Hi there and welcome to this week’s blog post. Whilst driving home today in my car I’ve been listening to the radio; and apparently there are a lot of people wanting to emigrate to Canada from the UK, following current tax reforms here. So a big hello to all you Canadian readers of my blog; and you should expect a few new people with funny British accents in your neighbourhood sometime soon! Anyway radio ramblings aside here’s this week’s article:

Question

I would love to know how to deal with anxiety in Aspie children I have a son, 6 years old, who suffers anxiety and night terrors.  The anxiety can get so bad at times that my poor son will throw up out of fear.

Answer

Although sleep problems are not part of the diagnostic criteria for autism, sleep problems seem to go hand in hand with autism.  Many parents report this as a problem in their children with autism. A new study from the University La Sapienza in Italy shows children with Asperger’s Syndrome have more sleep problems than average children.  Dr. Oliviero Bruni, the researcher, found that children with Asperger’s have a high incidence of sleep disorders and other problems, such as getting to sleep and restlessness, as well as daytime sleepiness. The study, published in the journal SLEEP, November 1, 2007, states that 50% of the children with AS didn’t want to go to bed, 75% needed a light or television in the bedroom, 87% had difficulty getting to sleep, and 75% fell asleep sweating.

There are medications such as Seroquel, Klonopin, Celexa and others that may help your son.  Melatonin has had some good results, as have selective serotonin re-uptake inhibitors.  But avoid the use of Singular for asthma or allergies as many incidences of children having night terrors while taking it have been reported.  Some users have reported very vivid dreams and night terrors while on Strattera or while getting used to it.

Children and teenagers who spend two or three hours a day engaging in exercise have an easier time going to and staying asleep because they are more tired physically.  So, make sure that your son gets plenty of physical exercise.
However, sometimes Aspies who are over-tired experience night terrors, so you have to find out how much exercise is good, but is not too much.

Sometimes keeping a journal of one’s thoughts can help reduce night terrors.  Fears and concerns can be written down and that seems to reduce the brain’s need to process them at night.  Since your son is so young, perhaps he could tell you his thoughts and you could journal them for him.

Counselling may help night terrors.  Also, perhaps a medication is promoting night terrors.  Talk to your son’s doctor about this.

There are two Exploring Feelings books by the highly-acclaimed Aspergers expert Tony Atwood. One is designed to explore and manage anxiety, the other to explore and manage anger. You can read more about them by clicking here. The original program was designed for small groups of two to five children between the ages of 9 and 12 years, with two adults conducting the program. However, the Exploring Feelings program can easily be modified to be used with just one child. The activities can also be modified to be age-appropriate for an adolescent or adult. The program was designed as a treatment for an anxiety disorder or anger management problem in children with Asperger’s syndrome, but the program can be used with children with High Functioning Autism and Pervasive Developmental Disorder, Not Otherwise Specified (PDDNOS). The author also designed the program so that it does not have to be implemented by a qualified psychologist. A teacher, speech pathologist, occupational therapist, or parent can implement the program without having training in Cognitive Behaviour Therapy.

Until next time …
Dave Angel

PS – The new Parenting Aspergers website is coming on leaps and bounds and I am working with an excellent web designer called Valerie (co-incidentally out in Canada!) who is working hard on the final look and design. This week I’ve been working on ways to add Aspergers information using video to the site; which I hope will be another great feature. I am really excited about the potential help this site will be to so many parents.

Hello and welcome to this week’s Aspergers article. I’ve been burning the midnight oil a little of late and getting some information together for the new big project, specifically for parents of girls with Aspergers. The stat’s have Aspergers pegged largely as a male issue but I know from the survey I carried out a while ago there are a number of you with Aspie girls to look after. This is an area that I have probably neglected in the past so I’m working hard to make up for lost time! Here’s this week’s question:

Question

I would like to know the long-term side effects of Seroquel and Concerta medications.

