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Autism Spectrum Disorder (ASD) Parenting

When my son was diagnosed with ADHD, I thought, as a psychologist, I was prepared for the continuing challenges of parenting. But I was wrong. All my knowledge went out the window as I attempted to plead, cajole, beg, bribe, yell my way through parenting my son.  Those early childhood years of his life were increasingly tough. There were many moments I wished that there could have been a support group, a therapist, someone, who knew what I was going through. So that all of these increasingly difficult behaviors weren’t on mine and my husband’s shoulders alone. We were very lucky. We had friends and family, and a WONDERFUL therapist who helped us through it all. And even with all the support, we felt isolated from our parent-peers.  There are many parents out there who don’t have the support base we had. And it’s not just parents of children with ADHD that experience this burn out. One population of parents in particular has an exceptionally high rate of anxiety and depression. Parents and primary caregivers of children with Autism Spectrum Disorder (ASD) have significantly high rates of depression and anxiety (50% and 40% respectively).  Despite this, very few seek treatment for themselves. We know that if treatment is received, we can decrease these rates of anxiety and depression, thereby increasing satisfaction and effective parenting techniques, and decreasing alienation and loneliness. A recent study by Lushin and O’Brien (2016) has found that using the Early Intervention Program to provide treatment to parents, either in a home-based or clinic-based setting (where their child receives services) helps reduce the symptoms and severity of the depression and anxiety related to parenting s child with ASD. Receiving treatment for their depression and anxiety helps them parent effectively, which in turn helps their children. The Early Intervention Program seems like a perfect vehicle to provide these services. And we know that the early the effective services are provided to the child (and that includes appropriate parenting), the better the child is in the long term. And the better we all are. Lushin, V., & O’Brien, K.H. (2016) Parental Mental Health: Addressing the unmet needs of caregivers for children with autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 1013-1015. http://dx.doi.org/10.1016/j.jaac.2016.09.507

OCD and Sensory Overresponsivity in Children

Many of us can walk into a familiar room and get a sense if something is out of place or moved around, or “not quite right.”   We can handle that.  We shrug our shoulders and think, “it’s not a big deal,” and we continue on with our day.  But what if you can’t? When obsessions (ideas or thoughts that continually preoccupy or intrude in one’s thoughts) and compulsions (irresistible urges to behave in a certain way, even if you don’t want to) interfere with daily functioning, it’s called Obsessive Compulsive Disorder (OCD).  Sometimes, the compulsions associated with OCD are driven by the thoughts, or obsessions. But sometimes, especially with some children, the compulsions are driven by that sensory experience of things “not being quite right.” Sensory overresponsivity is often seen in children who have an Autism Spectrum Disorder, and issues with anxiety.  Research is now showing that some children with OCD also exhibit sensory overresponsivity, and that it leads to a significant impairment in functioning. In the latest study by Lewin, Wu, Murphy, and Storch (2015) as much as one third of children diagnosed with OCD have sensory overresponsiveness, which is higher than the general pediatric population. This overresponsivity is more common among preschoolers as well and children who are also depressed, have disruptive behaviors, and ADHD. They found that the sensory overresponsivity was related to compulsion (doing) severity, not obsession (thinking) severity.  Children who had higher the sensory overresponsivity, suffered from a higher global OCD and impairment. As might be expected, the highest levels of sensory overresponsivity were found in children who had contamination obsessions, eating compulsions, and symmetry compulsions. Sometimes that feeling of “just not quite right” can stop us from getting on with our day. We can’t be the best “we” until everything is “perfect.”  But it never is.  Knowing where these feeling are coming from, with regard to OCD, can help us understand and treat it better.

Early Signs of Autism

Children are increasingly being diagnosed with Autism Spectrum Disorder (ASD) at higher  rates than previous years.  It can look different at different stages of life.  But what does it  look like preschoolers? Here are some behaviors to look out for.  Remember, if you are concerned, please  seek out an early childhood specialist, such as a psychologist, to get a clear diagnosis. Signs in Language Development
  • Young children are learning to talk. So they remember words, and then forget words. They make up words. This is typical. Some children who are suspected of having ASD have words, and then lose them.  But, they don’t regain those words. They may use language in their own way, such as calling a “cookie” a “coocoo.”  These children are resistant to changing their language.
  • Young children tend to repeat words just for the sake of repeating them. This, too, can be a normal part of language development. Children repeat words, as a way to grasp what the sounds are or how their mouth moves.  But children showing signs of having ASD have no obvious intention for repeating words.  For instance, they might hear someone say a phrase like “Do you want a cookie?” and repeat it over and over again.  They aren’t looking for a cookie; they are just repeating the phrases.
Social Cues Children with ASD often have poor eye contact.  Also, they often don’t respond when their name is called.  Their lack of response is not with a smirk or meant to give silent treatment.  There is simply just no response.  Many of these children also seem very independent. They don’t need your help because they do everything themselves. And when they can’t, they don’t ask for help; they may take your hand and use your finger to point or reach for what they want. At Play Play in early childhood develops at different rates. Some children like to play by themselves. As they get older they may choose to play near other kids, doing different or similar things. Only later do they play together, in a group, towards a common real or imagined goal.
  • Children with ASD tend to play by themselves, their own games, even when most of their other same-aged peers have moved on to a more parallel or cooperative play.
  • They may be interested in parts of a toy, playing with it in ways that are unintended, such as spinning the wheels of a truck over and over again. They may lay on their head, looking at the truck out of the side of their eye.
  • Their toys may have to be laid out in a certain manner, according to their own organizational rules. They may play with their hands or body in ways that other children don’t, such as flapping, rocking, moving their fingers near their eyes.
As with all other diagnoses, if you have concerns, seek out a trained medical professional.  A psychologist, who specializes in early childhood, can help determine what the concerns are, and how best to treat your child. Autism Spectrum Disorder is not the end of childhood, but these children have a much better prognosis if they receive treatment earlier rather than later.
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