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Autism/4 year olds behaviour

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Question
Hi Sharon,
I have a little girl aged just four who is awaiting assessment for autism spectrum disorder. I am writing asking advice on her behaviour as there is going to be a long wait for assessment and during this time I am without support and finding her behaviour increasingly difficult to manage. I also have three other children, two diagnosed on the spectrum also.
My daughter is extremely bright, she talks in full sentences, can hold complex conversations, can read, write, spell etc however the difficulties lie mostly in her social,emotional development and her inflexability and need to be in control at all times. It's like living with a teenager at times.
If I ask her to do anything she will refuse, make excuses like her legs are broken or she is too tired. I cannot reason with her, she will argue everything. If I put her in timeout she will be hysterical and seems to kind of get too upset and cannot calm down, she will often say sorry after but then repeat the behaviour.
Where as other children will get a bit upset over trivial things my daughter will suddenly completely loose control, scream, kick, punch me in the face even. What concerns me more is that she never seems to show any remorse for hurting people.
She always has to be in control and the center of attention and thrives adult attention. If I have a phone call and ask her to play quietly she will talk over my conversation. If I move to another room she will follow making it impossible. If we have visitors its the same.
She will often behave in a way that deliberately upsets people such as making a repetitive noise dispite being told to stop, she will climb the slide and refuse to come down when the other children are waiting or take much more time than she needs if someone needs to use the bathroom.
She is extremely confrontational and her meltdowns can last for over an hour.
At the moment things are really getting me down, the house feels like chaos much of the time and as much as I try to maintain control I just don't know what to do, things seem to be spiraling out of control and no matter how consistant I am the behaviours don't change.If it's not one child having a moment its the other, the constant shouting and crying, argueing, fighting and meltdowns and leaving a trail of mess everywhere they go. I devote lots of time to my children so its not that they are without attention.  I want to enjoy my children dispite there special needs but at the moment I dread every morning and often feel completely overwhelmed and exhausted. The first thing I think in the morning is here we go again. I feel all my confidence as a parent has gone and just don't know where to start, feel completely  overwhelmed by my situation at the moment. I am trained as a nursery nurse and have a lot of experience with children but don't know how to change things. I do not know if my daughter will get a diagnosis, we have been told she has a lot of red flags but either way that doesn't help my situation now. How can I gain back control and have a peaceful home?  Thank you in advance for your response.

Answer
First, you have my admiration. If you have two children already diagnosed with an autism spectrum disorder (ASD) and suspect that your third child may also have autism, you have an incredibly full plate. Yet, even though it's tough, you are managing. You don't mention a spouse. If you are doing all this as a single parent, my hat is off to you and your children are incredibly lucky to have a woman like you as their mum.

It sounds like this little girl is likely younger than your other children if two have already received a diagnosis. Since there may be a genetic component to autism, then it is a possibility that your youngest may also be on the spectrum. There is also a possibility that she is copying the behaviour of her older siblings, or using the behaviours at her disposal to control her world. That will make it a little more difficult to tease out the factors contributing to the "red flags", but not impossible.

But, from your point of view, I'm not sure the label is the most important thing. What you likely want are ways to make your children's lives (and your own) calmer. I understand that you must be just exhausted when you fall into bed at night. Your days might be full of responding to crises.

Do you have any options for respite? By that, I mean, does anyone come in to look after the children so that you might have a break? Even time to go out for a quiet cup of tea of your own, or to visit with friends might help. There are a # of autism agencies in London; they would be able to tell you about the respite options near you.

Apart from respite options, what I think might help your situation is if you were able to take back control of your household. It's my guess that you have tried to establish routines and likely, you have a certain way/time you want things done. Neurotypical children would automatically pick up on your routines, but kids with autism likely won't. They need to be taught these routines. And, since kids on the autism spectrum take in information that they see much more readily than that which they hear, teaching these routines should be done visually. The easiest way is with a visual schedule. Rather than verbally repeating over and over what you want done, show the kids on a visual. You could fill your home with visual schedules - one in the bathroom for their morning routine, one on the fridge for how breakfast should run, one by the door with pictures showing how they should hang up their coats, etc.

Does this sound like a lot of work for you? Yes, initially, it is work to create these schedules. But you need not be an artist. A stick-figure rendition will work, or you could cut out pictures from a catalogue or magazine. A website that offers many free pictures and suggestions on how to make such schedules is www.do2learn.com.

But, you do not need to jump right in with this. Pick the time of day that you find the most trying, such as getting the kids into bed at night. Create a schedule for how you would like this to flow. Keep the schedule displayed prominently. Then, teach the kids to use the schedule. Remain firm that this is the way things are now.

