Asian Family Health Workgroup: Parent tips on autism

For those of us who do not have Autism (ASD) we are able to use our vision and our social
skills to recognize and explore things and keep track of what’s going on around us…but, unlike
kids without ASD, kids with ASD have a lot of sensory differences, especially when it comes to
looking at people and using their vision. For example, most kids with ASD have a very, very hard
time using eye contact in social situations with other people to explore things and figure out
what’s going on. From a very early age, children with ASD find that making eye contact and
using social skills can be very overwhelming. Also, we have learned that most kids with ASD
have a very hard time “filtering out” things in their environment that are bothersome to them
and sorting through what the most important thing to focus on might be, whereas those of us
without ASD can do this automatically without thinking or using too much energy. So, these are
the reasons why sometimes kids with ASD end up using alternative senses to explore their
world and over-use one sense more than another or are unaware of some of their other senses.

It’s important for us, as parents, to not just let others know that our kids are different, but to
also help people understand why they are different. For example, instead of saying, “Our son
behaves like that because he has Autism,” it’s better to explain his behaviors and say “He
makes that noise and puts his hands over his ears when he gets overwhelmed, because that is
how Autism affects him. He hears you and he sees you, but he just does it differently.”

It’s important to know and understand your child’s “developmental age” which is based on
his developmental delays. This age may be different than how old he is. This can be frustrating
for parents, but if your child has some delays, his social, or play skills may also reflect his delays.
For example, if your child only began to speak or communicate when he was 4 or 5, whereas
most kids begin to do this when they were younger; you may need to adjust what you expect
from him so that he has more time to catch up with these skills. It takes time and patience as
well as using a lot of social stories or visual supports like picture schedules or behavior charts.
Understanding this and using new tools will help you and your child feel less frustrated.

It’s very important for us as parents to help teach behavioral and social rules to our children
from an early age, even if they have special needs. It’s not always easy to teach this to children
with special needs, however there are a lot of tools available that use visuals to help to do this
and it’s most important that the family reinforces these expectations very clearly. By learning
what our kids’ senses and needs are we can help find substitutes and learning tools to help
them to understand these situations. It is important for parents to learn from teachers about
what to do and it takes a lot of practice and consistency to change behavior.

Playing with genitals directly with their hands or by lying down or rubbing on something with
their genitals is normal for all children as they develop and explore their bodies. However, how
children learn to manage this is most important. When a child has Autism, teaching them how
to manage this in combination with their sensory-seeking needs and their more limited ways of
finding enjoyment in social and play activities, can make this a very difficult issue. The sooner a
family helps their child to find a way to more appropriately manage this natural tendency, the
better it will be to reduce that chances that masturbating will become problematic as the child
gets older.

• First: in a clear way, make sure your child is told or shown that this activity is for
  “private time.” So use pictures or few words and show them that this can only be
  done in private, such a bedroom or bathroom.
• Second: Although masturbating is a natural tendency, many kids with special
  needs use it to satisfy their cravings for deep pressure and sensory input since
  this need is not often satisfied during their daily routine. All kids need to move
  around and use their bodies enough to receive the important feeling of
  satisfaction that most children get from physical play. If a child is not getting this
  sensory experience at least three times a day in their daily routines through
  running around, rough-housing and playground time, then they will find it on
  their own, in any way possible; quite often through masturbation. So, make sure
  to offer other options for sensory input for your child at least three times per
  day. There are many ways to do this for your child, but it requires a family or
  school that is willing to put in the time and effort. You can look at “sensory diet”
  ideas on the web or explore the video “No Playground? No Problem!” on the website
  www.smallworldspecialneeds.org . It is available in 7 subtitles, including Chinese.
• Third: No matter what your child’s disability is, it is very important that you and
  your family take responsibility and initiative to teach them about sexuality issues
  so that they do not learn the wrong thing from others.

Kids with ASD do not always automatically recognize the subtle sides of social situations, for
example, how others see them or the ability to recognize feelings or emotions in themselves or
others. When a child is “ramping up” or escalating, it’s not usually helpful to tell them to just
“calm down.” Imagine if you were upset and someone told you to “just calm down”? Most
likely, someone saying this to you would only make you feel more upset, and it’s the same for a
child being told to “calm down” when they are so hyper. It is more effective if you use this
moment as a teaching time to reflect to them and say “you are very excited right now.” This can
help them to learn self-awareness, new emotional vocabulary words and to label their feelings.
This is what we call, “a teachable moment.” Then they can learn that “when I behave like this, it
means I am excited and I may need to have a lower voice or calmer body.” Keep in mind that the longer a child has a habit, the longer it may take to create a new way to manage it, so the best thing you can do is to be a consistent, firm and patient teacher to your child. Even consider giving them a small reward, like a hug or a high-five when your child is able to both recognize how they are behaving and then regulate themselves and quiet down. Remember, it takes an average of 85 times to learn a new behavior well, so make sure you have fair expectations for your special child.

