Asperger Subtype: The Emotion Boy

Paranoid boy

Asperger Subtype: "The Emotion Boy" This is the most difficult type to deal with because rules and reasons mean much less to him or her. Many of the Asperger children fall into one of the emotion types. Their emotions control their behaviors. If you do not recognize and deal with their emotions, your success is diminished. This group has many more tantrums, is less available, easily disengages, or is more prone to acting out. Those dealing with the Emotion Boy can often find themselves in a state of frustration at best and a crisis state at worst. The vast majority of this group will end upon medications for their issues because their coping strategies are poorly developed and inadequate to meet the demands of the world. Fortunately, the right medication and an effective behavioral plan can do wonders.

Paranoid Boy
By far, this is the most difficult type. Fortunately, their numbers are small. Some other subtypes may have characteristics similar to this type, but not all. He sees the world from an adversarial point of view. The world is against him. Everyone is out to get him and no one can be trusted. The only coping strategy he has is to maintain a good "offense" and so he attacks before others do or say anything. Even the slightest issue is a source of provocation. Once he begins his attack he can be relentless, and keep coming at you until he is exhausted. If he is younger, you might have the stamina to deal with this. If he is older, the police are often called. These children are unusually bright. Their thinking involves violent themes and their actions are hostile and aggressive to others. They want to "fire, murder, devour, shoot, destroy" people who go against them in any situation, no matter how trivial. Typically, they receive multiple diagnoses, often oppositional defiant disorder or some other psychiatric condition such as bipolar disorder.

Recommended Approach: Since this is the most difficult type by far, you must take extraordinary means to help these children. Placating your child or "walking on eggshells" will only give you a momentary reprieve. Most parents of these children refrain from physical interventions, but may be using a good deal of restraining techniques. This again is a temporary solution. To begin with, you must seek professional help, in terms of both medication and behavioral interventions. You must maintain calmness in your interactions with these children. Only the most powerful reinforcers may be of some use. A highly structured environment with firmness is needed, along with great persistence and patience. Dealing with this type is something you don't do alone.

ADHD boyADHD, OCD, and Fantasy Children
The factors marking these three subtypes – attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and preoccupation with a fantasy world – are very closely related, even intertwined. In all three, the child is often described as being inattentive, but there are a number of reasons for the inattention. If he is an ADHD child, he is inattentive because he is nowhere. He is not focused on any one thing for very long. He is distracted by anything new or different that passes in front of his eyes, and his interest moves from one thing to another and he cannot easily control his focus. He has many of the other signs of ADHD as well. He is easily distracted, disorganized, forgetful, and impulsive. He may or may not be hyperactive.

The OCD child, on the other hand, is inattentive because he is somewhere else. He is not so much distracted as preoccupied with something else that is of greater interest to him, usually related to some preferred activity such as videos, numbers, or how things are placed in his environment. Some children have one or the other, ADHD or OCD, and most have both to varying degrees. Since symptoms of both disorders can exist at the same time and to varying degrees, it can be difficult to tell which is which at times. In either case, the result is a lack of awareness of what is going on around him. However, it is important to distinguish between the two and decide how much each contributes to the inattention, because your approach for each will be different. Underfocusing (predominantly ADHD) and overfocusing (predominantly OCD) are important variables that must be addressed, as well as the child who dwells in a fantasy world.

Predominately ADHD
This child is very unfocused and has difficulty attending to and processing information on a consistent basis. He is easily distracted and forgetful, loses things, and has significant difficulty keeping track of school assignments. He wanders around in the classroom and may not be able to stay in his seat at home and in school. Conversations are difficult because he is always looking around the room at something else, but doesn't stay focused on any one thing very long.

Recommended Approach: Medication is very important to deal with inattention and impulsiveness. Careful monitoring of all tasks and situations, along with powerful reinforcers, is sometimes helpful. He will find it hard to stay focused on most tasks. Frequent breaks, structured tasks, and supervision are all necessary. If you find the right medication, the inattention reduces significantly, but may not disappear.

OCD boyPredominately OCD
This child has many obsessions that take him elsewhere, away from the here and now. Although he appears inattentive, in reality, he has other issues that he is dealing with instead. For example, are his shoelaces tied the way he likes them? Is everything around him exactly where it belongs? How many dots are in that ceiling tile over his head? Did he ask the question that he wanted to in the right way? And so on. The list can be endless. But no matter what is on his list, it usually takes precedence over anything that is on your list. He is often a perfectionist, and everything has to go a certain way. If it doesn't, it's the end of the world. There is no middle ground; everything is black or white. It is either perfect or it is terrible.

