Therapy Options for HF Tweens/Teens

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Let me be clear: I don't think good therapy options for high-functioning/aspie tweens/teens exist, or if they do, they're about as easy to find as unicorns.

But my in-laws (who are super-sweet people and I value their opinions) keep pushing us to get therapy for my son. He's 12, verbal, very smart, has meltdowns and some sensory issues, OCD/contamination phobia, and Tourette's. He's home schooled, but used to receive services through the local elementary--he graduated from OT and PT by being too competent and I stopped sending him to social group because his opposition to the program was more of a problem than his behavior. I had hope SG would help him make friends, but it was really useless.

My father-in-law thinks my son needs speech therapy (me: that's Tourette's. you can't therapy away tourette's), but I think he basically thinks that a bunch of services exist that don't because he's read all about the importance of years of ABA for autistic kids. I've tried to explain that these therapies aren't aimed at kids like mine, but he's convinced that something must be. My in-laws are also worried about kiddo's general mood and the fact that he sleeps past noon (we home school... so why not?). I agree that he has been moodier lately but not to a degree that seems abnormal for a 12 yr old.

That said, I would happily get/do whatever I can for my son that actually works and would make him happy or his life easier, so I thought I'd ask you fine folks if any good therapy options or approaches exist. Maybe I'm all wrong and ABA would be just the thing. Who knows. What do you think?

Thanks!

You're right and your in-laws are wrong: therapists are as useful as ***s [udder] on a bull. They don't actually DO anything; they just "ask how did that make you feel?", and/or parrot back whatever you said to them. A simple computer script, like Eliza, can do the same thing for free, rather than fleece you and/or your insurance for $100+ an hour.

As for ABA, it's basically the human equivalent of Ivan Pavlov's dogs training. That's how it was done on me when I was your son's age. If said something my therapist wanted to hear, like how I got an A for an 8-page paper, she'd praise me joyously in a tone that puts a Latin telenovela to shame. If I said something she didn't want to hear, liked how my parents called me a "baby" when I told them I wanted to go to Disney World, she'd mock me or pretend not to know what I was talking about. Reason being she was their flying monkey and dishonest with me about it.

There were many sessions when I wanted to jump up and beat her with the chair I was sitting in. But then she's say I'm being "resistant". So over time, I memorized her expectations well, and the sessions degenerated into a trashy theatre: I recited random trite phrases that made me look good, and she gullibly fell for them and gave me equally trite praise.

Then again, if you do decide to enroll your son into therapy, have him practice with the Eliza chatbot beforehand; he'll have a better therapy experience because he'll know what to expect from his therapist. Link: https://web.njit.edu/~ronkowit/eliza.html.

I got sent to very similar "therapy" as a kid, Aspie1. I guess my mom thought I needed to discuss my lack of social skills or feelings after her divorce or something, I don't know.

I would say that speech therapy was the most useful for my son. He would say the same. It isn't about enunciating words, although it can be. It involves the full spectrum of communication. The pragmatic use of language. Using speech to accomplish specific goals. Synonyms, symbolism, etc. And, yes, that has to be taught. It surprised me, too, when they suggested speech therapy, since my son had an expanded vocabulary and spoke constantly and clearly. And yet.

Don't discount the ability of a good speech therapist to help your son. You won't know unless you talk to one.

Note that kids can "graduate" from therapy but re-qualify again later. That is because the standards used to judge need are a moving target. As kids get older, they are expected to be able to do more. But when they have a developmental delay like ASD, that target can quickly move far ahead of them. It's a process. My son "graduated" and re-qualified multiple times during his education.

I know a lot of our members have had frustrating experiences with different therapies, so it is important to get your child's input before starting anything, and to listen to his input as it progresses. No therapy can be effective if your child feels like the therapist is an antagonist instead of a helper. Personality match between child and therapist is important, as well, and the first try won't always be a hit.

I vote for trying speech therapy first.

As for mental health therapy, I didn't read anything in your post to suggest that your son is experiencing mental health issues. I think a lot of families have confused the natural frustrations that come from living with a neurodiverse brain with a mental health issue, hence so many posters here who speak very negatively as soon as the term "therapy" comes up. A child can have both, of course, but, again, consider what your son is thinking and feeling.

I never found a therapy that addressed meltdowns; we tackled that at home by studying my son's patterns, identifying the signs of stress build up, and redirecting him into self-calming strategies before the stress broke over. By his mid teens he took over responsibility for all the steps in the process, and hasn't had a meltdown in years. My son did participate for a year in an anger management group when he was ten or so even though we knew that wasn't really his issue. He found the strategies and discussion to be useful for helping him keep control of his own stress and choose to continue with the group until it's scheduled end. Again, seek input from your son and really listen.

