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Why children and
adolescents who have
Asperger’s syndrome (autism
spectrum disorder) need a
programme to understand
and express affection

Affection in childhood

Within our families and friendships, we expect there to be a mutually enjoyable, reciprocal and beneficial regular exchange of words and gestures that express affection. From infancy, our children enjoy and seek affection from us, and as they become toddlers they learn to recognize when we expect affection and therefore learn when to give affection.

One of the early signs used to diagnose an autism spectrum disorder (ASD) in an infant or child is a lack of appearing to be comforted by affection when distressed. As typical children mature, they have an intuitive understanding of the type, duration and degree of affection appropriate for each situation and person. Children under two years know that using words and gestures of affection is perhaps the most effective way to help someone who is sad to feel happy again.

Affection for a child with an ASD

Unfortunately, for some children with an ASD, a gesture of affection, such as a hug, may feel like an uncomfortable and restricting physical sensation; your child may have learned not to cry as a result, to avoid eliciting that ‘squeeze’ from you. Your child may also be confused as to why you respond to his or her distress with a hug. As an adult with Asperger’s syndrome said, ‘How does a hug solve the problem?’ Sometimes hugs are perceived and enjoyed by children with an ASD as relaxing deep pressure rather than a gesture to help them to feel happier.

Young boys and girls with an ASD often seem to prefer to play with hard toys, such as plastic models of dinosaurs and metal vehicles, rather than soft toys that represent human characteristics and tend to elicit strong feelings of love and affection in typical children and even adults. Children with an ASD will often not share when playing with peers. For typical children, sharing an activity or toy is generally an indication of their liking for someone. A child who doesn’t like to share may be perceived as unfriendly or as not liking the other child.

Children with an ASD may also not recognize the social conventions of affection; for example, your child might express and expect in return the same degree of affection with a teacher as they would with you. There are also gender differences in the expression of affection between friends, with typical girls anticipating that affection will be part of their play. The absence of affection in the play of a girl with an ASD can be a barrier to friendship, and appearing aloof or indifferent to the affection of peers can make it difficult for both girls and boys with an ASD to be included in social groups and develop friendships.

Levels of affection

In general, a child with an ASD may enjoy a very brief and low-intensity expression of affection but become confused or overwhelmed when greater levels of expression are experienced or expected. However, the reverse can also be the case. Some children with an ASD need almost excessive amounts of affection for reassurance or sensory experience, and frequently express affection that is too intense or immature. A child or adolescent with an ASD may not perceive the non-verbal signals and contextual cues in order to know when to stop showing affection, and this can lead to feelings of discomfort or embarrassment in the other person.

Affection for emotional repair

When you express your love for your ASD child, perhaps with an affectionate hug, his or her body may stiffen rather than relax to match and fold into your body shape. Your child may also not be soothed by your words and gestures of affection when he or she is distressed. When an expression of love and affection is rejected or is not effective, you may wonder what you can do to repair the distress or whether your son or daughter actually loves or even likes you. Because your ASD child rarely uses affectionate gestures and words, you may feel deprived of affection. A mother of a daughter with Asperger’s syndrome said that her daughter’s lack of affection to family members was ‘basically breaking her father’s heart, he’s devastated’. Another parent said, ‘It really hurts that you can’t have the relationship you wanted.’ If affection is not reciprocated, you may try to elicit a greater degree of affection by increasing the intensity and frequency of your expressions of affection. This can lead to even greater withdrawal and mutual despair. Another characteristic often seen in children with an ASD is having a strong attachment to one parent and only accepting and expressing affection with that one parent. This can lead to the other parent feeling rejected and jealous.

Capacity for affection

When it comes to expressing affection, children with an ASD have a limited vocabulary of actions and gestures, and these often lack subtlety and (in the case of adolescents) may be inappropriate or immature for their age. Their expression of affection and of liking or loving someone may be perceived by family members or friends as too little or too much – drought or flood. An adolescent with Asperger’s syndrome explained, ‘We feel and show affection, but not often enough, and at the wrong intensity.’ Each person has a capacity for expressing and enjoying affection. For a typical person, this capacity can be thought of as a bucket; but for someone with an ASD, it is like a cup that is quickly filled and slow to empty. If you fill the affection cup to capacity, your child can feel saturated with affection and unable to return the same degree of (or sometimes any) affection.

Affection in adolescence

Teenagers with an ASD may not understand the value in an adolescent friendship of mutual exchanges of appreciation and affection, which range from liking to loving. Such teenagers may have learned a vocabulary of words and gestures to express affection when they were very young, and then not modified these as they matured and as their social situations changed. For example, they may invade personal space and not know which parts of a person’s body are now inappropriate to touch. The teenager with an ASD may also not know how to progress beyond a reciprocal but platonic friendship, or how to express deeper feelings of affection. There can also be a problem when an adolescent with an ASD develops a ‘crush’ on a peer. The expression of interest and affection can be perceived as too intense, and the adolescent may not recognize the need for mutual consent or age-appropriate social conventions and boundaries.

Thoughts and feelings

Often, children and teenagers with an ASD find it difficult to reflect on their own thoughts and feelings, as well as the thoughts and feelings of others. (Psychologists use the term ‘impaired Theory of Mind’ to describe this difficulty.) Thus, a friend or acquaintance’s act of kindness may be misinterpreted as having a more significant meaning than was intended. The person with an ASD may assume that the other person’s feelings of affection are reciprocal, and may persistently follow the other person, seeking further acts of kindness. This can result in allegations of stalking and the destruction of the friendship.

