Sunday 19 November 2017

David Coleman: My grandson has autism and we're struggling to cope

Photo posed by models
Photo posed by models
David Coleman

David Coleman

Advice from parenting expert and clinical psychologist David Coleman on how best to help a child diagnosed with Autistic Spectrum Disorder and on how to deal with a five-year-old daughter's masturbation.

Q. My seven-year-old grandson has recently been diagnosed as being on the autistic spectrum. He has a younger brother aged six. The boys encourage each other in bad behaviour. The eldest is always invading the younger one's space, pushing, shoving, not doing what he's told, and not listening. The younger one antagonises and goads when no one is watching, and then just whinges all the time. My daughter's family is really coming under pressure and she needs some skills to help them to behave.

David replies: If your older grandson has an Autistic Spectrum Disorder (ASD) then that will influence how your daughter needs to respond to him and manage him.

The fact that the word "spectrum" is used gives an indication of the fact that within a diagnosis of ASD there can be a wide range of different difficulties, and the needs of one child with an ASD can be very significantly different to the needs of another child with an ASD.

So, as a starting point, your daughter needs to go back to the assessment team that diagnosed your grandson and see what, if any, recommendations they made about intervention and help.

In my view, the only point of assessing a child is to understand better what kind of help that child now needs. It is really useful when assessment reports also contain a well thought out and comprehensive intervention plan.

In many cases, however, the assessment process seems to be solely focused on reaching a diagnosis. Once that diagnosis is arrived at, few tangible resources are identified, or made available, to actually help and support the child and family.

Indeed, in some areas of the country, the assessment and intervention services are separate, such that when a child receives a diagnosis they are then placed on a further waiting list and could wait many more months and sometimes years for direct help. This is especially the case for slightly older children (like your grandson) who have moved beyond what might be considered "early intervention".

So, your daughter may need to make a fuss in order to get the help she needs to reduce the pressure they feel and to get guidance and the skills they need to be able to function more effectively as a family.

I don't know how significant the level of difficulty that your grandson experiences is. Although you say he has an ASD, it doesn't fully explain what his needs or difficulties might be.

For example, I don't how good his language understanding or expression may be.

That could be very significant in terms of his interaction with his little brother. For example, if your older grandson struggles to understand and process what is said to him, he will need to have simple verbal directions, perhaps combined with some kind of visual direction (like being physically guided, or physically shown what he needs to do).

Similarly, if he struggles to express himself verbally, then he may experience greater frustration that other people don't seem to understand his needs, as he best tries to let people know. That might also lead him into more conflict and rows with his parents and his brother.

Children with an ASD will often find emotions, and aspects of the non-verbal behaviour of others, very hard to read, such that they may say or do things that are provocative, hurtful, rejecting, or "cold", without any intention to upset or frustrate the other person.

Your younger grandson may feel resentful and distressed at his older brother's behaviour (even if its unintentional), such that his own behaviour becomes difficult and demanding. He may find it impossible to get any attention within the house, unless he whinges, since his brother's behaviour may take up so much of his parents' time.

So, the situation is complicated, probably more complicated than I can give straightforward advice and guidance about here.

With that in mind, your daughter needs to go back to the professionals who diagnosed her son and ask them for more assistance to support him, and her, in order to meet his needs.

My five-year-old daughter constantly masturbates. Should I stop her now or will she grow out of it?

Q. My five-year-old daughter was constantly "grinding" on her chair in school last year and I had numerous meetings with her teacher. She has done this grinding since she was a baby. I can remember her doing it in her high chair and she also does it in her car seat. She can't seem to stop herself and I can only assume she enjoys the feeling it's giving her. I don't want the other kids to start noticing her doing it and start picking on her. Can I, and should I, try to stop her doing it or is it something she will grow out of?

David replies: For your daughter, as with any child, the sensory experience of touching her genitals against different surfaces (or for other children with their own hands) is pleasurable. Occasional masturbation, like this, is also completely normal. What might make it problematic is the frequency, intensity or public nature of her "grinding".

For most children, engaging in such self-gratification is an occasional tension release, a response to boredom or a need for some comfort. Some young children will be entirely unselfconscious, like your daughter, and some will be more discreet.

By age five, most typically, children will have learned to keep any masturbation private. This is due to their own growing self-consciousness and because their parents have probably been reminding them of the need for privacy for some time.

Your daughter either hasn't received this message, or has ignored it because the stimulation she receives from the "grinding" is so pleasurable that it overwhelms her. It may also be something that is so habitual that she just isn't aware enough to be able to consciously stop or distract herself.

I do think, because of her age, that you would be wise to intervene.

You do need to help her to become aware of her behaviour. You will need to be clear with her that the masturbation itself is not a bad thing, but that the public nature of how she engages in it is problematic.

It will help to know why she masturbates so frequently. Is it to do with pure habit? To do with comfort at times of stress? To do with filling in time when she is not engaged or focused on anything else? Or, is it mainly to do with seeking out the intense pleasure of the physical experience?

There are two key aspects to helping her change her behaviour. The first is to raise her awareness of what she is doing. So, every time, she "grinds" you need to let her know that you notice it. Then she needs to be steered to a more appropriate time or place.

Linking the "private" nature of her genitals to the need to keep any touching of these parts equally private will help your daughter to understand a consistent message. Again, you are explaining that rubbing those private parts is not a bad thing, but it is only okay to rub them in private.

It will also help to find a way to distract her, or to engage her in a more appropriate behaviour. This is where understanding the main reason why she grinds is helpful as it might indicate the best kind of distraction.

So, some other comforting behaviour, like getting a foot rub, or back massage might help. Or, she may just need to get up and start moving, or get focused on some other task that will keep her mind from drifting.

You don't mention how she is getting on in school this year, but you definitely need to talk to her teacher again this year as he, or she, also needs to understand the plan and have some way to adapt it to the classroom.

Creating some kind of signal, that the teacher and your daughter are aware of, will allow the teacher to alert your daughter to the fact that she is masturbating.

Then, like at home, you and the teacher need to find some creative ways to distract her or divert her attention.

Hopefully, the repeated awareness-raising and distraction will help your daughter to become discreet and private such that she keeps her "grinding" to moments of secluded contemplation, reducing the frequency and intensity to a more appropriate level.

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