Autism Spectrum Disorders and Navigating through Adolescence

ASD and Navigating through Adolescence
By Sandy Shaw, Ph.D.

Adolescence is a tumultuous time for everyone, including individuals with Developmental Disabilities (DD) and Autism Spectrum Disorders (ASD). ASD includes Autistic Disorder, Asperger’s Syndrome and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS). Often time, individuals with DD and ASD may have intellectual disabilities and delays in development so we tend to forget that they also experience the significant physiological and social-emotional changes like everyone else. As individuals enter the middle and high school age for any child, it is important to incorporate related developmental factors, including puberty, sexuality, mood changes, and independent living ability in their daily lives. These are issues that impact all children, including children with developmental disabilities and Autism Spectrum Disorders (ASD), coming into adolescences. These issues also drive how we approach treating adolescents with ASD in teaching skills and addressing their behaviors.

Overtime, as children become middle and high school age, Applied Behavior Analysis (ABA) should continue to be utilized by parents, teachers and other professionals to teach skills and to address behavioral issues. However, the presenting issues and behavioral problems would change as they approach adolescence. For instance, adolescents should learn about public safety, not talking to strangers, what to do when they get lost in the community, and how to ask for help when alone in the community. They should all receive concrete and detailed sexuality training to teach them what is appropriate touching, dating issues, being attracted to someone and what to do when they become sexually excited when in public and general issues relating to sexuality. These issues should be taught at each individual’s developmental and cognitive ability. ABA strategies break down these issues step by step and teach these steps through the use of visual cues, social stories, comic strip conversations, role playing, scripts to follow when encountering specific difficult situations, and thinking maps.

As individuals with ASD grow older, so are their parents and other caretakers. This fact alone makes it extremely important to teach them to be as independent as possible in their skills of independent living. Parents and professionals should strive to teach and guide individuals with ASD to become as independent in their daily functioning as possible. The focus should be on independent living and transition for life after school ends, specifically vocational skills. These skills should be based on their strengths and interests to help them become a contributing and functioning person within the society. ABA strategies, such as TEACCH strategies, are extremely helpful in providing specific guidelines and structure within daily living within the home and vocational performance within the work place.

Through ABA, these issues can be broken down into manageable steps so that target skills are much easier to teach and for individuals with ASD to comprehend and follow. Remember that prompt hierarchy and prompt fading need to be integrated into the training steps to help increase individuals with ASD to become as independently functioning as possible. Prompt hierarchy is steps to prompting for specific behavior or skill that is increasing in degree and intrusiveness; as the skills become mastered, the degree of prompting and prompt intrusiveness should decrease accordingly. Prompt fading is gradually fading out of prompting for specific behavior or skill; prompts are slowly faded out to increase independent practicing of the learned skills. As always, parents and service provides should continue to provide opportunities to practice and generalize learned skills within the natural environment. Additionally, it might be best to teach skills of independence with middle school and high school aged children within the natural context and environment to further assist with skills mastery and maintenance overtime.

Inappropriate behaviors, including self-stimulatory behaviors, self-injurious behaviors, physical aggression, obsessions (often with eating and foods), and perseveration can significantly increase as individuals enter puberty and even pre-pubescent age range. The information gathered from a Functional Analysis Assessment (FAA) or Functional Behavior Analysis (FBA) can help create effective behavior intervention plans. However, changes in mood (i.e., depression and anxiety) can occur during adolescence just as it does with typically development individuals. We need to be cognizant of that and consult health care professionals for assistance if we suspect presenting mood issues. Additionally, medications are often very helpful in complementing the behavior intervention plans by helping the individuals focus better, be calmer and less anxious or depressed.

Social skills training through individual psychotherapy and social skills groups are highly effective in addressing the social deficits that persist for individuals with ASD. With this age group, it is best to pair them with same age peers to help them adjust to soon becoming adults. They can also be integrated into community based groups and activities such as activities provided through the Parks and Recreation Department, Special Olympics and organized sports.

Bio:There should always be close collaboration across all disciplines of treatment for children with ASD. With individuals within this age range, it is extremely important to communicate with health care professionals to address medical issues that can mask as issues relating to puberty, such as weight gain, lethargy and hypothyroidism. Individuals with DD and ASD can navigate through adolescence with great success with the assistance of professionals within the community and the parents’ efforts in implementing ABA strategies.

Sandy Shaw, Ph.D. (PSY 18351)

Dr. Shaw is a licensed, clinical psychologist with over 18 years of experience working with individuals with developmental disabilities, specializing in Autistic Disorder, Asperger’s syndrome (Autism Spectrum Disorders – ASD) and related Developmental Disabilities. Dr. Shaw is the founder and director of Applied Interventions & Methodologies, Inc. (AIM). AIM is a psychological agency providing behavioral, educational, and psychological services to children, adolescents, and adults with ASD and related developmental disabilities across the home, school, and community settings. The services AIM offers include Infant Development Program, Intensive ABA Program, Behavior Consultation/Assessment, Social Skills Training Program, Play Therapy, Individual Psychotherapy and Family Therapy, and Diagnostic Assessments.