You will need to know that whenever you initiate a behaviour program of any kind, the kids will resist. They are comfortable in what they are doing (even if it feels chaotic for you) and change is difficult. They will rebel. They behaviours you wish to eliminate will increase temporarily as the kids try to assert their will. Stand firm. You will win in the end and life will become easier for all of you. Kids actually take comfort in routines and rules and limits. The negative behaviours will decrease. They will not all go away as they are still kids and kids with ASDs. But, the more calmness that presides over your household, the better equipped you will feel to handle those flare-ups when they occur.

If you're thinking that this sounds overwhelming, it could be if you tackled everything at once. Instead, begin with just one small thing, perhaps the time of day that bothers you the most and get that routine firmly in place. You will feel more in control and less like you are merely reacting to what's going on all the time.

It might help if you read this short book. It's a novel about raising a 5 year old with autism. I wrote it because I was often told by parents and teachers that they have no time to search the internet for help or to read textbooks. So, I wrote a short, easy-read novel that demonstrates some of these techniques in action in a home and in a classroom; there's also a little romance in the story. I was lucky and the book became an Amazon bestseller. You can get the e-book for £1.99. It is available in paperback version as well. The book also talks about some of the sensory calming techniques that might help your children. I think the book might give you some ideas. You can take a look at http://www.amazon.co.uk/Autism-Goes-School-Book-Daze-ebook/dp/B0085HN9HQ/ref=sr_.

You have my admiration. Although sometimes you may feel like you're at your wits end, you are hanging in there for your children. They are very lucky to have you for their mum.

Best wishes,

Autism

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Dr. Sharon A. Mitchell

Expertise

Sharon can help with parenting and educational concerns. She has worked in teaching, special education, counseling and consulting for over thirty years and gives workshops to educators and parents on working with kids with autism spectrum disorders. Sharon speaks from both the education and parent points of view, having an adult son with Asperger's.

Experience

Sharon has spent decades as a special education consultant with a school district and autism consult for the province's Department of Education, giving workshops and individual consults. Currently she works as regional autism consultant for a health district in between teaching university classes. She is an Amazon bestselling author or a series of novels, each depicting a child who has an autism spectrum disorder. Sharon's Master's thesis looked at the long-term outlook for persons with high functioning autism and Asperger's. Her Doctorate focused on strategies to help those with autism spectrum disorders.

Organizations
Website at http://www.drsharonmitchell.org and sits on Autism Today's Panel of Experts (www.autismtoday.com)

Publications
Author of "Autism Goes to School" - a novel about autism that that became an Amazon bestseller. Get this Amazon bestseller free at http://www.drsharonmitchell.org. In the next book, Autism Runs Away, Ethan is only in grade one and already has been kicked out of one school due to his tantrums and pattern of running away when in a panic. Now in a new school his mom remains glued to her phone, waiting for the call to tell her that they don’t know what to do with a child who has autism. Sara is about to learn if this new school is up to the challenge. (https://www.amazon.ca/Autism-Runs-Away-Book-School-ebook/dp/B01FCYQ7DC). Autism Belongs is the 3rd book. Manny's life has shrank to the confines of their house. His parents are desperate not to rock his world because the aggression has gotten to much worse. Where will this lead? Is there a chance that Manny could actually belong out in the world? You bet! Get a free sample at https://www.amazon.com/Autism-Belongs-School-Daze-Book-ebook/dp/B0184ZQMI6. Book four, Autism Talks and Talks, is about a 12 year old girl who has Asperger's. She's bright, inquisitive, highly verbal, but lacks social skills. Try a free sample at https://www.amazon.ca/Autism-Talks-Book-School-Daze-ebook/dp/B01IIUZH3S Book five, Autism Grows Up features Suzie, a bright, twenty-one year old whose life collapsed after she finished high school. Now, she lives in her mother's basement, spending nights on her computer, afraid to broach the world outside their door. Autism Grows Up is found at https://www.amazon.com/Autism-Grows-School-Daze-Book-ebook/dp/B01JB8QW3U. Prefer a boxed set? Get the first 3 books bundled together at https://www.amazon.com/Autism-Box-Set-School-Books-ebook/dp/B01KBEHJ08. Co-author of Amazon.com bestseller, The Official Autism 101 Manual (http://autism101manual.com/).

Education/Credentials
B.A. in Psychology, B.Ed. in Special Education, M.A. in Educational Leadership PhD. in Psychology Management, specializing in autism.

Awards and Honors
B.R.A.G. Medallion for the novel Autism Goes to School - Book 1 in the School Daze Series. (http://www.bragmedallion.com/medallion-honorees/2013/school-daze-autism-goes-to-school). Like Autism Goes to School, the third book in the series, Autism Belongs, also ranked #1 on Amazon (http://www.amazon.com/Autism-Belongs-School-Daze-Book-ebook/dp/B0184ZQMI6). Manny is not like other children. He doesn’t talk. He doesn’t leave the house. His parents desperately try to arrange their world so that Manny does not get upset. Because, when he does, well, the aggression was getting worse. At ten, Manny was becoming difficult to handle.

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