Asperger群心理咨询师Sylvia van Meerten 问答记录：
1. My kid has a hard time accepting failure. He often melts down when he loses a game or gets a bad score on a math test. How can I help him deal with it?
This is so common for kids with autism or aspergers. Many kids have a hard time making an accurate prediction about what will happen in a high pressure situation, and they imagine themselves being perfect. I would write a note (or an email or a text) to your son a week or a few days before a game or a test and tell him that you will be proud of him for working hard, but he doesn’t need to be perfect. Tell him that making a mistake is part of growing up. Make a specific plan with him for what he can think and say if something goes wrong. You might write, “Most people have gotten a bad grade or lost a game. I am proud of how hard you work and I don’t expect you to be perfect. Let’s make a plan for what to do if something goes wrong. If you yell and cry when you lose, it’s not fun for you, and other people think you are immature/overdramatic/out of control. Instead of yelling and crying when you lose, you can say, OH WELL, I’ll try again next time and walk away. Then we can do something special to cheer you up. If you say OH WELL I’ll try again next time, other people will think WOW that kid has a great attitude.” Writing this information down will help an autistic person understand it better than if you just say it out loud.
2. When my kid doesn’t want to go a place we decided to go(even though he was told ahead of time that we were going, he was OK when we told him), he will say no by finding an excuse and cry hard so he doesn’t have to go a few minute before the trip. What do we do?
Do you guys use a written schedule? A lot of autistic kids experience a lot of anxiety about where they go and what they will do during the day. Sometimes that anxiety is expressed by trying to control parts of the day that are not up to them. Sometimes you can alleviate that anxiety by writing down a list of what will happen in a day. Some kids can handle seeing the whole day at once, and some just want to see half a day. Other kids really like using a calendar so they can see activities coming up later in the week and prepare themselves. A list for a 10 year old might look like this:
Pack for school: coat, shoes, lunch, homework folder
Home – snack (choice), bathroom, water
Some kids might need the exact steps for getting dressed written out and some kids might need less information. The basic idea is to give your kid the information about what is happening, and when they have a choice about what they will do. If you’re just starting out with a schedule, I would suggest writing an intro note to go with it. This note might just level with your kid and say, “It’s really hard for everyone when you change your mind about going somewhere. We want you to have some choices about what we do, but we can’t change all our plans if you feel nervous right before we leave. I am going to start writing down our schedule so you will know what we are doing. The schedule will show which things are a choice and which things you have to do.
3. Why would a young adult choose to ignore important deadlines and important communications pretending that things as usual rather than asking for help or deadline extension?
I’ve found this to be pretty common for autistic people, especially young people. Time management is sometimes difficult for people on the autism spectrum, and they are often embarrassed that they are behind on something. Knowing when to communicate about a project or what to say when you’re worried about missing a deadline is a highly nuanced social skill that we don’t teach explicitly. When you supervise or teach autistic people, it’s best to be really clear about how you want them to communicate with you and when you want to know about their work. It’s also possible that the young adult was so anxious about messing up that they just shut down and couldn’t think of anything to do. I think I would need a little more information to give a better answer. I’m happy to talk about this further with you if you want.
4. My son does not like criticism, whenever we tell him not to do something(an inappropriate behaviour),he gets really upset, and will displays his winning, cranky behaviors, as well as non compliance to whatever we ask him to do, how do we teach him to accept criticism?
I think that criticism is pretty hard to accept for everyone, depending on how often you get criticized. Many of us would consider it a really awful day if someone criticized us 3 times in one day, yet we often correct or criticize our autistic children 20-30 times per day. I would suggest picking 2 or 3 things you really want him to improve, writing down what you want him to do (instead what you DON”T want) in those 2 or 3 areas. Show it to him and then start giving him a lot of positivite feedback for doing what you ask. What does he like? If he like being praised then praise him, if he likes high-fives then do those, and if he likes tangible rewards then I think its ok to trade him those in exchange for making a change that you want. The most important part (and the hardest part) is to see if you can let everything else go for a month or so until he gets good at those 2-3 things, then pick a few more and write those down really clearly. You might notice that he makes better progress when he is focused on just a few things at a time. Depending on exactly what you want him to do, how old he is, and what happens when he gets cranky, we could make a more specific plan that’s tailored to your family.
5. My son is 15, how can I help him to accept his diagnosis and agree to go into counseling or accept help as he does not see that he has any problems.
