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Q and A about Autism
How can I modify her outbursts along with
convincing her to improve her hygiene? I am always calm and patient with her,
but she gets really mad at me, if I make helpful suggestions.
Response: Children who are diagnosed with Pervasive Developmental Disorder (PDD) each have their own individual profile within the autistic spectrum. While your child thankfully seems to have normal intelligence, she has issues in other areas. Sometimes the fact that a child such as yours is so verbal and also gets along with peers confuses the situation for parents, teachers, and therapists. Sometimes we expect more than such a child can deliver. Let's take a brief look at three issues you mention: First, you mention that your daughter is hypersensitive to touch. Many children with a diagnosis of Autistic Spectrum Disorder (ASD) have problems processing information received through their senses. These children have difficulty interpreting sights, sounds, and sensations from touch and movement. They may become unusually upset, for example, by bright lights or loud noises, or by being touched or moved unexpectedly or in a certain way. They might also have problems using their muscles effectively which might cause difficulty in learning to run, jump, or hop if groups of large muscles are involved (gross motor). If groups of small muscles are involved (fine motor), they might have difficulty with such activities as buttoning, zipping, cutting, or writing. If a child has difficulties rooted in the sensory system, then Sensory Integration Therapy may be able to correct the problem. In The Out-of-Sync Child, Carol Stock Kranowitz helps parents to understand and address these issues. A child with tactile defensiveness may react negatively to light touch and therefore exhibit anxiety, hostility, or aggression. She may seem to reject affection, but upon closer examination may enjoy firm hugs. She may avoid certain textures and cling to others. Picky eating and resisting brushing teeth also are part of this profile. You will find do it yourself strategies, such as brushing and deep pressure in Kranowitz's book. Given the intensity of your situation, I would recommend a thorough sensory evaluation by a qualified occupational therapist who will recommend a specific sensory diet to help integrate and normalize your daughter's sensations. This can make a huge difference in her behavior. Her brothers and sisters can also be involved and this can be a source of mutual joy as opposed to conflict. Second, your daughter's outbursts may respond to the approach described in The Explosive Child by Ross W. Greene, Ph.D. Greene suggests that the best way to help your child explode less often is to approach the difficulties before rather than after the explosion. Once the explosive goes off, it has a life of its own as many of us know all too well. Greene teaches us to recognize a stage he calls “vapor lock” and thus prevent or avert the explosion. So the Greene book is another source of many “do-it-yourself” ideas. One of the basic concepts is that better understanding as opposed to better discipline can help to reduce the number and intensity of explosions. You may want to consider the guidance of a mental health professional if the problem persists. Third, you mention that your child's medications don't seem to be working. Perhaps, combined with the strategies mentioned above, you will notice a difference. Medication is often a tool to help other approaches work. On the other hand, all medications have side effects, and without a positive main effect the risk to a growing child may not be justified. So if there is no progress, I would recommend you consider a re-evaluation of your child's medication. The problems you describe are complex and individual. I hope this response gives you some direction and some hope. RN |
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She
maintains herself at school and gets along well with her classmates. She does
have an hour per day of special education due to learning disabilities. She
is on a low dose of Ritalin and Risperdal to control her outbursts and
repetitive behaviors, but it doesn't seem to help that much. The problem is
that when she's at home all she ever does is sit on the couch, rock while
banging her head, suck her thumb, and hold a dirty old blanket. If she gets
mad at her siblings, she flies into a rage. She will throw things, knock over
chairs, and swear at them. She becomes totally out of control. She also is
very tactilely sensitive to touch, most foods, fabrics, bathing, and brushing
her teeth.