Support in helping your Child with ASD manage their emotions and tips for managing challenging behaviours

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Professor Tony Attwood recently visited Belfast and was our key speaker at the Autism Diagnostician’s Forum 10th Anniversary Conference. Professor Attwood is a leading figure in ASD worldwide and is widely published in this area including his cognitive behaviour therapy guides for anxiety and anger management in young people with ASD. More relevant probably to most parents is the fact that he also has a son with ASD. I have summarised below some of the learning points I made from listening to him and hope some of them will be helpful to you.

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People on the Autism Spectrum may have difficulties expressing and managing emotions due to their difficulties reading other people’s facial expressions, eye contact and subtle non-verbal cues. Most parents can empathise with the phrase “I feel I am always shouting at the top of my voice before he notices I am angry !”. A reduced vocabulary to describe a range of emotions /emotional experience can also cause issues. Professor Attwood described the need for more Music and Art Therapists in our teams as studies have shown the positive benefit engagement in these activities has on young people’s mood and overall engagement socially. To help our Young People with Autism describe or explain their emotions to others as well as recognising how they feel themselves they can be advised to pick a song, picture, scene from a movie or a poem that describes their sadness, anxiety, anger or happiness. Some young people like to create a poster board with all of their happy memories/favourite things that they can revert to when they are feeling stressed or anxious.

 

We have known for a long time that around 85% of those with ASD have anxiety issues. Professor Attwood discussed the benefit in some Young People of using  Sports watches to anticipate the early increase in heart rate when a young person is becoming stressed or anxious before a meltdown happens. This can also be useful to demonstrate to others that whilst the young person appears calm inner signals say otherwise. It also helps the Young Person recognise they are feeling stressed and enables them to avail of time out or calming strategies. There are of course a small number of young people who may become more anxious on seeing their heart rate
increasing so this will not work for everybody.

 

Often an underlying anxiety can present as anger or sadness so it is important to look for sensory issues or environmental factors that may be precipitating outbursts.

Examples of activities to explain emotions
For happiness you could do the Happiness Thermometer , gauging how much the young person likes their special interest, school or what could mum or dad say to  make them happy. Feelings rated from 1-10. Scrap books for sadness and happiness can also be included and it may be easier to carry out these activities than have a formal conversation about emotions. A scrap book may be created for each particular emotion or a diary made for new experiences both positive and negative. Carol Gray Social Stories can be used to explain the inner world of other people to a young person with ASD. Presented in visual format is often easier for the young person to process and can be pitched at the person’s specific level. Sometimes if an incident has occurred you can use stick figures with speech bubbles to demonstrate what went wrong and how each person felt in the scenario. Siobhan Timmins has adapted this strategy to help calm her son and allow him to identify when he was stressed with a range of social stories (All birds have anxiety by Siobhan Timmins-
successful social stories for your children).Useful websites to assist with “mind reading” are www.jkp.com (older children) and www.transporters.tv (younger children)

Keeping a mood diary yourself on your child or allowing them to do it can also help identify particular stressors.

Possible triggers for anxiety in an individual with ASD

• Transitions (especially if rushed)

• Failure of self or others to follow rules

• Over-sensitivity to sensory stimuli

• Separation from a parent

• Unexpected environmental change

• Crowded social places

• Unwanted social attention

• Being teased

• Overload (overstimulation from prolonged social events)

• Uncertainty (unknown upcoming events or change)

 

Routines, rituals and special interests may act as a way for the young person with ASD to manage their anxiety and block unwanted thoughts therefore they should not be prevented completely from engaging in these activities.

 

The exploring feelings (anxiety or anger) CBT intervention by Tony Attwood is very helpful for children/teenagers and their parents (available from Jessica Kingsley publishers). It provides an emotional toolbox to “fix the feeling”. Physical tools such as sports/exercise, relaxation tools(may be special interest), social tools (being with a pet, family, chosen friend, seeking advice and validate feelings), awareness tools, sensory tools and mindfulness tools are part of this toolbox which can be tailor made for each child. There are also unhelpful tools which can be discussed also such as  violence, aggression, and self injury.

To improve self esteem the concept of a “this is who I am book” outlining the young person’s personality, positive features, interests and abilities with support from family or friend sometimes being needed to point out these positives. This book can be used as a reminder when the person is feeling low/stressed. For younger children qualities in themselves similar to their favourite superheroes can also work well.

 

Young people with ASD can experience sudden dips in their mood to the point of despair over a range of issues. Managing these episodes appropriately can help reduce their duration

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Safety plan for a “depression attack”

• Strategies for the support person (can be agreed and written down)

• Stay calm and reassuring

• Do not at the time ask what is causing the distress

• Stay with the young person

• Try not to fix the problem

• Do not move too close unless asked to or previously agreed

• Validate the feelings and listen

• Remind the young person that the intense despair will go

• Engage in minimal conversation

• Find a quiet sanctuary

• Avoid intense eye contact

• Allow time to process the intense emotions

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Self Affirmation Pledge Liane Holliday Willey

• I am not defective

• I am different

• I will not sacrifice my self worth for peer acceptance

• I am capable of getting along with society

• I will ask for help when I need it

• I will be patient with those who need time to understand me

• I will accept myself for who I am

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For further information look at…
www.mindsandhearts.net – Tony’s website for further information