This one really depends on the person. What problems do you think he has that he doesn’t accept? It’s sometimes really hard to accept a diagnosis if you feel like it labels you as ‘permanently broken’ or ‘always less than everyone else’. Maybe we can discuss this further and you can tell me more about him. Here are a few things that have worked for other people:
· Call the counselor a ‘coach’ and say that their job is help him build a life that he really wants. Have them meet at a coffee shop or somewhere more equal than a therapy office.
· Make a list of famous people with autism and write mini-profiles for them. Leave it around the house and start talking about how much you respect autistic people and what they contribute to society. Talk about how unfair it is that most of the world doesn’t understand autism. Then after a few months, propose that he talk to a ‘coach’ you found that helps autistic people deal with annoying neuro-typical at school and work.
· Reward going to therapy with extra money, video games, trips, etc.
6. My son is 5. He can become sad from being happy in one second. He gets frustrated very easily and reluctant to try again when he cannot get things done quickly, even with some simple tasks like bucking the safety belt. He doesn’t have the sense of safety. He cannot read the social clues from others and respond properly.
A lot of this will even out as he gets older, so even if you do nothing, things will get better. In the meantime, maybe you could make some videos of him trying things a few times without being mad (is there anything that he can do 2-3 times happily? Or would he make a video ‘for other kids’ to show them how to do a seatbelt?). Then watch the video and narrate how proud you are that he is practicing and staying calm. You could also write a note or make a video to explain the whole idea of practice and why everyone learns to practice. There is a good website calledwww.do2learn.com that has good videos and social stories about safety for autistic kids.
As for the social cues, that will take time and may not ever be perfect. It’s ok, you can teach him to ask people how they feel and he can practice reading expressions using online programs if you want him to.
7. My son is 5, we recently got complaint about him acting silly in class with another classmate. He tends to copy others’ behaviour, good or bad, he seems cant judge whats right and wrong, how can we help him？
Judging what is right and wrong is a social skill that some autistic kids struggle with.I think you could make him a list of things that are the best things to do at school (that make the teacher and you happy and make it easiest to learn). Then make another list of things that usually annoy a teacher, make you unhappy, and make it harder to learn. Start adding common behaviors on each list and then start asking him to decide which behaviors should go on which list. You might also want to tell the teacher that many autistic kids don’t pick up social cues, so s/he might have to be more blunt about what s/he expects.
8. What is the key when discipline an ASD+ADHD child (6 yrs and up)? How to communicate with him/her efficiently?
Discipline can be tricky for kids with ASD and/or ADHD. I usually recommend that people start by making a big list of motivators (things your kids really loves). See if you can write down 15-20 things that your kid gets excited about (TV shows, favorite foods, favorite activities, favorite characters, people, special interests etc). Then use this handouthttp://empowerautism.com/wp-content/uploads/2013/11/Rules-and-Rewards.pdf to make a reward system for the exact behavior that you really want. It’s easier to teach a behavior that you want than it is to punish behavior that you don’t want, because there are so many things a kid IS NOT supposed to do, while there are usually only a few things that they are supposed to be doing. When you design a new behavior system, write your kid a short note where you explain what your new plan is and explain how they can earn rewards. The more structure and positive routines you have, the better chance your kid has at behaving the way you want.
9. My son (6) has social difficulties and social withdrawals at school. From what he says he has no friends at school. No one wants to sit by him at free choice time and he couldn’t keep a conversation with peers. (His teacher told me that he might shout: who are you? I don’t know you! I don’t like you, etc. when his peers wants to talk to him.) Moreover, He feels bad about himself. He refuses to tell people his name and refuses to write it down. He doesn’t want to share his school life with me, and avoid talking about social topics. He always complains about his school time is boring. His teacher said that he said several times a day that he is tired and wants to lay down(he did the same thing at home) . How can I help him? Thank you.
This is one of the hardest issues for us parents to watch! It’s so sad. Would it be possible to have an expert come in and do a workshop for the teachers so they can learn more strategies for inclusion? Or maybe someone could do a neurodiversity workshop so kids could understand that he thinks differently, but that some of the best inventors and scientists have autism too? For his self-esteem, I would suggest that you start a whiteboard in your house that is a list of stuff he does really well. Write stuff every day that you are proud of that he does. Ask if the teacher will send you some items from school that he does really well and put that on there. Ask him every day what was his favorite part of the day.The thing about him tired and laying down seems a little different to me. Maybe he is just sad and worried. But also maybe he needs to go to the doctor to get blood work done to see if he has a vitamin deficiency or something because what if something is wrong – would he know to tell you that he feels really bad?