He may have completion rituals where things must be finished before he moves on. And there are many rituals or routines in this child's life. For example, he can't shut off his Game Boy until he reaches a certain level or he can't shut off the TV until the program is totally and completely over. All of this and more can be going on in his head and cause him to disengage from reality and become unavailable.

Let's look at an example: Tommy, age seven, only wants to play his video games. He always plays them after dinner until bedtime. When he is playing them, he finds it very hard to stop. He argues, whines, and may even have a tantrum when asked to try an alternative to video game playing. He has certain requirements for getting ready for bed and an order to them. He changes his clothes under his covers, even though there is no one else in his room. He brushes his teeth for 120 seconds. Mom has to kiss him good night first, Dad is next, and then he gets a story that he always picks from the books on his shelf. He has to have his radio on in order to fall asleep because he has to hear the music and have the light from the radio shining in his room. Tommy has lots of rules about how things are supposed to go in his world. He is an OCD child. Now, it may seem like he is a Rule child with all of these rules, but there is a difference. The Rule child will typically follow others' rules once they are spelled out to him. The OCD child makes up his own rules about everything and only wants to follow his own rules, no one else's. The OCD child is compelled by his anxiety to follow his own dictates: he must be in control. The Rule child's anxiety compels him to follow everyone else's: he must obey. Each has a different motivation and therefore a different response.

Recommended Approach: You must gain control over his obsessions. There must be limits and restrictions on certain activities. Rituals and routines are addressed through sabotage. You must teach him how to be more flexible by changing routines. You must expand his repertoire of interests, teach him shades of gray, and have him develop a balance in his life. Obsessions will remain, but you can use them as reinforcers as long as you limit the amount of time spent on the obsessions. Each of these things is discussed later on.

Fantasy boyPredominately Fantasy
This child is very similar to the OCD type except his distractions primarily involve his preoccupations with fantasy. This means Game Boy, Nintendo, Xbox, video games, Pokémon, Yu-Gi-Oh!, the Cartoon Network, TV shows, Japanese animé, fantasy books, show tunes – the list is endless, but often involves electronics in some way. Not only does he obsess over the use of the electronic equipment, but the fantasy reoccurs without it as well. If the fantasy involves books or music, he doesn't need the actual object to experience its pleasure. So he replays, re-creates, or in some way engages in the obsession in his head. As he is eating dinner, sitting in class, doing his homework, or talking to you, there is another tape playing in his head. And this tape is all about fantasy. He does word-for-word scripting of dialogue and scenes in his head, combines different ones together, or makes up his own based on something he has seen or read. He may have many other obsessions, but the strongest are about fantasies. These fantasies serve many functions – besides being very enjoyable, they remove him from the unpleasantness of the real world, demands are reduced, and everything goes just the way he wants. As a result, reality is avoided, interactions with others don't occur, and life goes on without him. This is how he copes with stress and reality. Interfere with his preoccupations and you will experience his wrath. Leave him to his preoccupations and he can amuse himself for hours.

Recommended Approach: Everything we said about the OCD type applies here. Additionally, you must go beyond those techniques to include teaching him the difference between reality and fantasy – how to recognize it, what constitutes each, and how to be in the here and now. You must limit fantasy time and help him to develop the ability to enjoy nonfantasy activities. If he can't enjoy the real world, he won't want to be a part of it. Medication is almost always necessary.

Anxiety boyAnxiety Boy
This child differs from all other types because he has no coping strategy. While every other type experiences anxiety to some degree, they cope with it through rules, rituals, obsessions, or fantasy. The Anxiety Boy has never figured out how to deal with problems. As a result, his anxiety overwhelms him and he shuts down, hides under furniture, cries, wants to stay at home, acts silly, wants to stay inside, and tries to avoid people and places outside of his small comfort zone. In other words, he becomes a mess. He is very rigid but doesn't really know the rules of the world. His anxiety comes from his confusion and lack of understanding of how the world works. He just doesn't get it.

