Conduct Disorder vs. Autism: Identifying the Differences

A persistent and pervasive problem within school systems is the conflating of conduct disorder with autism. Research has shown that while individuals with conduct disorder have problems with social interaction and the perceptions of others, their problems are considered to arise from abnormal social learning, rather than the intrinsic developmental difficulties of Asperger’s Syndrome (AS) and other autism spectrum disorders (ASDs).

Those with Asperger’s are significantly more impaired than the conduct disordered group in terms of their threshold for annoyance, perception of their own role within a conflict and their ability to withstand teasing.  They tend to value a friend in terms of what that person did not do such as, “he’s my friend because he doesn’t laugh at me." 

While the level of overall symptomatology is equal between the groups, AS individuals have more inwardly directed problems such as sleep disorders, obsessions and compulsions.  Unlike the conduct disordered group, they are seldom prone to outward expressions of their problems through stealing, drugs and alcohol.

Individuals with Asperger’s are frequently misdiagnosed as conduct disordered and even when they are properly diagnosed, they are still labeled “behavior problems” and treated as such.  Conduct disordered kids are given a strict system of rewards and punishments to modify their behavior.  Often it is laid out that if they commit a certain act, they will experience “natural consequences” for it. “Natural consequence” is code for “naturally, you will be punished."

Asperger’s Syndrome expert Dr. Tony Attwood has made it abundantly clear what parents of AS children already know – punishing them does not work.  When they are upset, remaining calm and giving them space is the best option.  To modify their behavior, appeal to their logical reasoning, which is their personal compass in life.  Because they are so intelligent, they loathe being patronized or having to follow rules they deem illogical.  Soundly make your case, and they will be won over.

Shaming them before their peers, punishing their outbursts, getting caught up in contest of wills or making them “talk it out” when they are already provoked are all recipes for disaster.  The adult approaching an Asperger’s child in this way will only be inflaming the situation, then pointing to their meltdowns as evidence that they are conduct disturbed.

That’s why it’s so important for parents to work with schools to identify the child’s triggers and come up with a “toolbox” of coping strategies.  Sometimes, having a tent in the corner of a classroom for the child to retreat to with a favorite toy or book is useful. An iPod to provide soothing music can be written into an IEP. Stepping outside for a breath of fresh air works wonders. Tony Attwood suggested making a “Pleasures Book” (a scrapbook of things that make your child happy) to take out when they need comfort.

This topic is on my mind now because of my son.  Last year, he had a wonderful teacher in middle school who knew to shift his attention when he got upset and provided soothing choices for him to de-escalate.  He actually became self regulating, and went months without a meltdown.  But this year, he’s hit a wall in high school – all his progress has been obliterated by a behaviorist teacher who knows nothing about Asperger’s or ASD. 

I was so upset about his regression that I even called a member of the school board who replied to my tirade with campaign platitudes like, “I care about special education” and “our school district values inclusion."  When I told him the special ed teachers don’t know anything about autism he grew indignant and replied, “but that takes money!”

Autism Awareness Month begins in one week and it’s my desire for those in our school systems to use that time to further educate themselves about autism spectrum disorders.  Awareness and education are the only ways to combat the ignorance that currently exists in our schools and greater awareness will go a long way in helping educators understand and differentiate autism from similar, yet unrelated conditions.

Bully Victim Casey Heynes Speaks Out, Describes Years of Abuse

Last week, we wrote about a popular video clip involving Casey Heynes, an Australian student who retaliated after being bullied by 12-year-old Ritchard Gale. The video struck a chord with many across the globe and went viral, being viewed by millions in the process. We covered the story on our site because of the inordinate number of children with autism who are bullied on a daily basis and felt the need to shed additional light on this growing epidemic that currently exists in schools.

On Sunday, A Current Affair (ACA) Australia, aired a fascinating in-depth interview with Casey Heynes (posted below) that gave the back-story that led up to the on-camera bullying episode and subsequent retaliation.  