• Remember that most kids with ASD have a very hard time making eye contact and it may not appear that they are listening to you when you speak with them or show them something. Instead of telling them to look at you, it’s best to say to them, “Show me how you are listening.” This then becomes something you can learn from your child, so that you can also be his best teacher.
• Remember that parenting is a long process that takes a lot of time and patience. If your child has special needs, it will be critical for you to develop many visual tools to support his skills. You can see many examples of visual tools on the web or look at some on the https://smallworldspecialneeds.org/ website in many languages.
• Remember, most kids take a long time to learn new behaviors whether they have special needs or not. Parenting is best when you have others to share in your challenges and your joys…we encourage you to reach out create a community of support along your journey.
• Remember that NOT every behavior a child has is because they have a disability…many times kids have difficulties just because they’re kids and they are of an age where certain things are challenging, such as sharing!
• One of the best things a parent can do is help to teach their child how to deal with disappointment. Also remember that the concepts you may be trying to teach your child, such as sharing or loving, can be very abstract and hard for them to really understand until they get older. Try to use as many visual aids as possible when you are trying to teach your child these skills because kids with ASD have a hard time when things are not clear, which makes many social issues really hard for them to understand.
• Dr. Clarke shared that it might be helpful to watch some of the TV shows like the “Big Bang Theory” and “Parenthood” because they have characters living with ASD and are portrayed very well.

对于我们这些没有自闭症 (ASD)
的人而言，我们能够通过我们的视觉和社交技能去识别和探索事物，并且留意周围发生的
情况……但是，不同于未患有自闭症 (ASD) 的儿童，患有自闭症 (ASD)
的儿童有很多感觉差异，尤其是在看人和使用视觉方面。例如，大多数患有自闭症 (ASD)
的儿童很难在社交场合下与他人进行眼神接触以探索事物和了解周围发生的情况。患有自
闭症 (ASD)
的孩子从非常小的年纪开始就会发现，进行眼神接触和使用社交技能对于他们来说非常困
难。我们还了解到，大多数患有自闭症 (ASD)
的儿童很难“过滤”环境中让他们讨厌的事物，可能也很难整理出最需要给予关注的重要
事情。而像我们这些没有自闭症 (ASD)
的人自然而然地就会做这样的事情，无需思考或付出太多精力。所以，以上就是为什么患
有自闭症 (ASD)
的儿童有些时候会使用其他感官去探索世界，而且，相对其他感官而言，会过度使用某一
感官，或者对某些其他感官毫无意识。

作为父母，我们不仅要让他人知道我们的孩子跟别人不一样，而且还要帮助人们理解
他们为什么不一样，这点至关重要。例如，不要说“我们儿子做出那样的行为是因为他患
有自闭症”，而应该解释他的行为“他在不知所措时会发出那样的噪声并把双手放在耳朵
上，这是由于自闭症造成的。他听你说话，也看你，只是他的反应跟别人不一样。”

知道并且理解您孩子的“发育年龄”取决于其发育迟缓程度，这点很重要。这个年龄
可能与他的实际年龄不一样。这点可能会让父母感到沮丧，但是如果您的孩子有些迟缓，
他的社交或玩耍技能可能也会反映出他的迟缓。例如，如果您的孩子在 4 岁或 5
岁时才开始讲话或交流，而大部分孩子在更小一些的时候就开始讲话或交流了；您可能需
要调整您对他的期望，以便让他有更多的时间来发展这些技能。这需要时间和耐心，并且
需要使用大量社交示例或可视化辅助工具（例如，图片式的计划表或行为演示图等）。理
解这一点并使用新的工具将帮助您和您的孩子减少挫败感。

作为父母，即使孩子有特殊需求，我们也需要从小就教导他们行为和社交规则，这点
至关重要。教导具有特殊需求的孩子这些内容并不非易事，但是有很多工具可以通过视觉
材料提供这方面的帮助。最重要的是，家庭需要非常清楚地强化这些期望内容。通过了解
我们孩子的感觉是什么以及他们需要什么，我们可以帮他们找到替代物和学习工具，从而
帮助他们理解这些情况。父母应向老师学习需要做些什么，这点很重要，改变行为习惯需
要大量的练习和纠正。