Typical adolescents have many friends to provide guidance on appropriate levels of affection in a friendship or a romantic relationship. Adolescents with an ASD can become increasingly aware of the expressions of affection that occur between their peers and the apparent enjoyment of sensory experiences between a boyfriend and girlfriend. Such relationships can be elusive for a teenager with an ASD, but there may be an intellectual and emotional curiosity and a longing to have similar experiences. The adolescent may seek information and guidance on expressing affection from other sources, such as television programmes, which tend to emphasize dramatic expressions of affection; or from pornography on the internet, which portrays age-inappropriate or illegal activity. Serious problems can arise if such behaviour is suggested or imitated with peers. Immature and naïve expressions of affection can be misinterpreted as indicating a desire for greater intimacy than intended. Particularly for girls, this can lead to accusations of ‘leading someone on’, and to serious and traumatic experiences.

Recognizing signals

Another concern for some adolescent males with an ASD is knowing when to stop expressing affection in a romantic relationship. Typical teenagers recognize the verbal and non-verbal signals – the ‘amber’ or ‘red light’ signals – that indicate there is no consent to continue. If these signals are not recognized, accusations of assault and subsequent legal implications may follow.

In their desire to be popular, adolescents with an ASD are vulnerable to being ‘set up’ by malicious peers. There have been instances when a young person with an ASD has been deliberately misinformed that someone is romantically interested in him or her. When this false assumption leads to unwelcome advances or suggestions, the adolescent is confused – and accused. In contrast, some adolescents with an ASD are confused by aspects of affection and almost develop a phobia of experiencing, or even seeing, expressions of affection. They are then perceived as prudish or puritanical.

This programme has been designed primarily for children from 8 to 13 years with an ASD and an intellectual ability within the normal range. However, young children and older adolescents with an ASD who are particularly immature may also benefit from the activities and strategies used in the programme.

Empathy

If your child with an ASD rarely expresses affection, especially in situations where affection is anticipated, people may think that he or she lacks empathy. You wonder why such an accusation would be made toward someone who may demonstrate many acts of kindness.

There are two problems that could make people feel this way. The first is your child’s limited ability to read the subtle body language and contextual cues that indicate someone is feeling distressed. If these subtle signs are not perceived, the anticipated response of concern, compassion and affection will not ensue. Furthermore, your child may not know how to respond appropriately and may fear responding in the wrong way – it may feel safer to do nothing.

Second, young people with an ASD can express and enjoy feelings of genuine and deep love and compassion for someone, but usually by practical demonstration rather than words or gestures of affection such as a hug or a kiss. For example, if someone is distressed because an object has been damaged or broken, your child’s first response might be to repair or replace the object. However, if the cause of distress is a broken heart, perhaps because someone has died, your child may not know what to do and may be frozen in uncertainty. Thus, he or she may not recognize that a gesture or words of affection are a quick, powerful and inexpensive emotional restorative for friends and family members.

Affection to repair feelings

We have found that the three most effective emotional repair strategies for someone with an ASD are being alone, being with animals, or engaging in a special interest. This may explain why a young person with an ASD may choose to leave alone or avoid someone who is distressed. Another response that can be perceived as uncaring or annoying and indicative of a lack of empathy is trying to engage in a conversation about a special interest. This is not a display of callousness; it is actually his or her way of showing compassion. In other words, if it makes me feel better, it must work for you.

People with an ASD seem able to relate to and express affection and love more easily to animals than people. Thus, you may observe that your child can, and frequently does, express affection for a pet to a level far greater than is expressed for you. This can lead to feelings of envy of the pet and resentment that your child can express love but not for you. From your child’s perspective, human beings have complex needs, can deceive or tease, interrupt and prevent you from engaging in your preferred activities. In contrast, animals are loyal, respectful, predictable and so pleased to see you, and it is easy to make them feel happy. Cats are particularly popular. Tony has sometimes referred to cats as being autistic dogs! You may feel that your son’s or daughter’s response to affection is like that of a cat: it is enjoyed sometimes when your child is in a receptive mood, but at other times it is clearly and almost painfully indicative of discomfort, and that leads to you feeling rejected.

Frequency of affection

We anticipate compliments and frequent words or gestures of affection as a natural part of a relationship or friendship. For your child with an ASD, this can be perceived as repetitive, illogical and a waste of time. Once a statement has been made, why should it have to be repeated? A mother complained to her adolescent son that he never said he loved her. He became very annoyed and replied that he had said he loved her when he was six years old. Why would he need to say it again? Was she developing signs of Alzheimer’s?

Sensory sensitivity and affection

It is important for you and other family members and friends to recognize one particular aspect of ASD that may affect your child’s ability to enjoy and express affection, and that is hyper- or hypo-reactivity to sensory experiences. For example, if your child is hyper-sensitive to touch, even light touch on his or her skin is an extremely unpleasant sensory experience. This will obviously affect your child’s enjoyment of and response to gestures of affection, such as touching his or her hand or arm during a conversation to emphasize a point or to express compassion.

Unanticipated touch (such as a pat on the back or a hug from behind) can elicit a startle response. A kiss can also be perceived as an unpleasant tactile sensation. When experiencing a hug, a person with an ASD can be hyper-aware of someone’s perfume or body odour, perceiving it as an extremely unpleasant sensation which is best avoided. All this can explain why your child may avoid the more demonstrative members of your family.