Friday, July 31, 2015

When Your Child Keeps Making a big deal out of Injuries

Some people with Asperger's syndrome are actually quite good at shutting out pain while others seem to feel every single cut, bruise or scrape in the most traumatic way.  It's also not unusual for a person with Asperger's syndrome to sit at both ends of the spectrum at more or less the same time.  Different types of pain register quite differently.

Being Under-Sensitive
One of the biggest problems, particularly with babies with Asperger's syndrome, is that when there is a very real problem, they don't always make enough noise to have it taken seriously by their parents. It's not uncommon for a child with Asperger's to be, for example, "a quiet child who rarely cries" but turn out to have ear problems due to repeated ear infections.

If you're lucky enough to have a quiet baby remember that if it does cry for a long period at some point, that small cry might be the equivalent of an all-day cry from a "frequent crier" baby.  All kids do not express their pain equally.

Overly-Sensitive Children
Some children seem to be overly sensitive and even the smallest of bumps will bring out the tears. At a young age, this is easy to dismiss but as the child grows older, it becomes a problem. Children who "cry at the drop of a hat" can often lose friends over the problem.

There are different ways around the problem;

Big Boys Don't Cry
Making a rule that "big boys" or indeed "big girls", don't cry is an old, time-tested method. It's the method my parents used on me and I can confirm that it certainly does work as a method of getting the crying to stop. Unfortunately this is quite a harsh discipline by today's standards and it doesn't stop sadness but simply drives those feelings beneath the surface. Teaching children to suppress their feelings can lead to other problems as they get older.

It will stop.... eventually.
This is essentially the modern parent's knee-jerk reaction to the "Big Boys don't Cry" rule. Let them cry all they want and hope that eventually your child will grow out of it.

This is actually a good policy for younger children and it's true that kids generally do eventually grow out of constant crying but it's quite possible that they'll set themselves up for bullying if they cry a lot in front of their peers at school. It's okay to let things go for a while but eventually they may need to be told to stop.

Stopping the Crying
If your child is approaching their teen years and is still a constant crier, then you really can't leave it any longer -- you need to get involved. 

First of all, you need to evaluate your child for issues. For example, consider and if necessary, consult with a doctor;

  • Does your child exhibit unusual sensitivity to light, to touch or to sounds or smells?  If so, it's possible  that your child has Sensory Processing Disorder (SPD). Usually this is picked up at an early age but sometimes it can remain hidden for years. SPD could mean that your child is experiencing constant discomfort as they navigate their world. Sometimes, just a few simple changes, such as noise reducing headphones or  glasses with Irlen Coloured Lenses can reduce that discomfort to a more manageable level.
  • Has your child experienced psychological trauma? Normally people mentally associate psychological trauma with child abuse but that's not necessarily the case. Children are very sensitive to the world around them and they take a lot of "background" information on board. For example, if you've been busy helping a close friend or relative with a debilitating and/or traumatic illness, such as cancer, you may be surprised by how much of that trauma your child is taking on board. Clear signs could include an unreasonable fear of doctors, hospitals or medications ... or simply clingyness.

If your child's reactions don't seem to stem from medical or psychological issues, then it's time to push forward with behavioural modifications intended to reduce the crying.  As discussed earlier, negative reinforcement does actually work but it can hide other problems.  Positive reinforcement is the recommended treatment;

Praise for Control
If you happen to see a moment when your child is clearly emotional but manages to control their sadness, be sure to praise it (just not "in the moment").  Wait until your child has put significant distance between the event and when you're by yourselves.  After all, even discussing a distressing event can bring memories of it flooding back and undo all their hard work. That's okay though, you're not trying to suppress tears when you're alone (everyone cries when they're alone), you're trying to prevent them in a public place where they could lead to exclusion and ridicule.

Tell your child; "I saw that you managed to not cry when xyz happened.  I'm so proud of you for holding yourself together. That's very grown up behaviour".  Then, let the matter drop. Don't harp on about it because if your child has managed to let it go, you should too.

Offer Support
If your child looks like they're struggling in a social situation, help them find the words to excuse themselves. Teach them that they can ask to go to the bathroom or call for "time-out" or ask for a bit of "space". Sometimes you'll have to say the words for them but eventually they'll be able to follow their own initiative.

Keep Moving Forwards
Your child is bound to slip up at some point. Remind them that everyone has bad days every now and then. That's okay. Don't dwell on failings, just help them pull themselves together and move past it. Better luck next time.

As your child becomes more centred and less emotional, they'll usually find that their new-found stability makes them easier to be friends with. A little stability can lead to a significant increase in overall happiness.

Thursday, July 23, 2015

Where to Now? Medication and Paediatricians and Teenagers with Asperger's Syndrome

We've been taking our kids to see the same developmental paediatrician for a decade now and sadly he's moving to a less accessible place. Happily, he's such as great doctor that we'll still go the extra mile (miles) for him but our last visit did prompt the discussion;

Where to now?

I thought I'd share some key points of discussion with you because I know that so many parents are in the same position (not so much of losing a doctor but of having kids that are growing up).  It's probable that many of my readers have not yet have asked these questions.

