Autism, Attention, Anxiety & Academics

There’s not much time left until the start of the new school year, and there are plenty of tips on the web about how to prepare your children for the event. Rather than those standard offerings, I wish to present another perspective, utilizing my extensive background with high-risk infants who graduated from the NICUs around the country, and focusing most recently on the developmental challenges of ASD and ADHD.

For the youngest children, especially under 3 years, consider NOT going to school. Neuro-typical children do not learn when they are sick, so it can be even more stressful for those with social and communication issues. The constant onslaught of germs causing colds, ear and other infections is more likely in an environment when children and teachers carry their cooties to school and smear them on each other. Being sick often delays improvement from other important autism therapies. Yeah, I know, this is often easier said than done, right?

For 4-6 year-old children, the most important skill is socialization. This involves watching other children play, learning to get along in that setting, and transitioning from one activity to the next. Parents should worry less about reading or arithmetic and focus on play. Kids learn much more from other kids than they learn from us, anyway. Concerned teachers often report that the child doesn’t focus or pay attention. Such behaviors often demonstrate immaturity, but stimulant and/or anti-anxiety medications weren’t made for children so young. Patience will often be rewarded.

The early school years are an important time to address doing basic, not advanced schoolwork. Holding back a child, especially in 1st or 3rd grade, may be helpful. However, too much repetition is boring and can result in disruptive behaviors in order to get attention. There is often a great deal of anxiety leading to obsessive-compulsive behaviors that confer some level of control for the affected patient. Calming supplements such as tryptophan and pycnogenol may help.

From 9-11 years, there needs to be an evaluation of the ability to focus on tasks. Frequent readers are aware that I am no proponent of medication. However, if it takes 4 hours to complete 1/2-hour worth of homework, it might be fair to try utilizing a stimulant medication to improve focus. Such intervention is neither a panacea nor a picnic. Drug ‘holidays’, correct dose and timing can assist with the effects of poor appetite, sleep and slightly decreased height.

Middle school is an important time for the family to assess what features the children need to work on in order to develop skills that will take them through life. A recent study demonstrated “Inattentive symptoms, in particular, were strongly associated with problematic video game use for both groups, and role-playing game preferences may be an additional risk factor for problematic video game use among children with ASD.” At The Child Development Center, we see this as a crucial age when parents do or don’t gain the upper hand.

High school students should be encouraged to get out of their own skin and help someone else. A church group, volunteering for an event, or mentoring younger children may be a possibility for some affected patients. According to Temple Grandin, “The idea of exposing autistic individuals to new experiences is a key concept for caretakers to grasp as they strive to show their autistic loved one the area in which they are truly gifted.” “The thing is you’ve got to push these kids,” Grandin said.

Finally, don’t give up on the biomedical interventions. Proper sleep and diet are as important to a successful school year as any other aspect of their development. After all, ASD and ADHD started out as medical, not psychological abnormalities.

Yes, it’s easy for me to say “Try this intervention or that strategy,” but observing the outcomes of so many children who have gone on to have their own children has been an important element in my education.

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Brian D. Udell MD
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