In the ACA segment, Heynes describes a chronic pattern of abuse that occurred "practically every day."  Some of his torment included being called "fatty," taking slaps across the back of the head, being tripped and bombarded with water bombs at school. The bullying began all the way back in the second grade and continued until the day Heynes’ incident was caught on camera. The harassment was so severe, Heynes describes how he considered suicide as recently as last year. "Bullycide" as it is called, has become a major problem among teens who are tormented to the point of taking their own lives.

As a parent of a child with autism, these bullying stories are extremely upsetting and much more needs to be done to address this seemingly out-of-control problem.

If there is any silver lining to the Casey Heynes incident, it has brought significant attention to bullying in schools and will give further ammunition to those seeking legislative changes to address the epidemic. In fact, as we reported the other day, California Congresswoman Jackie Speier will soon be introducing legislation that addresses bullying against special needs students.

The video below is a great testimony of how a single incident can change the course of how the public perceives a particular issue and the good that can come from it. In fact, the Casey Heynes story may be the proverbial straw that breaks the camel’s back, providing a catalyst for significant change to help finally protect our children from bullies once and for all.

Treatment of Special Needs Guests at Disney World Unparalleled

Last month, we reported about an incident that occurred at Disney’s Hollywood Studios involving some bullies and a child with autism.  The incident itself was unfortunate, but Disney’s poor handling of the situation afterwards created a lot of anger on message forums and blogs (including our own), with some parents threatening that they would not be returning to Disney in the future.

In fairness, I have decided to post a recap of our recent trip to Disney World’s Magic Kingdom, the most popular of Disney’s four major theme parks in Florida.

Our family, which includes my 9-year-old son with autism, packed our bags and headed to Orlando.  Immediately upon arriving at the Magic Kingdom, we visited Guest Services and let them know about our son’s condition.  They were extremely accommodating and provided us with a Guest Assistance Card.  This is a must-have for families of children with autism who are visiting any of the Disney World parks.  It allows your child and up to five other guests to access the "FastPass" areas, by-passing many of the long lines in the process.  However, be prepared to show documentation from a doctor about your child’s condition.  Additionally, the card does not guarantee your party will skip every line in the park — it only provides the opportunity when available.  On some of the more popular attractions, there is still a wait, but nothing near what you would experience from normal lines.

However, the good news did not last for long.  Ten minutes after entering the park, our son complained that he felt sick and became very nauseous.  We had planned this trip for several months, only to have him get sick almost immediately after entering the park.  As a parent of a child with autism, nothing is surprising anymore — after these many years, we have learned to just roll with the punches.

A wheelchair was summoned and I took our son over to the First Aid Station, which is an infirmary located within the park.  The nurses there were amazing and incredibly friendly and caring.  They took my son in with no wait time, laid him down on one of the many sickbeds and took very good care of him.  I have had my share of emergency room visits over the years and the treatment we received today was very different than what we are used to.

After about thirty-minutes of resting, my son said he felt better and we were back enjoying the park after some Motrin was given to reduce a mild fever.

The day went as well as could be expected, but was eventually cut short after the medicine wore off and the fever returned.  

The thing that really stood out for me was how accommodating Disney was not only after learning of our son’s autism, but also after he became sick.  I found out first-hand that Disney’s treatment of special needs guests is unparalleled to what most are accustomed to in the "real world."

We’re hoping to make it to Epcot tomorrow, but with our son’s sickness, we may have to cut our vacation short and return another time.  Regardless of when that is, it’s comforting to know that my son and the rest of the family will be in good hands should any health or autism-related issues arise during our visit.

Helping Children with Autism Find their Passion

Lately, I’ve been addressing the many hard and scary aspects of autism, in particular, safety issues at school and in the community.  I now feel the need to shift my attention.  It’s easy to see the world of autism through a glass darkly when there’s so much work to be done to ensure our children have a warm, safe place to be within society.

On the flip side, I want to let the sun shine on a day of happiness I enjoyed last Friday as my son competed in a regional robotics competition in Seattle. My son has high functioning autism and has always been inordinately shy and self-contained. At the age of fifteen, one of his current IEP goals is “to initiate a conversation with a fellow student once a week."  This goal is indicative of just how shy he is. 

