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Bonnie
Bonnie, Psychologist
Category: Parenting
Satisfied Customers: 2169
Experience:  and pediatric nurse practitioner with 30 years of experience counseling parents.
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Thank you for taking the time to help us out. We have a

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Thank you for taking the time to help us out.

We have a happy, well adjusted eleven year old son.
He has a great attitude about life, he’s kind to younger children, he loves being with his parents, he volunteers to help, he gets straight A's in school. What more could we possibly ask for?
He has a serious habit of talking back.
It is hard to say exactly when the talking back became a problem, but by the age of 8 we started trying various ways to correct it. It seems, in retrospect, however, that there has always been an element of talking back present. He was diagnosed at age 4 on the Autism Spectrum - exact diagnosis "High Functioning Autism" – so his verbal communication has not followed a typical path of development. By age 4 he did not respond to questions (he was very verbal, but 90% of his verbal responses were "echolalia": 1. he repeated what he heard on a video - word for word - but was not talking to anyone in particular: 2. if we asked if he wanted a glass of milk, he'd repeat the question). By age 5, after much intervention, and possibly due to a change in diet, it flipped to 90% appropriate responses, and 10% "echolalia". He no longer displays "echolalia", but it seems that there is a possible mixture of "echolalia" in his "talking back". Autism experts say that "echolalia" is possibly a tool employed to help make sense of verbal communication. One therapist said that we all talk to ourselves when we lose our keys and we are in a hurry: “let’s see, where did I possibly leave those silly keys…” So, it appears to be a normal, albeit primitive, cognitive mechanism that helps us when we are under pressure.
Regardless, the counsel from experts on autism is to always treat behavioral issues the same way you would with any child. We have tried very hard to separate behavioral issues from attention issues. Hopefully my long explanation about “echolalia” and its possible influence on his talking back is not just my own denial.
We have been very consistent with our expectations and discipline.
We've tried:
Time out (that worked for a while, until he started to enjoy the solitude).
Fining him money (he earns money for certain goals met, and we tried removing money when he talked back). This never seemed to work.
Withholding privileges (no television, video games, play dates or desserts for a day).
This has been the most effective method, but it only seems to put him on his best behavior in order to get his privileges back. But, as soon as he has them back, he starts talking back.
We’ve had numerous discussions with him about his understanding of what he does, and why he thinks he is doing it.
When he loses his privileges, he is remorseful and he apologizes to us, but the impulse to talk back wins out the next time around.
We’ve role played, we’ve helped him dissect the impulses that underlie the behavior, and we’ve even had challenge matches to see who could resist the impulse to talk back (sort of like a staring contest).
Yet nothing has helped us stop it.
He started talking back to his teacher at school this year.
He loves his teacher, and she responds very appropriately, but it really needs to stop.
Do you have any advice?
Thank you very much.
Warren
Submitted: 2 years ago.
Category: Parenting
Expert:  Bonnie replied 2 years ago.
Hello and thank you for consulting JA,
My experience with children "on the spectrum" is that the normal behavior modification techniques only work on behaviors which are voluntary. You have framed this (I believe rightly so) as an impulse which is difficult to control. So we have an impulse control problem that may also be called a compulsive behavior.

I believe that this may be a medication issue. He should see a child psychiatrist with expertise in autism. If he already has a psychiatrist or developmental pedicatrician, the doctor should be informed of this behavior and consider a tweeking of his medication.

I hope this is helpful....
Customer: replied 2 years ago.
Thank you Bonnie.
Our son is not presently receiving any medication.
He is not receiving any counseling either.
We spent a few intensive years in RDI, which was very successful.
He has been in mainstream school since kindergarten, and received some school counseling (the therapist was very good).
We are not opposed to medication, and have considered it at the beginning of each school year, when he finds it very hard to get through the first few weeks without getting out of his seat etc.
His teacher this year did not even see any signs of autism until well into the year.
I am not in disagreement with your answer, but I would like some clarification.
I can see the impulse factor. He often answers out of impulse.
However, he can control his impulses when he is trying to earn back lost privileges, so he is capable.
I was hoping for some parenting strategies that might help us. I'm 52 and my wife is 46, and believe it or not but we never heard of "Time Out" until our son was about three. Our friends don't have young children so we went a while before learning that "trick". I was hoping you had some behavioral tips for us.
Thank you.
Warren






Expert:  Bonnie replied 2 years ago.
Hello,
I was thinking you were probably wanting behavior strategies but, truthfully, from all the info you shared, you have tried it all. My favorite is token economy (that is what it is called when you offer money as a reward and a fine) which you have tried. You might look into variations of this and change it occasionally to keep his interest.

http://www.educateautism.com/token-economy.html

But...the thing is....that even though he can control his behavior at times (as evidenced by controlling autism behaviors at the beginning of school year)...it is at a great cost. It takes significant energy to do this and results in fatigue and cannot be sustained during stress. The back talk is like a "tic" which requires constant mental effort to control.
Bonnie, Psychologist
Category: Parenting
Satisfied Customers: 2169
Experience: and pediatric nurse practitioner with 30 years of experience counseling parents.
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