Expert: Dr. Sharon A. Mitchell - 12/1/2009

Question
My son is almost 11 and has been complaining of no one liking him, I have seen him with other kids and he will only  talk about what he is interested in and goes on and on about it until they go away. He also yells out "hello...." to kids at inappropriate times. He talks loudly to his peers and asks weird questions.

Also, he has always had anger outbursts but now they are changing. He yells and screams and is easily frustrated about doing daily living skills he has been doing for a few years now. I am confused at these new behaviors and am unsure how to handle them?

Answer
This is hard for a parent to watch, isn't it?

Only wanting to talk about what interests him is common with kids with autism spectrum disorders. They have their interests at the forefront of their mind and can't see why the topic could not possibly have other mesermized as well. Unfortunately they are not skilled at reading body language or picking up subtle clues so do not realize that they have bored their audience or monopolized the conversation.

That does not mean it needs to be this way forever. There are things you can do to help your boy.

You could work on reciprocity, the art of the back and forth of conversation. This is something that typical kids just pick up naturally but often must be taught to kids with autism.

Use a timer and set it for 30 seconds. Let him speak on any topic he wishes. When the timer goes, hold up a stop sign (one you've made). He now must remain silent while you speak for 30 seconds. when he can tolerate this, change the rules a little. Initially when it's again his turn to speak, he may take up exactly where he left off, regardless of what you might have added to the conversation. So, have him repeat your last sentence before he can speak his piece. When he's able to do that, change the game again. He can only speak if what he says is related to what you just said, training him to listen to what the other person says.

You can also help him learn to read body language. If people look at the ground, shuffle their feet, hunch their shoulders, turn their shoulders away or try to move, then those are likely clues that he has talked too much. To repair the conversation he can ask them a question about something THEY like. Or apologize for talking too much and ask what interests the other person.

If you go to the website www.do2learn.com, you can find some free games that help kids learn to identify facial expressions and body language.

Is this social difficulty new for your son? Did he seem to interact more easily with kids in previous years?

When children are younger, they tend to play with things and the rules to games are pretty well understood by all. But as puberty approaches, kids alter in their interactions. Social talk becomes more important, along with wearing the "right" clothes, listening to the cool music, using the popular slang, etc. These are all subtle things that often go right over the head of children with autism. Your son may sense a change in the other kids and is confused about why things do not seem to be as they once were.

You can help by selecting clothing that won't make him stand out, introducing him to popular music, familiarizing him with slang and other pre-teen lingo. He certainly does not have to become a fashion plate but neither should he stand out. A Barney lunch box is no longer cool at his age, even though he's loved his since he's been 5.

As for the outbursts, is he ill? Since autism is a processing disorder, sometimes kids can have an ear infection, a kidney or sinus infection or problems with headaches without mentioning anything because they have trouble processing and interpreting their feelings. I would suggest that a medical check-up is the first step to rule out any physical cause for the increased outbursts.

It could also be that the hormones of puberty are already at work in your son even though he is not quite 11. Puberty can be a difficult time for many youngsters but it is especially confusing for a child with autism. Be frank with your doctor about the past and present behaviors.

Is your son on medication? Some kids with autism take no medications; others find that they are helped by taking some type of med. If your son has been on medication for a while but you feel that it is no longer having the positive effect it once did, possibly your son's increased body size or changing metabolism with approaching puberty can created a change that necessitates a review of his medications.

Best wishes,

Sharon A. Mitchell, B.A., B.E., M.A., Ph.D. candidate
www.autismsite.ca