Answer

Just as a precursor to this question (as it covers medication) I need to point out that I am not a doctor or medically trained individual and any information in this article is for information purposes only. You must seek appropriate medical advice from an approved health care practitioner for medical diagnosis and treatment. OK boring legal jargon out of the way let’s get on with the article …

Seroquel is an antipsychotic medication that changes the chemical activity within the brain. It treats the symptoms of schizophrenia and bipolar disorder (manic depression), which are psychotic disorders.

Be aware that the following is a comprehensive list of possible reactions to Seroquel. It is rare that most or all of these symptoms will occur.

As with most other medications, there are side effects when taking Seroquel. This medication might cause high blood sugar, diabetes, and suicidal thoughts. Also, Seroquel might cause impairment of thoughts or reactions to external events, and it is not recommended to take Seroquel if you are going to operate a motor vehicle. Another side effect of Seroquel includes adverse reactions if alcohol is consumed.

Please be careful if you are also taking medicine for colds/allergies, sleeping pills, muscle relaxants, or antidepressants. You can become sleepy if Seroquel interacts with these medications.

You will need to contact an emergency medical facility if the following reactions occur: difficulty breathing, hives, swelling of the face, lips, tongue, or throat.

Call your doctor at once if you have any new or worse symptoms such as: mood or behaviour changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts of suicide or hurting yourself.

Concerta is widely known to be a medication that treats Attention-Deficit Hyperactivity Disorder (ADHD). While Concerta offers a number of advantages over pre-existing ADHD medications, it has side effects that you should know about.

Concerta is taken once a day because it is a timed-release medication. It comes in capsule form, and it has an outer coating of medication that quickly dissolves when swallowed. The medicinal effect of Concerta lasts twelve hours, and the following need to be considered when taking this medication:

It should be taken in the morning hours. If a dose is skipped, wait until the following day; otherwise, your sleep/wake cycle will be affected.

A dose of Concerta cannot be adjusted. Any change in milligrams must be done with a new prescription. Also, a Concerta capsule cannot be mixed with food; this will prevent the proper release of the medication.

Concerta is not recommended for people with digestive problems.

A comprehensive list of Concerta side effects includes: abdominal pain aggravation, aggression, anxiety, depression, hostility, insomnia and prolonged sleepiness, loss of appetite, increased coughing, nervousness, sadness, drug dependence, dizziness, headache, tics, sinusitis, upper respiratory tract infection, vomiting, allergic reactions, increased blood pressure, and psychosis.

Concerta is not recommended for children under the age of six or pregnant women.

Also, Concerta may be habit forming.

Enjoy your day.

Dave Angel.

Question My 9 year old Aspie grandson is rarely happy, unless he is watching TV and/or eating. His self esteem is very low. Any suggestions to help self esteem or change his attitude from negative to positive would be wonderful. Answer

Successful experiences in your grandson’s life will build his self-esteem and give him a more positive attitude. In addition, when he sees that he is accepted and loved by others, he will feel secure and achieve self acceptance. Then, he may make more of an effort to try other activities.

Consider for a minute WHY he takes pleasure in eating and/or watching television. First, it’s safe and reassuring. He is familiar with television programs that he watches on a regular basis, and food is well known for providing psychological comfort. Second, it’s a predictable, solitary activity which always gives him the same safe results. He knows what the consequences of his behavior are, and he feels rewarded by them. Children with Asperger’s have a strong need to feel safe and reassured; they learn by following well-explained rules that contain predictable outcomes. These are the reasons for his repetitive, satisfying activities, and these behaviors can be managed in several different ways.

You must accept that he needs some time (at least for now) to watch T.V. and eating is a physical necessity. Consider that Asperger’s individuals are often confused and overwhelmed by choices; at this point, build in a few alternative behaviors for him to engage in, such as using a computer. Discuss his options with him, and let him pick an activity in addition to eating and watching television.