Chronically underestimated by teachers, I’ve always known his potential, even as they cast dire warnings about his future.  Lack of eye contact, emotional withdrawal and struggles with homework are issues, but do not define him as a person.

My son has always gravitated towards science and his interest has been honed to engineering.  Just as he entered high school, a new robotics club was founded at his school.  Ecstatic at his good fortune, he faithfully attended meeting after meeting.  He joyously learned C++ programming, which he excelled at to the point of becoming head of the programmers, only one of two ninth graders to hold a position of leadership within the club.  Towards the end of the build season, he put in eight-to-ten hour days on weekends and over vacations, working hundreds of hours on a robot.  The social skills and sense of belonging he acquired through this club could never have been delivered through an IEP goal.

Yesterday, the huge event was held in which all the roboteers and their creations assembled to compete against one another.  The atmosphere was incredibly festive as teams feverishly worked in their assigned pits to ready for battle.

Looking down upon my son from the balcony, I felt tears of joy well up that my self-professed geek had finally found his people and path forward in life.

The first round of competition ended badly for my son’s team.  Their big robot didn’t even place one inner tube on the hook as it was supposed to and their minibots assigned to block the other team seemed quite unequal to the task.  Afterward, everyone on my son’s team, including the mentors, looked like their dog had just died.  One frantic team member ran off with a big part of the robot in his hands looking as if he was carrying his very heart.

My son’s dad had rallied from his sickbed to come see our son and we had to leave soon after, as he was fading fast.  We could only hope the day got better after we left.

When my son got home at eight that evening, he was beside himself with happiness.  His team had won a special award for “Best Rookie Team” based upon citizenship, dedication and teamwork.  And he brushed off the opening fiasco, proclaiming that they improved throughout the day and had a solid finish. 

These are the things that make having a child with autism such a poignant experience.  Any parent would be proud of their kid on a day like today, but for a parent of a child with autism, the feelings are amplified one-thousand fold.  In moments like these, the weight of the burdens of autism are more than counter-balanced by the blessings.

Help your child find his or her passion.  When they are young, give them lots of clay, paint and paper.  Turn on the music and let them dance.  Take them to museums with hands-on exhibits.  Read to them as much as possible.  Buy an annual pass to the zoo and the aquarium.  See if they like children’s drama.  Try not to impose expectations, especially in the area of athletics, as many children on the autism spectrum shun organized sports.

You may never be a little league dad or a soccer mom, but that’s okay.  Regardless, let your child reveal himself to you out of the plethora of experiences you provide.  Believe me, as I have just experienced, the rewards will be immeasurable and profound.

Tsunamis, Wars and Nuclear Meltdowns: Dealing with Anxiety in a Child with Autism

istockphoto.com/jcrosemann

A global financial crisis. Unrest in the Middle East. Earthquakes and tsunamis in Japan. Nuclear radiation fallout. Bombings in Libya.

A cursory glance at these recent headlines would give any neurotypical person reason for concern at our world’s current state of affairs. However, for those on the autism spectrum, these events can create unneeded anxiety and worry, particularly for those who are high functioning.

My son is at an age where he pays attention, understands and fully comprehends current events. As it stands, he already has an elevated phobia of earthquakes and natural disasters, so recent events in Japan only served to exacerbate those fears.

As with any child, it’s important to keep a healthy balance of reality, while at the same time, protecting them from unnecessary information that is going to cause undue fear. As renown autism expert Tony Attwood once stated, "Autism is anxiety looking for a target.” 

Many fears associated with those who have autism manifest when routines are disrupted and children find themselves in unfamiliar situations and events. With apocalyptic headlines coming in on a near-daily basis, parents should do everything possible to provide comfort and solace to their children and ensure them that no matter what happens around them, they will continue to have a loving and caring support system in their lives.

