As children become older, they begin to develop a sense of self. This is known in psychology as metacognition: becoming aware of yourself, your thoughts, and how you relate to others.
Research suggests metacognition is responsible for much of an individual’s responses in social situations and behaviors (e.g., (Nelson & Narens, 1990) (Grainger, Catherine, and Williams, David M. and Lind, Sophie E., 2016)).
This process can be particularly difficult for children with signs of autism since many of their self-soothing and repetitive behaviors already lead to ostracism and judgment in public social situations.
Many peer-reviewed articles suggest cognitive-behavioral therapy can be very helpful for improving self-esteem and reducing anger/anxiety-related behaviors in higher-functioning children with autism spectrum disorder (ASD).
Because every child is different, this approach was modified in different studies. In one study, higher-functioning children and their parents attended a nine-week CBT course. The course covered relaxation techniques, inappropriate vs. appropriate responses, differentiating emotions, and their positive or negative consequences, and more.
Parents watched their children on a monitor during the sessions and were given educational material to take home (Scarpa and Reyes).
For nonverbal children or children with more functional difficulties, a behavioral analytic approach (otherwise known as Applied Behavior Analysis) may be a better fit (Rosen et al.).
This method involves identifying links between problem behaviors and the environment and replacing those behaviors with more appropriate responses. For example, if a child is learning how to brush his/her teeth, the task will be broken down into individual steps (hold your toothbrush, turn on the tap, run the brush under water, etc.).
Every time the child correctly performs a portion of the task, the child is rewarded with a small snack or several minutes of a favorite activity.
Six evidence-based techniques to improve your child’s behaviors:
1. Create “social stories” to discuss potential stress-inducing situations before they occur, like “having a sleepover” or “eating lunch at school.” A visual learning experience demonstrates how to handle the experience appropriately and safely and shows examples of effective coping mechanisms despite potential uncomfortable situations. See autismspeaks.org for specific examples and template.
2. If possible, discuss the concept of thoughts that affect feelings that lead to behaviors. Understanding this connection can help you and your child identify what situations cause discomfort and some of the origins of his/her feelings. Once specific thoughts about situations are identified, more appropriate positive thoughts and behaviors can be selected. This is the basic framework of cognitive-behavioral therapy. See therapistaid.com for plenty of helpful kid-friendly handouts and templates.
3. Help your child to think critically about his/her assumptions. If he/she gives definitively negative statements about himself/herself, ask, “Is that completely true?” Then explain the child’s positive traits. This helps train the child in positive self-direction combined with critical thinking.
4. Praise attempts at good behavior, not just complete successes. This will help the child understand that even if we don’t succeed, trying our best can also have positive outcomes and help us learn for the next time.
5. Encourage your child to express himself/herself through art or other passions. Painting, playing an instrument, drawing, and dancing are great forms of expression. When your child finds something he/she is passionate about, participate in the activity as a family for some bonding time! After finding something your child enjoys, you can begin to model social tasks, like taking turns and sharing.
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6. If financially available, enroll your child in ASD-specific supportive therapies. Find a parent support group, and make sure you are taking time to care for yourself.
Research into ASD has come a long way, with many different therapies available depending on your child’s specific situation. Unfortunately, many of these therapies are time-consuming and expensive.
The current COVID-19 pandemic complicates this issue even further, as many of us are in quarantine with our families. The activities listed above are some examples of things you can do from home with your child, and hopefully bring you closer as a family. It is essential you begin helping your child to retrain his/her thinking around negative self-talk.
As he/she becomes even more cognizant of his/her thinking and development, judgment will be more difficult to deconstruct. Begin by working with your child on his/her thinking patterns and help him/her see the many things that make him/her incredible and wonderful.
Angela Scarpa and Nuri M. Reyes, “Improving Emotion Regulation with CBT in Young Children with High Functioning Autism Spectrum Disorders: A Pilot Study”;
Grainger, Catherine, and Williams, David M. and Lind, Sophie E. (2016) Metacognitive monitoring and control processes in children with autism spectrum disorder: Diminished judgment of confidence accuracy. Consciousness and Cognition, 42. pp. 65-74. ISSN 1053-8100.
This article was featured in Issue 107 – Caring for Your Autism Family