Caring for a child with autism spectrum disorder (ASD) could be stressful for parents and families. While children with ASD have unique strengths, coping with their challenges and maladaptive behaviors (e.g., aggression, repetitive activities) could elicit significant stress in parents and families. It is often helpful for parents to be equipped with valid information to better understand their child’s symptoms and behaviors associated with ASD
Better understanding of the patterns and reasonings behind the child’s challenges and behaviors could be empowering for parents, elicit increased empathy for the child, and provide ideas for more creative interventions to help the child better cope with their own distress and thus, reduce parental stress. Hence, we are presenting an article to discuss the neurological and psychological basis of common challenges and maladaptive behaviors seen in children with ASD.
Understanding Challenges with Social Communication and Social Interaction
ASD is a neuropsychological disorder. This means that the emergence of ASD and its symptoms in a child is due to deficits in distinct brain regions and the disruptions caused in the ways these brain regions communicate with one another. Amygdala is one of the brain regions that is understood to be disrupted in ASD. Amygdala regulates important social functions including social orientation (e.g., attending to social information such as what other people doing in the environment); social perception (e.g., understanding facial cues and body language of social interactions, learning to read others’ emotions and social cues); and social motivation (e.g., experiencing reward and joy when interacting with other people).
Amygdala Dysfunction and its Association with Social Difficulties
We often say that it is ‘natural’ for people to interact with one another. Not only interacting with others is beneficial for our well-being and historically, even for our survival, but emotionally, it is also a rewarding experience for us. We interact with people and build relationships with them because we want to; we like to. However, due to the dysfunction of the amygdala, children with ASD often don’t experience the same motivation, emotions, and reward to engage in a conversation or an activity with another person.
Amygdala also regulates functions that allow us to maintain social relationships (e.g., things we do to preserve a social relationship). Hence, a child with ASD may have significantly lesser social motivation to offer gestures of greetings and farewells, laughing at others’ jokes, and hide their true reactions and affect (e.g., verbally pointing out if someone smells bad). These social functions discussed here are all essential components of friendships and hence, children with ASD often have significant difficulties making and keeping friends.
As their caregivers, we are often uncomfortable and distressed when we see our children with ASD socially isolated. We may infer that the social isolation is causing them loneliness and sadness, but this may always not be the case. While it is not denied that children with ASD will benefit from friendships, we have to be patient, creative, and strategic in which we teach them about social interactions and building friendships.
Imposing increased social interactions to children with ASD without prior coaching and interventions may elicit considerable distress in them as they don’t have the neurological resources to adequately process the social interaction. The distress may lead to aggressive and anxious behaviors and further discouragement to engage in future social interactions.
Understanding Challenges with Restrictive and Repetitive Behaviors and Interests
Another common challenge seen in autism is persistence on engaging in repetitive and restrictive behaviors and insistence on carrying out routines and certain behaviors (e.g., eating the same breakfast; wearing the same shirt to school). From a neuropsychological perspective, challenges with restrictive, repetitive behaviors and routines, and rituals are related to their global difficulty with executive functions.
Difficulty with Executive Functions in ASD
Executive functions are often referred to as the ‘brain boss functions” as they are the ‘conductor’ of our cognitive skills. It is an umbrella term referring to a number of cognitive processes (e.g., attention, organization, time tracking, inhibition, etc.) that provides mental control and self-regulation in individuals.
Executive functions help us to manage ourselves and our resources to achieve a goal or complete a task. Research had shown us that difficulties with executive functions explain why children with ASD often struggle to inhibit repetition of behaviors or their cognitive rigidity to break away from the same routines and rituals.
From an emotional perspective, children with ASD often get very agitated and distressed when their repetitive, restrictive behaviors or same routines and rituals are interrupted. The agitation and distressed caused by the interference or interruption is understandable. The sameness and repetition of behaviors, routines, and rituals create a sense of safety and predictability for the child with ASD.
It may not make much sense to others as to why it is important for the child to follow certain routines or do things a certain number of times; these behaviors and activities could be deemed to be silly or unusual by the observer. However, these activities and behaviors help the child with ASD to make sense of their environment and maintain calmness internally. Thus, any interruption to their routines of restoring safety and predictability in their lives may elicit fear and anxiety in them. At many times, children with ASD struggle to verbally express those emotions and thus, often react with extreme crying, anger, aggression or other maladaptive behaviors.
It is the hope that information from the article will empower parents in becoming better advocates for their children and see the world through their children’s lens. It is a helpful reminder that what we consider to be atypical or abnormal, may not be that atypical for the child ASD. If we see the world through the child’s eyes, then we will better appreciate, and sympathize with their unique sources of joy and happiness and triggers of their distress.