Watching television can be used as a reward for completing other tasks. Take him outdoors and encourage him to play a game or walk for a short period of time. When he has successfully completed the task, reward him with a specified period of time for watching television. Doing this on a regular basis will increase his tolerance for an activity. A good approach is to increase the activity time by one minute per session and praise him lavishly each time he accomplishes the task. After he gets used to one activity, add an additional activity, perhaps swimming or bicycle riding. Little by little, increase the amount of time per activity and the number of activities. Always remember to reward and praise him each time the activity is completed.

After you reward him, sit down with him and discuss what you both will do the next time you go out, how long you will do it, and what the reward will be. He’ll be more enthusiastic once he’s had a positive activity/reward experience and has received the reward and your praise. Remember to start with the easiest activities first – a scooter, then a bike, for example. Try to avoid gender stereotyping any of your grandson’s activities. If you can’t get him on a swing or scooter at first, then start with just walking and looking at nature. Use the praise and reward for that activity before you branch out. Once you know that he likes a given activity, he is more likely to willingly participate in it.

Your best approach is to avoid confrontation and use negotiation when you work with his likes and dislikes. This way, he will be more likely to try new things with you. Your relationship will be much stronger if he perceives that you are both on the same side!

Have a great day

Dave Angel

This week’s article covers the following question:

My son (age 9) seems to suffer from SAD. Is this common in kids with ASD/HFA? What can be done (other than SSRIs)?

An extensive review of the current literature does not reveal a connection between Seasonal Affective Disorder (SAD) and Asperger’s Syndrome (ASD) or high functioning autism (HFA). However, that does not rule out the possibility that there may be one. Obviously, further research needs to be performed to determine if SAD is linked to ASD/HFA.

Seasonal Affective Disorder, commonly known as SAD, is caused by sunlight deprivation, which, in turn, can cause a neurochemical imbalance in the brain. This imbalance can lead to feelings of sadness or symptoms of depression.

The symptoms of SAD appear during the winter months, beginning in September or November and continuing through March or April. A diagnosis of SAD is usually made after three or more consecutive winters when the following symptoms occur:

Depression, including feelings of misery, guilt and loss of self-esteem, sometimes hopelessness and despair, or apathy and lack of emotion;

Anxiety and tension and the inability to tolerate stress;

Decreased libido and disinterest in physical contact, intimacy, and sexual activity;

Eating disorders, such as craving sweets and carbohydrates, weight gain;

Lethargy, a feeling of fatigue and the inability to carry out a normal, daily routine;

Mood swings followed by periods of hypomania (over activity);

Sleep disorders such as oversleeping, difficulty in staying awake or asleep, sleep disturbances; and ocial problems, such as irritability and a desire to avoid social contact.

Most sufferers show signs of a weakened immune system during the winter months, and this makes them more vulnerable to infections and other illnesses.

A very popular method of treating SAD is the use of light therapy. Research has shown that light therapy is an effective treatment for SAD about 50% of the time. Specially designed lighting is used in the home, and the person with SAD is exposed to the lighting for a daily period of time. Whether this treatment will benefit someone with AS remains to be seen.

There are two types of light therapy treatment. The first is bright light treatment. The person with SAD sits in front of the light for a specified time period. The second type is dawn stimulation. This therapy takes place while the person is asleep. A low-intensity light source is set to turn on in the morning, before the person wakes up. This light gradually increases in brightness as time passes. Many people prefer the passive experience of dawn stimulation because it is more convenient and less intrusive than bright-light treatment. It may be more appropriate for AS sufferers.

In addition to light therapy, a person with SAD can spend more time outdoors in the daylight hours, thereby increasing exposure to the healing effects of natural light.

Currently, research is continuing to determine the most effective way to use light therapy. In addition, medications and counseling may also be used to treat your child for SAD. Treatment for SAD doesn’t cure seasonal depression, but it can help relieve your child’s symptoms.

As with any illness, check with your child’s doctor and a psychiatrist before trying any treatment.

Have a great day

Dave Angel