Some things that can be done to allay some of the fears in children with autism include the following:

1) Offer up a favorite game or activity. When anxiety sets in, offer your child a familiar game or activity to help divert their attention from the problem at-hand. This could include a favorite iPad app, Nintendo/PlayStation/Xbox game or book. Tell them that things are going to be fine and providing them with a familiar activity will go a long way in soothing frayed nerves.

2) Limit television and Internet exposure. While it’s important not to completely shield children from the realities of our world, TV time and Internet usage should be kept to a minimum. Internet filters are also very important and one of the best programs I have come across for protecting a child on the Internet is the K9 Web Protection program. This is a completely free software program that can be installed on your computer that will filter news, social media, gambling sites, adult content and just about any other topic you can think of. Everything is customizable and the best part of this software is that it’s free. It can be downloaded at: http://www1.k9webprotection.com/get-k9-web-protection-free 

3) Pray. Take the time to pray with your children on a daily basis. Bedtime is usually an ideal time when you can say your prayers, then discuss the things that are concerning your child — all while they are in a relaxed and safe environment. Talk them through their fears and let them know that despite bad things happening in the world, there is a greater purpose to their lives and ultimately, God is in control.

Children with autism already have a lot to deal with and there is no need to add to those fears by having them concerned with every headline that comes across the newswires. Keeping an open line of communication with children and being a supportive parent or caregiver is typically the best anecdote for any anxiety that may be created from recent news events.

Bidet Device Helps those with Autism

The majority of children with autism have at least one or more sensory issues, which may include sensitivity to light, sound or touch. A particularly common problem for a child on the spectrum is an aversion to toilet paper, which can often lead to stressful potty episodes for parents. Even the softest toilet paper products on the market can turn a routine trip to the bathroom into a meltdown of epic proportions. 

Not long after our son was diagnosed with autism, I recall him dreading trips to the bathroom because of the uncomfortable feeling toilet paper produced on his backside. Wiping with paper is irritating enough for neurotypicals, so this problem is only compounded for those who are hypersensitive to touch, which included my son.

Then a few years ago, we discovered a relatively inexpensive product called the Biffy, which is a bidet-like attachment that affixes to existing toilets, turning them into powerful cleaning devices. The product was invented by a physician and has been a lifesaver for our family.

The Biffy is hygienic and doesn’t require any manual dexterity or coordination, which is particularly important for those with special needs. It draws from a home’s clean water supply and incorporates a showerhead-like apparatus that produces a fan of water to a user’s bottom, thoroughly rinsing the area clean. An adjustable dial helps a user control the strength of the spray, which can be quite strong when on its maximum setting.

The standard Biffy retails for around $99 and is definitely money well spent. However, we have found that it does tend to wear out after about a year or two, at which point you would need to buy a new one. To counter this problem, the company has recently released a "Chrome" version which is said to be more durable and last longer.

Other similar products include those from BBC Innovation and Bidet International, which I have not tried. Although they produce similar results, the designs are noticeably different from the patented Biffy.

I’m not a big fan of product promotion within our stories. However, there are times when we make exceptions if we feel something will be particularly beneficial to parents, caregivers and individuals with autism. The Biffy certainly fits this category and although it takes some getting used to, after a few times of using this thing, you will wonder how you and your child ever went without (no pun intended).

Bullying of Special Needs Students Remains Problematic

istockphoto.com/plherrera

The topic of bullying has been front-and-center this past month, including an anti-bullying conference held last week with President Barack Obama, along with First Lady Michelle Obama. The conference addressed the administration’s anti-bullying campaign and plans to hold school districts accountable if they don’t adequately protect bullied students. Then a video went viral this week featuring Casey Heynes, an Australian sixteen-year-old who turned the tables on a school bully and body slammed him into the ground.

More notably, Congresswoman Jackie Speier of California recently spoke before her colleagues about the epidemic of bullying in our schools and addressed the heartbreaking truth that children with special needs are bullied at a much higher rate than all others. Additionally, it was noted that bullying reported among those with autism and Asperger’s Syndrome was markedly higher than neurotypical children. Ms. Speier will soon be introducing legislation to address this crisis head-on, requiring schools to track incidents against children with disabilities and include content in anti-bullying programs that specifically addresses this susceptible segment of students.