He usually needs much more time to handle even the smallest issue. You cannot give him too many issues to deal with at once, even if they are all small, or he will be overwhelmed. Bigger issues are too much as well and he falls apart. Sometimes the issues are so small that you think they cannot possibly cause a problem. Not true. Even the smallest change can result in upset if his anxiety is too big. The degree of anxiety varies, and not all children have the same amount, and not all situations produce the same degree of upset. He can be upset if it's picture day at school, his teacher is absent, someone comes to visit his parents at home, he has to get his hair cut, you give him the orange cheese and not the yellow cheese – this list can be longer than any other list we've talked about because everything has the potential to be upsetting. You'll know you have an Anxiety Boy because he cries quite a bit, clings to you in new situations or with new people, doesn't want to leave his house, and when away from home often tells you he wants to go back home immediately. His tantrums end when he is allowed to be alone in his room under the covers. Once he gets used to something he can often do better. So once he is desensitized to school, he can be okay if he sees it as a structured, calm, and safe place. He, too, may then act better at school than at home, or he may be the same in both places.

Recommended Approach: This boy or girl needs a great deal of structure, routine, and explanation about every possible troublesome situation. You need to explain the rules of each situation, including what to do and what not to do, before he experiences the situation. You need to give him lots of warning on what is going to happen, preparing him for change. Never overwhelm him. Go slowly and don't try to accomplish too much at one time. Help him get past each issue that has occurred, to "get over it" and move on, or they will build up and the next small one will cause him to fall apart. These are the prevention aspects of dealing with anxiety. That is, you will try to prevent situations from overwhelming him. However, that will never be sufficient and he will need to learn how to cope with it as well. Teach stress management skills: stress resiliency, stress immunity, learned optimism, and "theory of mind." Teach him emotional regulation skills: anxiety management, self-calming, being okay, and the like. Medication may be needed if these skills are difficult for him to learn.

Angry boyAngry/Resistant Boy
This child or teen may look similar to the paranoid type, but he is less adversarial and less intense. He is also easier to deal with if and when he feels safer. He argues about everything, and almost anything can lead to a tantrum of some size. At times, he can be violent and physical or will destroy property. He wants things to go his way. He wants to control situations and has his own rules about the world and how things are supposed to be. He is often diagnosed with oppositional defiant disorder (ODD). This is another child who doesn't understand the way the world works and becomes anxious as a result. He feels threatened by others and thinks they are trying to control him or are being unfair and arbitrary. He needs to fight with them to gain control and get things straightened out to his way of thinking. However, his arguing does nothing but further aggravate the situation. His rigidity, lack of understanding, and disuse of logic prevent him from seeing this clearly. His emotions determine his actions.

Recommended Approach: Try to avoid power struggles. Do not show much emotion in your responses and try to be matter-of-fact. Stay focused on a particular issue and don't get sidetracked as you have a discussion with this child. It's very easy for the discussion to get off track and become nonproductive. Try to see his arguing as a sign of anxiety and not purposeful misbehavior. Try to get him to see you as a helper or problem solver rather than an adversary or problem causer. Don't overfocus on the content of a discussion, but rather on the process; that is, what is going on behind the content of the discussion.

For example, a discussion may begin around what he is going to get from you for Christmas. Before you know it, you are being accused of buying others bigger and better presents. Or perhaps the accusation is that you never buy him what he really wants. Rather than debate the merits of this argument, which will only escalate further, you should discuss how he is stuck on certain ideas that will only lead to greater upset, and the impact his actions have on himself and others. He must begin to see his role in what is going on and stop blaming others for what occurs. You will need to teach him how to stay focused and how to self-calm, as well as how to compromise and negotiate. But most of all, he needs to see you as trying to help him solve his problems, not making them worse.

Negative boyNegative Boy
This child or teen tends to be more of an annoyance than anything else. He does a lot of complaining and whining about doing things that are not preferred activities because he only enjoys preferred activities. As a result of his actions, there can be a good deal of arguing and refusals. He usually sees the world in a negative way–"the glass is half empty"–and rarely sees the good aspects of an event or situation, no matter how much good has occurred. Tantrums, bossiness, rituals, and rules are not issues. He may even be fairly cooperative at times. The major concern regarding this child is that he is more prone to future depression than any other type.

Recommended Approach: He must learn to be okay with nonpreferred activities and that it is better to "say nothing than be negative." You need to teach her how to use positive commenting and responses. Direct instruction in how to have a "positive attitude" and "learned optimism" is needed. Each child can have many issues that make him unique. You have begun to sort out those factors that make your child who he is. It is his uniqueness that tells you what subtype he is and what techniques you need to use. When you understand your child and his interaction with the world, you will be better able to help him reach his full potential. If you still are not sure of the subtype characteristics your child demonstrates, at least provide the two things every Asperger child needs: structure and predictability.


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