10. My question is similar to Q5. For a adolescent with asperger, refused to accept the diagnose and get help from counseling, having trouble socializing with peers, but choose to deal with all the pressure and isolation by trying super hard to excel academically and other extra curriculum activities at all costs, I mean sacrificing regular sleeping time for higher grades and also not sharing anything with parents. How can we help him not to burn out. Thanks!
I would try if you can find some academic material about stress and the mental and physical risks of stress. Present the material and see if you can make a plan for the whole family to reduce stress by having social time, regular exercise, counseling and lots of sleep. You could also see if any of his teachers would be willing to offer him an ‘extra credit’ project about taking care of himself or about managing stress. Maybe if he got a grade in ‘taking care of himself’ he would be more motivated. Does he wear a fitbit or something else that tracks sleep? Maybe he would be interested in getting sleep if he could look at the data from the fitbit.
11. My son is 7. He always talks “I don’t like…” “I hate…” “It is stupid….”. He tends to only look at the negative side of everything. He expresses himself best when he feels anything unfair. But there are too many of these compliants and he expects absolute fairness everywhere, which is impossible. He becomes more anxious and depressed as he grows older.
This is pretty common. Often kids don’t really know how they sound. You can encourage more positivity by writing him a note that says, “You are such a cool kid and people really like talking to you. People really like talking to you about positive topics like music you like, songs you like, your favorite color, your favorite food, jokes and other things that make you happy. I made you a chart to write down a lot of happy ideas to talk about. People don’t usually like to talk about stuff you hate or stuff you think is stupid, but they really like to talk about stuff that makes you happy.” Then everyday ask him about what his favorite part of the day was and prompt him to ask other people about their favorite part of the day too. Each day you can add some new happy topics to the list and make sure to give him a lot of praise when he talks about happy things.” Here is a handout about writing this kind of note: http://empowerautism.com/wp-content/uploads/2013/11/Using-Written-Explanations.pdf
12. My son is 12 and in 6th grade. His grade was fine until the start of the second semester. He would not finish the assignments for the subject he dislike. He kept saying that history is pointless, he doesn’t want to learn social study. His grade dropped from A to C. He has 4 missing assignments. He lied to me that he finished his homework while he didn’t. I don’t want to watch over his shoulder all the time but all else fails. I could not convince him that all subjects are important. What can I do to help him?
This one is a little complicated because I don’t know exactly what happened. Maybe you could give him a form to fill out about why he doesn’t like the history class. Have some check boxes and see if you find out more. Are there kids who are mean in that class? Is the teacher nice to him? Maybe there is something else going on. Is he having trouble staying organized? Is he trying to be too perfect and not able to get everything done? If nothing else is wrong and he is just resisting doing the work, maybe you have to write a note explaining why he has to do work even when he doesn’t want to. Tell him about how you have to do stuff you don’t’ like sometimes and so do all adults. You might have to tempt him into doing his work with a reward system if this doesn’t work. I’m happy to talk about this further with you if you want!
Question 13: My son who is 19 years old. He did not want to go to college but I forced him to. He went for one semester, and he hates it. Now he dropped out from college and he is at home without school or work. He says he wants to do programming but he is really wasting his life. He has no motivation to do anything.
Question 14: my son who is 19 years old. He likes dark so much. He dim all the screens(computer, phone), he closes all the curtains in the room, he wants to read or uses computer at night instead of during the day. Why? And how I can help him not be too bothered by the light?
15. Do you know any good quality residential treatment program / resources for young adult AS? One that teaches social skill, independent living skill, organizational skill, recreational skills, etc, all under one roof for young adult AS. At the same time, helping them to attend college.
I heard about these resources below, but not sure if these kind of programs are really effective for young adult AS. Do you know any success stories for young adult AS from such kind of residential treatment programs? (Would you recommend these kind of residential treatment program?)
(1) New Directions for Young Adults.
(2) College Internship Program (The Berkeley Center)
(3) College Living Experience
@Sylvia van Meerten Question 16: I heard many people talked about social thinking curriculum by Michelle Garcia Winner, how do you like it? If you think this really helps, can you recommend some books/ summer camp/ psychologist related to this? I am living in Houston, TX, thank you so much again [玫瑰]
@Sylvia van Meerten@Lynn (玲儿) MI G95 G95 G98 Questions 17: 我儿子13岁，焦虑敏感有tics，当他被严厉批评后情绪会激动（轻的批评不会），会说一些负面的话：我要自杀，我要结束生命，或我要离家出走。我说你明白自杀的后果吗？你真的想这么做吗？他说：我不想！他是非常胆小谨慎的孩子，有时说要离家出走也只是打开门走出院子而已，连小区都不敢走的那种，可是到了下次他还会说这些。我该如何引导他呢？