Today we’re hearing from Dorothy from Plano, Texas and Dorothy writes:

Dear Neil,

My 14-year-old daughter has recently been diagnosed with Level 1 Autism. She has had a rough road to get to that diagnosis. We started trying to treat her "anxiety" with pharmaceuticals at the age of 12 1/2. They all had terrible side effects that caused more harm. Now that we have this diagnosis, it all makes so much more sense. Unfortunately, she does not agree with the autism diagnosis.     How do we help her?

Dorothy of Plano, Texas

Now to Dorothy’s question:

First of all, what is ASD ? Some level of diminished ability to understand relationships, how our behavior affects others, a lack of understanding reciprocity in relationships.  This can be to a relatively minor degree as with your daughter Dorothy, or to a profound degree that severely limits a person’s ability to function.  There are many very accomplished and famous individuals who have made public that they have ASD  such as Steve Jobs and Elon Musk; you can google a list of people with this diagnosis if it will help your daughter see that it is just a way of being in the world and not a disease.  But it’s vital that you don’t fight about it or focus on it. 

Dorothy, your daughter doesn’t need to know or agree with a diagnosis in order to get the help and support she needs. In fact, what was the purpose of telling her? Teenagers hate to think of themselves as different in any way from other teens. They want to fit in. As with your daughter Dorothy, it’s common for teenagers with ASD to experience social anxiety. Socialization is an area of challenge for them, and adolescence is a time when kids build their own social relationships and begin to form social groups.

Dorothy, we want your daughter to know that she can “fit in”, in her own way.  Rather than a diagnosis, she can simply know that social relationships are an area of challenge for her.

What are her strengths? Art, music, sports, math, computers, mechanics, animals? Something else or several of these things?  How is her day constructed?  Is she growing and developing her interests and skills? This is what’s important.

In answer to your question, “How do we help her?” Dorothy, these are the ways you can help her.

1. Have a healthy vision of your daughter; have faith in her and in her developmental journey.  Communicate your faith in her and actively enjoy who she is, rather than focusing on her problems or who she isn’t.  
2. Have standards in place that require her best efforts. Teach and require a positive attitude; one that includes cooperation and respect.  Now that you understand her neurology and how it affects her personality better, your expectations can take her challenges into account, yet appropriately high expectations are still important for her to grow her skills, confidence and self-respect. 
3. Does she have a positive role in the family? In your family she does things for others that they appreciate and others do things for her that she appreciates.  
4. Help her focus on and grow her strengths and feel good about those. As she develops her self-confidence based on her strengths and she gains social experience, over time her social skills will improve.  She shouldn’t need a huge crowd to be part of; a few friends and some positive social activities such as sports, band or performing arts will offer her plenty of social opportunities.

Dorothy, you may find your daughter avoiding such activity and report that her anxiety is too debilitating to participate.  That’s where, just like any other parent and every other kid, you set limits. Obviously, medications didn’t help, but counseling to learn self-soothing and emotional management skills can be helpful. You can go together and that might feel supportive to her at first.  Then she needs to apply those skills and move forward in her day-to-day life as a teenager. 

Wow Dorothy, you’ve taught us parents and therapists a lot today. First is that diagnosis in mental health is a way of understanding something, but it will never explain everything. 

The second thing we learned is that at the end of the day, our children, teens, and young adults need to learn the skills to manage their feelings. In some cases, medication can help, counseling can help, even self-help books can help. But the desire to improve, the ability to improve and the responsibility to improve is within each individual. With the right combination of support and structure, parents can empower their kids to know and exercise just that. 

Thanks for tuning in today listeners and our thanks to you Dorothy for your important question.  We’re all pulling for you and I’m confident that with a committed parent like yourself, your daughter will come through this with flying colors. Here we are in the heart of summer; I hope you all are finding ways to enjoy the outdoors, that you’re not overheating and maybe even taking a vacation to a really enjoyable place.  But wherever you are and whatever you’re doing, please make time for you. You need it, you deserve it, you’re worth it.  Bye for now.