While I applaud these efforts, it seems more education and awareness will be required to truly make a difference. If a school has an inclusion program, as most do, guest autism speakers should address the PTA on what it means for neurotypical and children with autism to share a classroom. This would cue parents of neurotypical children to not be fearful or resentful of a child with autism sharing a room with their child. The parents could then in turn help their children become more compassionate and supportive of their special needs classmates.

Tragically, much of the problem comes from the top, as administrators and teachers themselves don’t understand or appreciate the nature of autism, even as they are required to meet the needs of those students in their midst. Too often, the principal regards the child with autism as a “headache” and a behavior problem absorbing his or her valuable time.

As far as teachers go, my experience has been that when a teacher sets a respectful tone towards a child with autism, students will follow the lead. Sadly, the converse is also true. 

Earlier, I recommended a new DVD called “Intricate Minds” as a way of facilitating a dialogue about Asperger’s Syndrome and though I personally haven’t had the opportunity to introduce it in a needed school setting, I hope someone else will do so and share their findings.

Personally, I would advocate training about autism among adults in schools who are most likely to encounter a child with autism and also require a fixed number of training hours for all special education teachers. There is also software that some schools are using with great success that enable students to report incidents of bullying they have endured or witnessed anonymously online to a school administrator. This is a resource that should be available in every school.

We all want to provide children on the autism spectrum a bully-free and safe environment, but we cannot do that alone. Only through knowledge and awareness will we be able to counter the ignorance and fear that currently exist in our school systems.

New Resources to Help Keep Children with Autism Safe

Cosmonaut Creative Media

The National Autism Association is making headlines for advocating the implementation of a diagnostic code on behalf of minors with special needs that have a history of wandering. A serious risk among children with autism is death associated with wandering, including accidental drowning and exposure. A special diagnostic code would increase awareness among physicians about this phenomenon and help disseminate critical prevention materials and safety recommendations. As we head into spring and then summer, accidents and fatalities associated with wandering will surely rise with warmer temperatures, making these issues all-the-more pressing.

In addition to greater preparedness and prevention, a diagnostic code would help police and search-and-rescue teams establish protocols for interacting with individuals that have autism. This dovetails nicely into the necessity of our police force to become more skilled in dealing with those in the community. As we have seen lately, too many avoidable tragedies have occurred when individuals with autism were unable to interact appropriately with officers.

Another related issue involving children with autism is the propensity to flee when their sense of safety is threatened. Statistically, these children are at a much greater risk for restraint. Unfortunately, I know this all-too-well as it has happened to my fifteen-year-old son multiple times and in multiple ways. 

Most recently, his anxiety was triggered in school, which caused him to flee his class and scream down the halls. While his teacher didn’t restrain him physically, she did tell him that he terrified the entire school and his classmates thought they were in the midst of another Columbine situation. I can’t tell you how devastated and humiliated he was to be told this. He even had a horrific nightmare that his teacher grew huge and sprayed him with pesticide and he died. Obviously, her tactics were as psychologically wounding as any type of restraint she could have used.

Since children with flight impulses have been known to disappear from environments where they are presumed to be safe, best practices entail addressing a child’s triggers at the source and having a response plan ready when an incident does occur.

Right now, there is a way to protect a wandering child with autism without having to wait for any changes to the diagnostic code. Project Lifesaver ( http://projectlifesaver.org ) fits individuals with a lightweight tracking device and trains teams to successfully recover them when they get lost. Cost of the service is twenty-five dollars per month for maintenance of the device, although sometimes the services are rendered for free. With the advent of the diagnostic codes, insurance would likely cover it as well.

There are so many ways parents of a children with autism need to address their safety, especially since their emotional and physical needs are so directly and powerfully linked. 

It’s essential to connect with existing resources within the local community and for those resources to be strengthened and expanded. And ultimately, it’s the people who interact with our children on a regular basis who are the ones that will be instrumental in helping us keep them safe.