直接用手或躺下玩生殖器，或者用生殖器在物体上摩擦，这些行为对所有孩子来说都
是正常行为，因为他们正在发育和探索他们的身体。但最重要的是孩子如何学会管理这种
行为。如果一个孩子患有自闭症，结合他们追求感官刺激的需求以及他们在社交和玩耍活
动中寻找乐趣的方式更加有限这一因素，教导他们如何管理这种行为成了非常棘手的问题
。随着孩子年龄的增长，家庭越快速地帮助孩子找到更加合理地管理这种天性的方式，手
淫成为问题的几率就会越低。
• 首先要明确一点，确保告诉或者向您的孩子说明，这种行为是“私密行为”
。所以，可以使用图片或简短的语言向他们说明，这种行为只能私下里做
，例如在卧室或浴室。
• 其次：尽管手淫是一种天性，但很多具有特殊需求的儿童需要通过这种行为
满足他们对高压和感觉输入的渴望，因为这种需求在他们的日常生活中经
常得不到满足。所有儿童都需要四处走走并充分活动他们的身体，以获得
满足感这一重要情感，大多数孩子是从体能活动中获得这种满足感的。如
果一个孩子无法通过奔跑、打闹和玩耍在日常生活中每天至少获得三次这
种感觉体验，那么他们就会通过任何可能的方式（经常通过手淫）从自身
找到这种体验。所以，请确保至少每天三次为您的孩子提供其他感觉输入
方式。还有很多方式能够帮助您的孩子做到这一点，但需要家庭或学校愿
意付出时间和精力。您可以查看网站上的“日常感觉体验 (sensory
diet)”创意，或观看网站上的“没操场？没问题！(No Playground? No
Problem!)”视频www.smallworldspecialneeds.org。7
个子类可供选择，包含中文版本。
• 第三：无论您孩子的障碍是什么，非常重要的一点是您和您的家庭应该在性
问题方面负起责任并且主动教导他们，以防他们通过其他渠道学到错误的
内容。

患有自闭症的儿童无法始终自然而然地意识到社交场合中不易察觉的方面，例如，其
他人如何看待他们或者意识到自己或其他人的感受或情绪。当孩子情绪“高涨”或情绪升
级时，仅仅告诉他们“冷静”通常没什么用。想象一下，如果您正在难过，而有人让您“
冷静一下”。有人跟您说这种话很有可能只会让您感觉更加难过，在孩子亢奋的时候让其
“冷静”也是一样的道理。如果您将此刻作为教育时间做出回应并说道“你现在非常兴奋
”，可能会更加奏效。这样能让他们学习自我意识、新的情绪词汇和认识他们的情绪。我
们称之为“教育时刻”。
然后他们就会知道“当我做出这种行为的时候，意味着我很兴奋，我可能需要降低声音或
者让身体平静一下。”请注意，孩子养成一种习惯的时间越长，通过一种新方式来管理这
种习惯的时间就会越长。所以您最需要做的是，成为您孩子的老师，言行一致、坚强并且
富有耐心。如果您的孩子能够意识到他们表现如何，然后能够控制自己并安静下来，可以
考虑给他们一些小奖励（例如，一个拥抱或击掌）。请注意，平均需要 85
次才能学会一个新的行为习惯。所以，请确保您对您的特殊孩子的期望是合理的。
温馨建议：

请注意，大部分患有自闭症 (ASD)
的孩子都很难进行眼神接触，而且您在与他们说话或给他们看东西的时候，
他们可能不会听你说话。请不要要求他们看着您，最好能跟他们说“让我看
看你听得怎么样。”这是您能从您孩子身上学到的东西，这样您才能成为他
最好的老师。
• 请注意，培养孩子是一个需要花费大量时间和耐心的长期过程。如果您的孩
子有特殊需求，那么掌握很多可以培养他的能力的可视化工具就显得尤为重
要。您可以在网站上查看大量可视化工具示例或在
www.smallworldspecialneeds.org
网站查看部分示例，有多种语言版本可供选择。
• 请注意，无论是否有特殊需求，大多数儿童都需要花费很长时间才能学会新
行为。培养孩子的时候最好能有人与您一起分担挑战、分享快乐……我们鼓
励您常见一个支持群，在这个过程中为您提供支持。
• 请注意，并不是孩子的所有行为都是由于他们有缺陷障碍……很多时候，孩
子有困难只是因为他们还是孩子，他们正处于一个特定年龄，在这个年龄，
有些事情，例如，分享，对他们极具挑战！
• 父母能做的最好的事情之一就是教导孩子如何应对失望。还有一点需要注意
，在孩子成长到一定年龄之前，真正理解您努力尝试教会他们的那些概念（
例如，分享或友爱），对于他们而言是非常抽象和困难的。您可以在尝试教
导您的孩子这些技能的时候，试着使用尽可能多的可视化辅助工具，因为患
有自闭症 (ASD)
的孩子很难理解不太清晰的事物，这使得他们很难理解很多社交问题。
• Clarke 医生分享道，观看一些电视节目，例如，《生活大爆炸》(Big Bang
Theory)和《为人父母》(Parenthood)，可能有所帮助，因为这些电视节目
里有患有自闭症 (ASD) 的人物，并且塑造的很好。