Is therapy necessary for aspergers teens?

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triplemoon18
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08 Jan 2014, 9:07 am

My daughter is 13 and was recently diagnosed as mild asd (formerly called aspergers). She was doing almost as well as her twin sister until she changed schools last year and had a hard time transitioning. She has accepted her diagnosis and I made her feel that it was a great thing and how she just sees the world differently than neurotypicals and how it would help us understand her quirks, etc.

She does not feel that she needs any help at all. We tried reading a book together on social cues, but it was way too wordy and intimidating. I got an easier book on social cues geared to 7 to 10 year olds and we read through less than 15 minutes before she was freaking out and frustrated about it, so I have not tried again. We are on a waiting list for therapy through the children's hospital here and we should have only a few months to wait for treatment, now that she has formally been diagnosed. I can also apply for the local ABA program, but it says it is a 2 to 6 month program for 2 to 4 hours per week. I am a single mother who buses, so I would have to miss at least half a day per week and although my boss was understanding about me missing work almost every week during her diagnosis, I don't think she realized it would be a permanent situation. I also am reluctant to sign my daughter up because I do not know how I will drag her for hours of treatment every week. The school wants her to start seeing the school social worker and she doesn't even want to do that, even though it gets her out of class and she hates school.

I would like to sign her up for this program that has aspies and NTs going on social outings together, but she will likely want me to bus there with her and time on the weekends is at a premium between chores, groceries and family time.

Is it necessary for aspies to receive treatment? I know adolescence makes autism symptoms more profound, but will she calm down on her own by adulthood? Will she not learn through living life? I know she is very high functioning and we figure having a NT twin has helped her tremendously in learning things over the years. Also, many aspies do not find out about it until they are in adulthood. Do they rush out to therapy once they find out? Is dragging a resistant teen to therapy going to actually help her in the long run?



ASDMommyASDKid
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08 Jan 2014, 11:46 am

Hi, and welcome.

I do not have a teen, but based anecdotally on what parents on here post, it is not at all common for kids who are first diagnosed as teens to resist treatment, b/c they don't want to feel even more different and also b/c it can seem like an endless time suck, taking away from special interests and/or much needed downtime.

Parents with older kids than mine will have more specific things to post but I did want to post to get some more information from you, to help others help answer you, if that is OK?

First off, I am assuming that by transitioning issues you mean transitioning from class to class. What other issues does she have? Does she do her school work, alright? Can she handle the paperwork aspect: turning in papers without losing them or forgetting? What other services, if any, does the school provide other than offering up the school counselor? Does she get speech for pragmatic issues, for example? How is she doing socially? By that I don't necessarily mean in comparison to peers, necessarily, but is she happy with whatever her social life looks like?

My other questions have to do with the specific therapies recommended. Who recommended them, and what are they supposed to address? The social outings could be promising, if she is interested. Maybe try one, and see how it goes? I am assuming you do not have to participate in all of them, and that you can do one a month or something, if she likes it, so you do not feel overwhelmed every single weekend??

As far as ABA goes, I am not sure what the benefit would be to her at 13 for mild AU. I know people use it for younger children for speech/communication issues and sometimes behavior. We never used it, as I am not a particular fan of rote learning, which I think is what it mostly is. People who have used it, can better answer if there are applications that are closer to what your daughter would need.

When money and time are a premium it makes total sense to weigh carefully what you do and do not do. I also agree that little will be helpful without her buy-in.



triplemoon18
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08 Jan 2014, 12:17 pm

For transitioning, I mean that she was in the same school for 6 years and was doing fine after a brief adjustment each fall because of having a new teacher, getting back into the school routine and knowing what the expectations were in that classroom. From grade 2 to 6, she was not in the same class as her twin. In grade 7, they both transferred to a new school and had some classes together last year and are stuck in the same class all day this year. (only one grade 8 classroom) My daughter does very well for her school work and only has some problems with math, but her behavioural issues have been horrid for the past year and a half. The school was calling me at least weekly to come pick her up or to suspend her. They put her in an alternative program called Reality Check last year for two months. This is when they started to suspect aspergers, when no other teacher ever had before. She got in trouble twice in a few months for making threats on the internet and the first time, they tried to scare her straight by having the school police officers speak with her, but she did not understand what was wrong because shd didn't act out on the threats and she never took them seriously. Now we have to do a diversion program through the police to avoid her being charged criminally.

The therapies recommended were by the school psychologist who assessed her. They only recommended the first hospital program and I was trying to figure out what else would benefit her. I feel like at 13, I have so much to teach her and help her before she can find a job, attend college and eventually move out on her own.

