Asperger Syndrome: Some Common Questions (continued)

I meant to say that this boy is 14 years old. . .

If he's 14, I'd also be looking at whether his world is actually shrinking, because he may be aware at 14 of his differences, and retreating from the world, so I'd also be looking at some of the signs of depression as a possibility at this stage. That lack of interest in other activities, etc. may be a sign of depression.

With a teenager at 14, I would look for that because often at 14 not only is it a time of hormonal change - but he may be going through an insight into being different. So, he may need a bit of help in that area too.

What is the best way to handle meltdowns and temper tantrums with youngsters?

With the temper tantrums, you may know with an individual that a certain situation is fraught with frustration, and potential anger. You know that the stress and strain of school days, which are so long and arduous - it's like a compressed spring. It's compressed, and compressed, and compressed, and when they get home, there's an explosion, and there's that Jeckyl and Hyde component. You may know that after school, it may be a time for going for a run, going for a walk, watching a TV program, or whatever it is, to get it out of their system, to debrief or to get rid of that tension.

There are ways that parents may pick up the signs — it may be rigid thinking, it may be being intolerant of imperfection - but there are warning signs that this person is starting to get agitated. So, in other words, the circumstances or warning signs may be a clue.

However, with AS, there are times when it comes out of the blue. When you have no expectation that it's going to occur, that it's out of proportion to the situation - it takes everybody by surprise. Often what occurs is that it's very, very intense, but brief, and at the end of it - "I'm fine, why are you crying? Why are you upset, I'm all right now" - not realizing that with that whole process, everybody else is unstable for some time. What you have to go through is a program on emotions and anger management for that individual, so that they can, hopefully, telegraph their anger before hand in more constructive ways.

We use what we call constructive destruction — it's basically vandalism, and it's what teenagers do because they hate the system, they will wreck things — so we call it recycling. One child we have has major problems with his mood swings, which seem to go up and down quite phenomenally, and includes periods of severe anger. But when he's coming up to those periods of anger, he's got cans to crush, telephone directories to tear up, there are all sorts of things that he's recycling because he's fascinated by the environment, geography, and recycling. He can be channeled to do that and feel better, having done that sort of mini-vandalism to get it out of his system.

Anger is an issue, because it can be the one reason that children are expelled from school. They may be okay with their school work, they may be reasonably coping with their social life, but if you have one or two periods of anger, especially if somebody is hurt, then you're often excluded from school. So, there are a number of kids, especially in adolescence, because of one or two episodes where the person has been teased, or has been wanting to join in a group, or misunderstood circumstances, that the anger and the intensity of it gets everybody frightened about the situation. So there are areas in anger management that need to be gone through, but really it requires someone with expertise in both AS and emotions.