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Dayannerah1
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06 May 2015, 7:58 pm

I have a 9 year old son who was diagnosed with bipolar disorder, ADHD, Executive Function disorder, Anxiety and depression over 4 years ago. My son, Shane, was recently given a Asperger's diagnosis. Although Shane had a Neuropsych eval done over 4 years ago to confirm the above diagnosis, he has not had a recent one to confirm/deny ASD. I am going to get the new eval done but in the meantime, what should I start doing for him. His aggressive behavior has increased and I don't know which way to go to help him.



ASPartOfMe
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06 May 2015, 9:33 pm

For executive functioning
Detailed Instructions or rules, Limit or eliminate multitasking, do not have several people speaking to him at once, Strict routines, limit as much as possible the unexpected. extensive pre preparation for any type of change

Sensory sensitivities
Figure out and greatly limit or eliminate things that may be oversensitive to him such as certain foods, lighting especially florescent lighting, touch (most difficult for people who are not autistic to understand and implement), noise especially sudden noises. He may feel heat or cold more acutely.

Do mistake lack of eye contact for rudeness or disinterest. He might have poor ability to both listen and make eye contact at the same time. For many of us eye contact is very unconformable or actually painful.

Use Literal language, avoid euphemisms. Do not mistake his "bluntness" for rudeness.

Encourage non destructive obsessions/special interests.

Being overwhelmed by too much multitasking and over-stimulation might be leading to the aggressive behaviors/meltdowns. Understand the difference between Autistic meltdowns and Temper Tantrums
http://ollibean.com/2015/01/13/autistic-meltdown-or-temper-tantrum/

Autustic people often have limited ability to understand others motivations and non-verbal communication.

While autism is a series of common core traits like anybody else we are different people so how these traits will present and the severity will vary. Autistics won't have every autistic trait and most non-autistic people have a few autistic traits.


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“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


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07 May 2015, 3:57 pm

The aggression may be a symptom of his bipolar disorder. Do the rages start randomly, or do they seem to be triggered by something (e.g a particular sound, change in routine, switching activities, etc.)? If the latter, that's autism-related frustration, if the former, that's more indicative of bipolar. Does he have manic episodes, or delusional thoughts? Both of these can contribute to aggression.

As far as the autism is concerned, I agree with much of what ASPartofMe wrote: fixed routines which are written or in pictures (e.g laminated velcro cards) that he can see and refer to; maintaining an appropriate sensory environment (OT can help desensitize some sensory problems).

Using any special interests can be a good way to engage him socially, just don't overuse it; autistics need a lot of alone time to refuel.

Learn to distinguish between temper tantrums (emotional manipulation designed to get or avoid something) and meltdowns (emotional outbursts which are the uncontrollable result of sensory or emotional overload); do not punish meltdowns, simply teach calming strategies (deep breathing, engaging in special interests, etc.) and teach him to read his body so he knows what it feels like when he's approaching meltdown (e.g feeling tense, angry, fast heart, difficulty breathing, like you want to break something, etc.). For meltdowns in progress, if possible, remove him to a quiet, sensory-deprived area (e.g his bedroom) and leave him alone to calm down. Stress during a calm period that this is not a punishment, but a way to let his body calm down.

Do not forcibly eliminate stimming (repetitive motor movements/sounds); they are self-soothing and necessary. If they are self-injurious (e.g hand biting, head banging), find sensory toys/fidgets for him to play with to try and detract from the self-injury.

Use concrete language, but do not stop using figures of speech; he has to learn what they mean. When using them, explain what they mean, and translate.

Do not provide more than one verbal instruction at a time; too much information can be confusing and overwhelming, and he will lose track of what you want.


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Diagnosed with ASD level 1 on the 10th of April, 2014
Rediagnosed with ASD level 2 on the 4th of May, 2019
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