Socially, she thinks she is doing awesome and because she has a twin, they share their friends. Right now, they seem to both hang out with the "misfits" because my aspie daughter ends up alienating a lot of their friends I was interested in the social outings with other aspies because I feel it would benefit her to meet other people like her. Right now, she only knows one aspie boy at school and she does not feel like she is anything like him.

Thanks for telling me about ABA - I really don't know anything about it and if it is memorizing things, I think my daughter would hate it. What exactily do they teach you? Would I be better off just reading books with her?

I want to help her, but I am really not sure how. I keep getting conflicting advice from family and coworkers. No one understands what it is like to parent my daughter. My own mother thinks she is now manipulating me to be her slave because I am trying to be more understanding to her needs as an aspie.



RemiBeaker
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08 Jan 2014, 12:26 pm

I think that depends on her problems.

Why do you think she needs therapy?
Is she a happy kid?
Does she likes the life she has?
How does she deal with emotions?
Is she assertive?
Does she have good problem solving skills?
Can she ask for help?
Is there anything she wants to change about herself or her life?

I was depressed and anxious as kid.
I still was depressed and anxious as an adult and by then i was self harming and suicidal to.
Therapy helped my a lot because there were some things i wouldn't just have learned through living life.

Therapy helped me with:
- Learning to listen to what my body and my emotions tell me
- Learning to recognize and accept my boundaries
- Being assertive
- Accepting myself
- Learning that my emotions are useful and that that serve as a compass which guides me better than my mind can
- Asking for help when i need it

I would be cautious with asking social behavior she isn't comfortable with of her.
If she crosses too many of her borders in order to obey to social rules that might be harmful to her.
Social stories that help her understand other people instead of telling her to behave might be an idea though.

Not all therapy or all therapist will be helpful.
Some therapists are better than others and not all therapists could help me.
Having communication issues can make talking therapy hard and it probably helps if the therapist has experience with autism spectrum disorders.

The combination of haptotherapy, mindfulness, a great social and a great haptonomist worker who both understood what i was saying far better than any other therapist i had, along with some changes in my life worked great for me.



Last edited by RemiBeaker on 08 Jan 2014, 12:36 pm, edited 2 times in total.

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08 Jan 2014, 12:29 pm

There are going to be others with much more knowledge of ABA than I have. It is not rote memorization but more like training a puppy. (There are programs that are not quite this bad, these days, and include other things I think, but this is my general feel for it.) With little kids it may be something like giving a child an object 10 times in a row, expecting a "thank you" and then giving them a token or a sticker if they can do it 10 times in a row. The heavy duty programs are like 40 hours a week, but again these days there are different options. So it is more rote in the sense of repetition of desired behaviors.

Editing as I think of things***

If she is making threats on the Internet and not understanding their impact I would think that she also needs speech and pragmatics training at school. It is nice that they are referring you to places for help, but they need to provide those things that are required of them, as well.



Last edited by ASDMommyASDKid on 08 Jan 2014, 2:01 pm, edited 1 time in total.

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08 Jan 2014, 1:29 pm

I was in therapy when I was a teen and it wasn't autism therapy, it was seeing a psychologist to help me in things like delayed reaction. There were other things I learned about myself like not reading social cues, not understanding my own feelings or how I feel, violent thoughts are not normal. Apparently it was my fault how I was treated in school because I didn't understand the rules of conversations or socializing so kids treated me the way they did. Back then I just saw it as him saying it was all my fault and I was defensive about it then.

Is ABA necessary for mild aspies? I have never been in any. I always thought it was more for people who are more severe or moderate. Also sometimes a doctor says someone is mild because of certain things but it doesn't mean they are mild.

Moving schools can be tough and it took me about a year to adjust and I had an aid with me in every class until my Junior year. Perhaps your daughter could use one too and if she starts acting out, the aid can take her out and take her to a quiet room like special ed or some other room.

I would be cautious about what therapy you give her because she might feel like she is broken and it might make it harder for her to learn or make her more frustrated.

I take it she wasn't in therapy before? so now you are trying to get her in some, I was in occupational therapy and speech therapy and I did group therapy and it was about passive assertive and aggressive. Before, I was in gymnastics, pottery, and voice lessons which also worked as therapy. My mom never wanted me in real therapy until I was older because by then I would understand it better and be more aware of my issues. I still felt broken and felt like I was getting fixed but the therapies were still fun. I never felt broken in speech until my school got a new speech therapist when I was 12 and the way she did it made me feel that way so I hated speech therapy all of a sudden and my mom had me stop taking it at school since it was no longer helping.