Ritalin into the Future
Our eldest has spent a decade on Ritalin/Concerta and we can attest to the fact that it doesn't present any serious side-effects (at least, not in him).  We've always kept him and his brother off Ritalin on weekends except where there are events requiring significant focus.

We stop the Ritalin during the holidays too, with the aim being to allow the boys to fully "be themselves" and hopefully learn to self-manage their unfortunate outbursts and impulses.  Sometimes this works and sometimes it doesn't.

Arguably, the main reason that we continue to see the developmental paediatrician every six months is that in Australia, Ritalin cannot be prescribed by a GP. It needs a doctor with the right training and focus. As it turns out, this is a happy event for us because it means that we at least have one doctor who is fully across the development of our children -- something that has become difficult in these days of "medical centres" and the lack of "family practice" doctors.

Rather than simply discuss "where are we going to get the Ritalin from now", I wanted to go back to our original thoughts. We'd always assumed that the kids wouldn't need to be on Ritalin for the rest of their lives and to be honest, I'd expected that they'd be off it long before now.

We were told that most kids find that they need to stay on Ritalin until they finish school but that nearly all come off it in the years immediately following school, either in work or university/college. Our doctor said that in his opinion there were two main reasons for this;

  1. The post-school age kids are just that little bit older and more mature -- and this makes it easier for them to keep their focus on tasks and control their impulsive behaviour.
  2. Kids in the workforce or in tertiary studies are there not so much because they have to be but because they want to be there.  Usually these studies are in areas which are more aligned to their interests and as such, it's not so difficult to remain on task. 

I think these are both good points, I'd always assumed the first but it's only now that I've listened to the doctor that I feel that the second point is more important.

I've always felt that the best thing you can do for a person with Asperger's syndrome is to ensure that they follow their special interests.

Developmental Paediatricians into the Future
The other important point that our developmental paediatrician raised was that once kids reach eighteen (our eldest is turning sixteen in a few months), they are really classified as adults and he can't continue to see them but must hand them off to a psychologist.

I'd never really thought about this before because personally I've dealt with most of the symptoms of my own Aspergers via the internet and forums.  I don't need a psychologist because for me, blogging, writing and discussing things with my peers (who are also on the autism spectrum) is therapy.

Obviously this  kind of therapy won't work for everyone, particularly not for younger or less confident people who aren't necessarily ready to confide in others -- and who may not even "know" what is really going through their own minds -- yet.

I thought about the transfer process from one doctor to  another and I've realised that a complete handover could be quite traumatic for the kids.  I'm sure that these transitions are done with care, perhaps over six or so months but I can't help feeling that we're actually lucky that our paediatrician is moving away.

We're going to start the transition phase early and instead of seeing our paediatrician once every six months, we'll see him annually (and see a psychologist with a background in autism in the alternate six month period).  This will allow us to stretch out the transition period just a little longer and it will hopefully keep the two doctors in communication.

Given the trauma of recent years (we've had a couple of very difficult and unexpected deaths in the family these last years), it might be for the best anyway, to start the boys seeing a professional who is able to deal with the trauma that life and autism throws up.

Wednesday, July 8, 2015

Book Review: My Autistic Awakening: Unlocking the potential for a life well lived by Rachael Lee Harris

There are a lot of "Autism Biographies" around these days and they mostly follow the same patterns; Childhood difficulties, school bullying, addiction to "alone-time", workplace bullying and finally the discovery of autism and acceptance of one's place in the world.

This story is quite different. 

This is a story about someone who didn't struggle quite so hard  Autism plays a part in this story but it doesn't have the starring role. This time, the star is Rachael, not her diagnosis.  It's definitely about a life well-lived.

Of course, there are plenty of moments throughout this book where it's clear that some of the qualities of Autism are affecting events for better or worse but for the most part, Rachael presents as a capable and occasionally "otherworldly" member of society.

If you've ever read a book or seen a film with a lead character who is defined by their autism and thought; "that's a bit excessive. I'm not like that. Maybe I don't have Autism after all..." Then this is the book for you.

It demonstrates how perfectly the traits of autism can hide in individuals, particularly in females on the spectrum.

The book is a breeze to read too because unlike some biographies, it reads more like a novel than a resume. Rachael tells the story with enough description for you to imagine yourself in the places she describes.

I found this book particularly interesting because we were born in the same month of the same year- and only a state away. Having spent many of my childhood summers in Queensland, I found many of the Australian cultural references very familiar.

As the story unfolds we follow Rachael overseas and into a nunnery - and it's a fascinating insight into how well the routine of these places fits with Asperger's syndrome.

In the later chapters, autism begins to play a much bigger role but I don't want to spoil anything- you can read it for yourself.

This book is a great read , particularly for mothers and daughters on the autism spectrum and for those interested in the way autism presents in females.

It's well worth reading and highly recommended.

My Autistic Awakening: Unlocking the Potential for a Life Well Lived by Rachael Lee Harris is published by Rowman & Littlefield and is available on Amazon in Kindle and Hardcover versions. It's also available as an eBook on Google Play.

Rachael Lee Harris is now a psychotherapist who is highly recommended by top Asperger's Syndrome Psychologist Dr . Tony Attwood, You can visit her web page here and her facebook page here

Honesty clause; I was provided with a copy of this book free of charge for review purposes.