The word "discuss" here speaks volumes. When authority figures say "discuss", it rarely means "have a true back-and-forth conversation". It often really means "tear him/her a new one" or "have the therapist tear him/her a new one". I learned that the hard way. So I'm sure your therapist "discussed" it with you, just as their "family therapist" job title dictated.

To this day, I can count on one hand the number of times I've used this word as an adult when I wasn't brown-nosing middle managers, who seem to like that word a little too much. Particularly in my current job as a computer technician in the local government, I've said "go over", "look into", etc., but never "discuss"; I know many people really hate that word.

My post about Eliza the chatbot was mostly serious; Eliza really was developed to emulate a therapist. So I very much think the OP's son will benefit from using it as a litmus test. If he finds it helpful, then go ahead with therapy'ing him; otherwise, don't do it.

I didn't actually mind my therapists, Aspie1. They usually had toys I could play with (the hand drill was particularly fun, but they never let me use that one again after I drilled into the floor) and sometimes I got to talk to other kids. What they didn't do is improve anything. Talking about my parents' divorce doesn't change anything (I never felt guilt or anything like that about it) and talking about my social skills, well, I was shy and developmentally behind. Talk doesn't change that, either.

IMO, what my son needs is a friend. (And a cat, but my other son breaks out in hives around cats.)

This is all very interesting; thank you very much. I wonder if I can get a book on the subject to educate myself and better support what he would be learning at home. Do you know what texts they might have used/studied?

I found the whole therapy process unnerving since day one, even months before my therapist started mocking me. Why? She acted "too nice", if that makes sense. I just couldn't understand why a woman 4 times my age was treating me like an equal and a friend---that just doesn't happen to 12-year-old boys in real life! (Unless that woman has creepy intentions! ) I much preferred the warm but distanced politeness hospital workers, like the urologist or the MRI tech, had treated me with. Sure enough, my gut feelings came true: I learned the hard way she was being "nice" to make me let my guard down and work me for incriminating information for my parents to use against me. They brought me to her to help me make friends again after a cross-country move, and to extract better grades out of me. How did I know that? Whenever I brought up the emotional abuse my family put me though, she changed her tune and mocked me to my face. But whenever I fabricated a story about eating lunch with a classmate for the first time or told her about getting an A on a test, she praised me like I gave her $1000.

This sounds more like public speaking training than speech therapy. I myself had very little of it. I took a public speaking class in high school, but since a school is such an artificial environment, it was useless. At the same time, I came a long way in that regard, all by trial and error. In middle school, kids broke into mass laughter when I gave class presentations---although the laughter could have been faked/staged in order to troll me. At age 36, I sang karaoke in front of about 100 people on a cruise, and got not only a mass round of applause, but also a woman inviting me to sit with her, who shouted the invite to me in front of the crowd. (I went on that cruise by myself.)

I was not aware of any texts being used, although the speech therapists must have had a standards guide they were trying to match up to.

My son was never shy about public speaking. What he didn't know was when to stop. Learning to know when to stop was the very first pragmatic speech lesson he was given. For several years we (and his teachers) had hand signals (suggested by the therapist) to let him know when he was expounding far past the audience interest. The precise content of speech therapy is naturally going to change depending on the needs of the student.

The various speech therapists my son had were hands down his favorite, some more than others, but that profession has really risen to the challenge of helping ASD children communicate effectively.

I am glad you've learned how to be comfortable speaking in public. Makes life easier in multiple ways.

Only thing that worked for my daughter when she was your son's age was speech therapy. Everything else propped up as "therapy" is B.S. (to put it politely)

Most people associate "therapy" with correction. Aspergers is different than having been in a car accident and trying to regain function.

What is needed is his development of skills so that he can have self-control of his life. To do this several things are needed. skills in forgoing immediate satisfaction of desires, persistency in the face of difficulty, the ability to shift focus to peripheral events that also require attention, how to be interested in and solicitous of others, etc.

These fall more into the realm of traditional parenting than "therapy". Your son will also be facing the years when he will need an opportunity for increased physical activity. Some try to deal with this through sports programs. If this type of social interaction is not suited for your son, you might consider swimming or a stationary bicycle as options.

Sleeping in late may not be a good option as it might be better allowed after he has demonstrated the ability to keep a regular schedule. Indulgences should be the exception, otherwise there is the possibility that indulgence become the primary motive in life. You will want your son to have as many options as possible in life and that will require him to cultivate skills and disciplines he might not choose at first.

Occupational therapy can be helpful for sensory issues and self-care skill delays.