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triplemoon18
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08 Jan 2014, 2:52 pm

Remibeaker: I feel that she needs therapy because it seems it is needed with an asperger's diagnosis, particularly since her psychological report said her coping skills were those of a two year old (which means she gets very upset and angers easily) and she deals with people at the level of a 4 year old. I just don't know how to help calm her down if she is like a toddler or preschooler when she has her meltdowns. Time outs don't work and she is bigger than me now, so it is impossible to get her to leave the room. The only discipline I have ever been able to use is losing her video games or losing dessert, but once she loses those, there is not much else to get her motivated to do anything. Right now, I feel like I have accomplished a ton if I can get her to get up and get ready for school, brush her teeth, have a bath and tidy her room a bit. It seems a struggle to get her to do ANYTHING. The teachers have the same problems when she hates doing work and she ends up leaving the room to go for walks to calm down. So emotionally, she has a lot of outbursts and she recognised it as being a problem for everyone before and even wrote down how she felt she should just be locked away in a mental hospital or a jail, so everyone doesn't have to deal with her.

Now that she has her diagnosis, she feels a lot better about herself and she figures we all have to just deal with her as she is and that she doesn't need to change. If you try to tell her she is behaving badly, she tells you that it's not true or her sister lied about what happened. Or she genuinely has blacked out about whatever she said and did while upset. I do know that she feels better already because she is no longer hitting herself or throwing herself repeatedly into the floor and slamming chairs and whatever across the room.

ASD mommy - The ABA program here is supposed to deal with even mild autism, but I am beginning to think this would not work for us because I cannot see my daughter spending 2 to 4 hours learning skills. It would be torture for both of us I think.

League Girl - thanks for letting me know how you felt about therapy and feeling "broken" and what worked for you.

I guess what I really need is whatever will help her with emotion regulation, but not charts or rewards or breathing or so many things I have read in books that did not work with her. The school psychologist and the hospital psychologist both recommended this book - the Explosive Child, but as soon as I see the cover, I feel anxious. I recall that this was not a good book for us. I wonder if I went back to toddler/preschool parenting books, would I find them more helpful for her seeing as she regresses so young when she is upset?

I almost feel like counselling for me would be better and her sister, so we could deal with her better. It seems if we can just keep her calm and happy, the whole evening or weekend is just great. But if we set her off, it can be just horrible until it passes. It is like a thunderstorm and half an hour later, it is all sunshine again.



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08 Jan 2014, 3:32 pm

ASDMommyASDKid wrote:
There are going to be others with much more knowledge of ABA than I have. It is not rote memorization but more like training a puppy. (There are programs that are not quite this bad, these days, and include other things I think, but this is my general feel for it.) With little kids it may be something like giving a child an object 10 times in a row, expecting a "thank you" and then giving them a token or a sticker if they can do it 10 times in a row. The heavy duty programs are like 40 hours a week, but again these days there are different options. So it is more rote in the sense of repetition of desired behaviors.
.


ABA therapy can be quite different from this. It can also be the therapist working with parents to figure out what the triggers are that are causing the meltdowns, and working on building skills for handling frustration (for instance by playing board games with the kid and helping them to identify when they are getting upset.)



triplemoon18
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08 Jan 2014, 4:43 pm

Thanks Zette - I was wondering what happens during ABA - hopefully someone will let me know exactly what you do for 2 to 4 hours every week. I do not think it would need to be this time consuming to come up with solutions and would not a psychologist or social worker be able to do this too during counselling sessions?



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08 Jan 2014, 8:58 pm

ABA's "ABC" =

[b]A[/b]ntecedent
[b]B[/b]ehavior
[b]C[/b]onsequence



zette
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09 Jan 2014, 1:05 am

I would definitely ask for lots of details before signing up for any therapy, and also to observe a session if possible. The logistics also have to fit into your need to work -- what do your kids currently do after school? Some therapists can come to your home or to an afterschool program. Not sure exactly what is available for teenagers.

You might also take a look at this book: Quirky, Yes; Hopeless, No. It describes social skills therapy for Aspergers that is definitely used with teenagers. The author is the director of an ABA therapy practice in my city.



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09 Jan 2014, 7:53 am

Only have a few moments to type. Have not read other responses. But I do want to suggest that you do research before putting her into an ABA program. If she is mild, and it is very traditionally-based ABA, she may not like it at all. Even as a preschooler, my daughter moved past being able to tolerate discrete trial learning. She found it ridiculously tedious and frustrating and it increased her negative behaviors. She did continue with "ABA" therapy, but her therapists adapted it to her particular needs. I know all ABA therapists say they adapt to the needs of the child, but when I say "adapt" I mean that what we ended up with was probably not technically ABA at all. Behavioral therapy? Yes. Done by behavior analysts? Yes. What you would expect of ABA? No. It is possible, though, that the program you are referring to calls itself "ABA" but that it is really more eclectic than that. The director of the program my daughter attended implied once that "ABA" was a buzz word that some practitioners used because ABA is viewed as effective and research-based, but that in reality, most practitioners no longer practice ABA in it's purest sense. That most use an eclectic approach that use elements of ABA, but blend in other things that work for the particular person being helped.

