your rules and you have just undermined yourself. You as the parent are going to have to go through this all over again when you try to get them to finish their homework later).
When you are trying to teach a new behavior, it is the most effective if you reward the behavior every single time it occurs. The reward should occur IMMEDIATELY after it happens and if you are implementing a behavior change program it should be utilized for at least two weeks before you call it quits and decide what you are doing is not working. Lastly, repeating yourself and repeating yourself and repeating yourself will not work with the ADHD child for sure. Talking and telling them about their negative behavior certainly is NOT going to change it. We need action here!! Consequences have to be used to change a negative behavior in your child. If you tell them that you are going to do something for a bad behavior make sure you do it and do it every single time. Don’t try to reason with your child, you are the parent and rules need to be followed. At the end of the day, your child is your greatest gift and you as a parent want to produce the best possible child so they have all the tools to become a successful adult.
Above all else, never blame yourself and think that you are a BAD parent. I here this all the time as a therapist!! You are doing your best and there is no such thing as a perfect parent or a perfect person. Never give up!!
Children with ADHD have difficulty staying on task and they usually live for the moment and often do not see future consequences for behavior. On tasks which they perceive as boring (often homework) you have to provide immediate feedback that they are doing a good job. Positive feedback can be given a number of ways, but it is most often given as praise or as a compliment. Often it can be given as a reward such as increased privileges or special treats or snacks. Be sure to be specific when you tell your child the behavior that they did that was positive. When you are trying to CHANGE a negative behavior, make sure you provide a quick reward and feedback for behavior that is done correctly and have quick negative consequences for acting inappropriately.
A mistake that is often made in parenting a child with ADHD that is displaying noncompliant behaviors is that we as parents forget to praise positive behaviors and we focus on the behaviors that are negative that we want to change. ADHD children require feedback and consequences that are VERY frequent. We as parents often get caught up in our own work and household chores that we forget to praise our children when they are behaving themselves at home. What I often tell parents is to put post-it notes in conspicuous places in their house reminding them to praise their child often. There is no better way to change a negative behavior then by providing frequent and consistent praise. Positive behaviors should be rewarded more often than punishing negative behaviors. DO NOT punish your child for everything they are doing wrong, this will not motivate your child to do well. The positive’s have to outweigh the negative’s in order to change behavior.
ADHD children like children who do not have ADHD do not always do what they are told. No child behaves perfectly all the time every single day, however a child with ADHD seems to be at a greater risk of noncompliant behaviors that will anger, infuriate or disappoint their parents. By very definition, children with ADHD have difficulty with self-control and do not organize well, have problems controlling their behaviors and predicting that there are consequences for their behaviors. Russell Barkley, a psychologist and leading expert on ADHD says it well when he advises parents of some simple instructions in dealing and correcting behavioral problems. (1) It is much more effective to give clear instructions (2) rearrange work so that it is more interesting and motivating for them (3) redirect the child’s behavior towards future goals versus immediate gratification and (4) provide immediate rewards for a completed task or adherence to rules.
As a therapist, what I frequently find when a parent brings their child in for counseling, is that the parent is angry; frustrated and seems to have lost perspective of what the problem actually is. Parents when they are angry or frustrated end up yelling at their child and this usually will provide a reverse effect in your child (they become even more noncompliant and end up tuning you out). Try to keep things in perspective and remember that your child has a disability and never argue with your child when they are not listening to you. Here are some simple rules to follow when parenting your ADHD child. By no means is this list conclusive in nature and a health care professional may be of instance in developing a behavioral management plan with you and provide feedback on it’s effectiveness.
Part 1 of the list will follow.
What to say-Don’ts
• Don’t tell them they need to learn more about what ADHD is. That is the job of the parents and teachers that work with your child
• Don’t tell your child that ADHD is who they are. ADHD is only PART of who you are, it does NOT define who they are as a person or who they will become as an adult
• Do NOT say that they have a disorder.
• If your child is being placed on medications, don’t make this a big deal for them. Some kids are embarrassed that they will have to take medications and often even more embarrassed if their friends find out about it.
• ADHD is not a PROBLEM, it is a challenge in life that can be tackled like any other problem
• Don’t get technical with them. If a health care professional has explained to you what ADHD is, reword it into language they can understand, but emphasize that this has positive aspects as well
You are your child’s best ally! Even when you lose patience, remember that your child is struggling right along with you. ADHD affects them more than it affects anyone else. The moment of diagnosis provides you as the parent with the opportunity to help your child develop their talents and individual strengths. Overall, ADHD is a challenge and not a problem.
What to say-Do’s
• Emphasize that now that we know that you have ADHD-we can work together as a team to help make things at home and school better. Be encouraging and positive!
• Tell them that lots and lots of people have ADHD. They are not alone.
• Explain that this can be used to their benefit. ADHD children constantly have new ideas and are full of energy.
• ADHD just does not go away, but parts of ADHD that they don’t really like can be worked on with help from you and others in your child’s life
• Identify that ADHD can be a strength to them, but make sure you don’t convey that ADHD is merely an excuse for bad behaviors.
• Reinforce to them that they have a part in their success at home and at school and also in their life for the long-term
Part 4 – what not to say.