Expert: Catherine Ridenour - 3/11/2010

Question
I have a set of 5 year-old triplets. I suspect the eldest boy has mild autism.  He is normal in almost all developmental aspects.  He can speak well and can understand what is spoken to him.  What bothers me is his daily tantrums (many times in a day).  He gets frustrated easily when he doesn't get his way or when he can't do something, eg buttoning his shirt.  He has trouble controlling himself.  He would hit his brother or sister when fighting over a toy. He would also shout "STUPID" very frequently everyday.  Today he tried to poke his brother with a pencil.  He seemed to have forgotten in the heat of the moment that his behaviour is dangerous and unacceptable.  I have tried the hard and soft approach and both doesn't seem to work.  The problem is he doesn't seem to link the punishment to his negative behaviour nor does the positive reinforcement help reduce negative behaviour.   I'm concerned he may be getting more voilent. Although he is distracted in class (will climb below his table & not do his work unless the teacher supervise personally). he is the brightest among the 3.  How can I help him to manage his anger and improve his attention span & cooperate with his teachers?  I have scheduled an appointment with the psychologist end of Mar.  What are the things I should note and questions I should ask the psychologist.

Answer
Hi Chui Har,

You should tell the psychologist exactly what you have told me.

I'm guessing your son has what is now called Asperger's Syndrome. He does not understand social signals from other people in the intuitive way that you and I do. He does not realize that other people have thoughts and feelings like he does, so he treats them like objects. His inability to understand cause and effect (misbehavior and punishment) is one of the common symptoms.

Direct teaching can overcome much of this but he must learn appropriate behavior for each new situation. He will have difficulty generalizing from one situation to another. For example: learning to share the truck in the sandbox won't transfer to sharing the blocks in the classroom. Over time, he will learn more appropriate behavior and so behave better in more circumstances. Most of these kids are very bright with excellent memories. This helps them build a catalog of behavior to draw upon. It takes a long time, but he WILL learn.

Discipline is tricky with these kids. They don't really feel guilt because they can't put themselves in the other person's place. So, prevention of misbehavior is most important. If you see the hand come up for a slap, catch the wrist mid-swing and say, "Hitting hurts. No hitting." Redirect with a better choice, "If you don't want to share the book, use your words. Say, 'I will give you the book when I am finished with it.'" Always give directions for "next time" so he has a shot at doing it right. Time out may help, but mostly as a cooling off period, not as a time to contemplate his errors.

Teach him about the way his body feels when he is becoming angry. Talk about the tight fists, the hot face, etc. These kids throw tantrums because they don't recognize they are getting upset until it is overwhelming. Ignore tantrums as much as possible. If he throws himself on the floor, just leave the room. Take the other children with you. Having an audience makes it worse.

While some of his behavior sounds like hyperactivity, I don't think this is the problem. Only the psychologist can tell for sure.

Best wishes,
Catherine