Bullying Victim Casey Heynes Exacts Revenge, Gets Suspended

The Internet and blogosphere have been buzzing all week about a bullying incident that occurred on Monday in Sydney, Australia. Sixteen-year-old Casey Heynes was the target of repeat bullying by numerous students at Chifley College, Dunheved Campus at North St Mary’s and can be seen in a video once again being tormented by a fellow student. However, the video, which has gone viral this week, shows an unexpected turn of events when Heynes decides to retaliate and ends up body slamming his 12-year-old attacker, who has been identified as Ritchard Gale. Despite the clear act of self-defense, the school made the decision to suspend both Gale and Heynes once the video began to circulate online.

The bullying had been so severe for the overweight Heynes, the Daily Telegraph reported the following:

Casey’s father said yesterday his son had been the victim of bullying for several years and feared for his safety if he spoke about the fight.

“There’ll be reprisals from other kids in the school and he still has to go to school somewhere,” he said.

Luckily, no one was hurt in the incident, despite Gale getting up with a severe limp after being slammed into concrete.

This story is important because bullying is all-too-common for children on the autism spectrum, particularly those who are high functioning. While the incident was unfortunate, it is encouraging that it is receiving so much attention as it will certainly bring greater awareness to bullying and some of the torment that many students have to endure on a daily basis.

Most incidents of bullying don’t turn out like this and it’s safe to assume Ritchard Gale will think twice about picking on someone again. Kudos to Casey.


Law Enforcement Woes Associated with Autism Continue

A recent Virginia case in which an teenager with Asperger’s was sentenced by jury to ten-and-a-half years in prison for assaulting a police officer is a horrible tragedy for all concerned. 

News accounts reported that the teen went to the library, but finding it closed, sat down outside on the grass. It was pointed out that the teen happens to be black and nearby school children became afraid and complained to the school crossing guard, saying that he might have a gun. Police were then summoned.

A single officer approached the teen, checked him for a gun and found no weapon. He then asked his name several times with no response. Because the teen wouldn’t tell the officer his name, he grabbed the youth by the arm and threw him over the top of his car in order to cuff him while declaring him under arrest. A struggle ensued and the teen caused injuries to the officer. 

This is a terribly disturbing case on many levels. The officer is himself the father of mentally challenged thirty-three year old and on that basis, was said to be highly sensitive of those with developmental disabilities. However, an officer experienced with autism would not expect their subjects to answer all questions asked or find the need to suddenly grab and arrest them. Why was there no call for back-up?

So basically, a young man with autism was sitting outside a library waiting for it to open and then a short while later, an officer is injured from a struggle and now a young man faces over a decade behind bars. 

This is the latest in a series of avoidable tragedies, including the wrongful deaths of two young adults with autism in Los Angeles. All of the cases share the fact that the suspects were committing no crimes, but failed to respond properly to police commands. The concerning element is without proper training and awareness, the number of these cases are going to expand exponentially as more and more children with autism grow into young adults. 

Because the teen had another incident on his record, the prosecutor maintained that he was wasn’t impaired by autism, but rather is an innately aggressive and dangerous person. The fact that the jury bought this parsing of conditions is not good news for anyone.

In a previous article, I advocated for a voluntary autism registry, but that is a distant goal that requires a great deal of work and effort, even after communities agree that it’s needed. I am now thinking that teens and young adults with autism should carry visible medical alert indicators such as a bracelet or necklace to notify officers of their condition and provide an emergency cell phone number of a caregiver. 

Of course, the need for more officer training in autism is only amplified by these heartbreaking turn of events. 

One of the premier organizations that offers autism training for officers is run by Dennis Debbaudt. Dennis is an ex-law enforcement official, father of a son with autism and the founder of Autism Risk and Safety Management. We interviewed him a few years ago and he provided some great insight into this emerging problem and what is being done to address it.

While his organization is doing a tremendous job, much more effort is needed by others to address this growing problem so these types of incidents are minimized or completely eliminated in the future.

 
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