I am sure you got helpful feedback elsewhere. Good luck!


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09 Jan 2014, 8:16 am

i was completely oblivious to the protocols that dictate effective communication before i was 12.
i was diagnosed as autistic when i was 6 months old (due to my inability to be affected by other peoples desire to communicate).

before i was 12, i saw other people (outside of my parents) as objects.
i did not think they were truly living like i was, and so i saw them as lumps of meat that were animated and that got in my way.

i always felt i was the boss of every situation i was in before i was 12, and i told people what i wanted them to do without consideration to what they otherwise wanted to do.

i manipulated people like toys and i had little respect for the people who i manipulated.

but then i was sent to an adolescent unit and i spent 3 years there the first time i was admitted. it was a very educational experience for me. i saw other kids who were completely off the planet in psychosis, and i realized for the first time that they had a soul of their own just like mine.

i had daily psychiatric consultations, and i slowly grew out of my utter mental isolation and i felt others for the first time.

here is an interview with my doctor, and then an interview with me when i was 17 or so that was broadcast on the radio.

it may convey how important group cognitive therapy is without me hav ing to type any more.

i never attained the status of normalcy, but at least i did not remain oblivious to the fact that other people have their own local consciousness.

http://www.soundclick.com/player/single ... 75593&q=hi



triplemoon18
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09 Jan 2014, 9:49 am

In this together and Zette -I am so glad for your advice about therapy. All the books I have read so far make it seem I have to rush out and put her in every kind of therapy to help her before we run out of time. I felt like a bad mom because I really don't want to spend so much time in therapy. Her psychological report said that socially, she needed a lot of help because her interpersonal skills are that of a 4 year old, but I was realizing that her and sister had friends over for the past 3 days and I figure socializing in real life must teach her skills too. We also watch a lot of movies and documentary type shows and I realize that she must learn from these too. It just feels like the learning must be structured or she won't learn anything.

B9 - thanks so much for letting me know about your experiences and what helped you. My daughter is pretty self-centred and this helped me realize that we must seem to be in her way times too. I didn't know that there was group cognitive therapy - this could be helpful for her.

Her school is trying to get her into the ASD program next year when she transitions to high school. There are only 20 spots in two schools for all the high school kids, so I don't know if she will qualify - but I sure hope she does get in. She would do 3 mainstream courses and then one in the ASD class that could teach her important skills. She is very high functional, so I don't know if she will get a spot, but her behaviour at school is so disruptive, maybe she will.



triplemoon18
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09 Jan 2014, 10:18 am

Zette - I put a copy on hold for Quirky yes, hopeless no at the library - do you think this would be a good book to read with my daughter? Does it have any pictures? Is it wordy? My daughter has told me she just wishes there was book with a list of dos and don'ts.



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09 Jan 2014, 1:12 pm

First off - Stop feeling guilty- you are doing the best you can with the information and resources you have right now and that is all you can do.

I have a 14 year old daughter who was diagnosed with Aspergers when she was in 2nd grade. She also has a non-verbal learning disabilility. That means she didn't understand body language, facial expressions, tone of voice or any of the other things NT kids pick up naturally. She has since learned these things, but it was many years before she mastered them, and she still struggles with body language.

I would suggest talking to your daughter and the school and determine what characteristics/symptoms she has the most trouble with - then check into treatments specifically for those 2 or three things. Don't try to do everything at once, it will be far to overwhelming. You mentioned she doesn't have very good coping skills and angers easily. Perhaps you can find some therapy to address those issues specifically and work on that until you feel she can continue to improve without therapy.

We have found peer therapy groups to be extremely helpful for our daughter because sometimes it takes a peer to explain a concept in a way she can understand. These are groups of other kids on the spectrum who meet several times a week (at least that is what she is doing right now) at school with a special education teacher to lead the discussion.

I applaud you for wanting to help her as much as you can and for taking the time to do the research, but this is going to be a marathon, not a sprint. Your daughter can benefit from a wide variety of things like changes in diet, chiropractic care, social skills therapies, peer group therapy, music therapy ,horse therapy and the list just goes on and on. The point is that there is no silver bullet that is going to help her - you are going to have to try different things until you find the right combination that works for her.

If you try something and it doesn't seem to be working, don't be afraid to stop and try something else. Your daughter is old enough to have some input, and you could even enlist her help in doing the legwork on looking for options. Good Luck and please be sure to come back here to ask questions or get support as often as you need to.

Raising a child on the spectrum is hard and we parents need all the support we can get.

God Bless


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