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AAP National Conference: Higher-functioning children with autism not immune to behavior problems :

October 22, 2016

Kids with autism who are high-functioning can have a lot of strengths compared to those on the other end of the spectrum. Their intellectual abilities may be average or even above average, and they often are in a regular classroom.

Yet, they are not immune to behavioral difficulties.

“Just because someone’s high-functioning doesn’t mean they might not still throw a tantrum in the middle of their fourth-grade classroom,” said Benjamin Handen, Ph.D., who will present “Autism Spectrum Disorder: Behavioral Challenges of the Higher Functioning Child (F1182)” from 5-5:45 p.m. Saturday in Room 304 of Moscone South.

Dr. Handen is a clinical psychologist with a wealth of experience working with youths who have severe behavior disorders, intellectual disabilities and autism. A professor of psychiatry, he has been on the faculty of University of Pittsburgh School of Medicine for 30 years. Prior to that, he was a special education teacher.

Pediatricians can play a vital role by providing anticipatory guidance to parents regarding transitions that may be particularly difficult for their child, Dr. Handen said. Those include when the child starts kindergarten, moves from elementary to middle school and enters high school.

Kids with autism often have a hard time dealing with change, making middle school a challenge.

“Here you go to middle school, and you have eight different teachers, which means you have to adjust every 35 minutes, every 40 minutes,” Dr. Handen said. “You’re switching rooms, switching seats, getting adjusted to another teacher’s style.”

Social issues also can lead to frustration, anxiety and depression.

“Once you get to middle school and high school, the social demands are just so hard,” Dr. Handen said. “It’s got to be exhausting.”

One way youths may try to cope is by playing video games. They may be good at them and have friends online even though they’ve never met them before.

“I think that it would be a natural tendency for someone to say, ‘This is a lot easier for me to stay in my room and play video games,’” Dr. Handen said.

Yet parents need to understand that their kids will develop social skills only by interacting with others. Pediatricians can encourage youths to get involved in activities such as computer clubs or noncompetitive sports like martial arts.

Bullying is another huge problem for high-functioning kids with autism. Anxiety and depression may be a tip-off that the child is being bullied. “It’s probably happening a lot more than the kids are telling us,” Dr. Handen said.

During the session, he will review effective interventions for behavioral challenges such as social skills groups in schools, daily report cards that provide structure, social stories to prepare kids for new situations and visual schedules.

Even if the child seems to be doing well academically and isn’t exhibiting any behavior problems, pediatricians should encourage parents to make sure their child has friends, Dr. Handen stressed. Ask parents whether their kids get invited to the mall or the movies or if other kids call them.

Even if things seem to be going well and no one is complaining, he said, there still is a lot of guidance that pediatricians should be providing.

For more coverage of the AAP National Conference & Exhibition visit
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