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The emotion repair toolbox

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The emotion repair toolbox

Autistic children and adults usually have a limited range of emotion repair mechanisms and are less likely to use the more effective strategies used by typical children and adults, such as putting the event in perspective, reappraising the situation, considering alternative responses, acceptance, or being able to disclose feelings to another person, thus seeking, and benefiting from compassion, validation and affection from a family member or friend. However, autistic children and adults can learn new emotion repair strategies, and these can be conceptualised as acquiring more emotion repair tools.

From a very early age, children will know a toolbox contains a variety of different tools to repair a machine or fix a household problem. The strategy is to identify different types of ‘tools’ to fix the problems associated with negative emotions, especially anxiety. The emotion repair for autistic children and adults can be conceptualised as a problem with ‘energy management’, namely, an excessive amount of emotional energy and difficulty controlling and releasing the energy constructively. Autistic individuals appear less able to slowly release emotional energy by relaxation and reflection, and usually prefer to fix or release the feeling by an energetic, potentially destructive action or thought and emotion blocking action.

The range of tools can be divided into those that quickly and constructively release, or slowly reduce, emotional energy, and those that improve thinking or reduce sensory responsiveness, as well as taking out of the toolbox those tools that can make the emotions or consequences worse such as self-harm.

Physical tools

A hammer can represent tools or actions that physically release emotional energy through a constructive and acceptable activity. For young autistic children, this can include bouncing on the trampoline, going on a swing or using playground equipment. Although these facilities may be available at a school, they may not be used by an autistic child due to the number of children using the same equipment, and the autistic child’s need to achieve solitude and avoid social interactions during break times. They may have special dispensation to use such equipment when the other children are in class. At home, it is easier to encourage such physical activities as an emotional repair mechanism.

For older children and adolescents, going for a run, or dancing alone in a bedroom may be used to ‘let off steam’ or release supressed or increasing emotional energy. An autistic adult described how, ‘running keeps anxiety away.’ Other activities may include cycling, swimming or playing the drums, tennis practice or horse riding, and going to a fitness centre.

Unfortunately, autistic children and adults often feel, and indeed may be, clumsy and poorly coordinated, and have often been teased in the past by peers for not being good at team sports and ball games. While research has confirmed that physical exercise decreases repetitive behaviour, aggression, inattentiveness and escape behaviours in autistic children (Lang et al., 2010), there may be limited motivation and low self-confidence with physical activities. A personal trainer may be able to assess the child or adult’s body type and personality and design a specific programme of realistic and achievable physical activities that can be completed in solitude, and do not involve activities in a social context where there is a risk of ridicule. We recognize that regular exercise is excellent for mental and physical health, but also to improve clarity of thought and problem-solving abilities. ‘Exercise will make you smarter’ is a concept we explain to autistic children and adults who often value and seek to demonstrate their intellectual ability.

Some autistic children and adults have identified that destruction is a physical tool that can be a very effective ‘quick fix’ to end unpleasant feelings of suppressed or increasing anxiety, depression and anger. At home, there are some household activities that provide a satisfying and constructive release of potentially destructive energy, without causing damage that may require expensive repairs.  For example, empty cans, water bottles or packaging can be crushed for recycling, or old clothes torn up to make rags. This ‘creative destruction’ might be the repair mechanism of first choice at home, and especially when returning home from school or work.

Relaxation tools

Typical children and adults usually know intuitively how to relax, and it is a state of mind that they will have often experienced. This may not be the case with an autistic person. Our extensive clinical experience has indicated that there is often a difficulty in achieving a state of relaxation, and confusion as to what to do when someone says, ‘Just relax.’

Relaxation tools help the person lower their heart rate and gradually release and reduce emotional energy. Perhaps a picture of a paintbrush or spirit level could be used to illustrate this category of tools for emotional repair. Relaxation tools or activities could include drawing, reading and especially listening to calming music to slowly unwind negative thoughts and fears. Routine chores or activities can result in a sense of accomplishment, satisfaction and relaxation when complete.

A characteristic of autism is find that solitude, in the sense of being alone rather than lonely, is a very effective means of relaxing. Being away from people, and from certain sensory experiences – perhaps retreating to a quiet, secluded sanctuary – is an effective way of reducing anxiety and stress, and achieving relaxation and emotional repair. The autistic person will need islands of tranquillity and solitude both at school or work and at home.  It may be possible for the autistic child or their parent to talk to a teacher about accessing somewhere secluded at school during break times or recess, for example, the library. Such solitude can be emotionally refreshing and a means of true and deep relaxation. A further source of relaxation can come from being in nature, walking or camping in a natural environment, with few social encounters and only natural sensory experiences and engaging with the wildlife.

Cue-controlled relaxation is also a useful emotion repair tool. The strategy is for the person to have an object, perhaps hidden in his or her pocket, that, through association, symbolizes and engenders feelings of being calm and relaxed. For example, an autistic child may feel relaxed when on holiday and going fishing: thus, a fishing float in a pocket can be retrieved and looked at to recreate the feelings, images and sensations of relaxation and enjoyment when fishing.

Meditation tools

In Western cultures, there is a growing awareness and appreciation of the value of activities such as yoga in encouraging a general sense of well-being and providing an antidote to anxiety. We now have yoga activities specifically developed for autistic children to use at school and home (Betts & Betts, 2006; Bolls & Sewell, 2013; Mitchell 2014; Hardy, 2015), and some teachers are now using classroom and individual meditation activities to encourage relaxation and enhanced attention for the whole class. Mindfulness is also being used to regulate attention toward the present moment, to let an emotion pass and encouraging an attitude of openness and acceptance using imagery, meditation and yoga (De Bruin et al., 2015).

A meta-analysis of 123 studies of the effects of meditation of the brain found that eight regions of the brain were consistently enhanced in meditators (Fox et al. 2014). All eight brain areas are associated with autism. Thus, meditation can be perceived as a form of therapy for autism.

Social tools

This tool is to be with someone, or an animal, that can help repair the mood. These tools could be represented by a sponge to soak up the emotional distress. The social experience will need to be enjoyable and without the stress that can sometimes be associated with socialising, especially when the interaction involves more than one other person. For an autistic person, two are company, three a crowd. There are social experiences that reduce anxiety, for example, being with someone who has the ability to be like an emotional ‘sponge’, soaking up worries and anxious thoughts; a particular family member, teacher or colleague who accurately ‘reads’ the autistic person’s emotional state and intuitively knows what to say or do to be reassuring and calming. Another social tool, in the broadest sense, is spending time with pets that are non-judgemental listeners and more forgiving and accepting than humans. Sometimes, even just looking at photographs of favourite people and pets on a mobile phone or iPad can significantly decrease anxiety, despair, and agitation.  Someone emotionally close to an autistic child or adolescent could make an audio recording of soothing comments on their mobile phone to help them cope with extremely anxious or distressing moments.

Helping others

Another tool is the act of helping someone and being needed – an altruistic act. Autistic individuals can change their mood from self-criticism and pessimism to a feeling of self-worth and resilience when they experience opportunities to help and be of value to others. This can include activities such as helping someone who has difficulties in an area of the autistic person’s talents or expertise: for example, helping a teacher or sibling fix a problem with a computer. Being needed and appreciated is a significant emotional repair mechanism for all of us, including autistic individuals.

Internet activities

Internet support groups and conversations between subscribers or multi-player games participants can be an effective emotional repair mechanism. Autistic individuals often have greater eloquence and insight disclosing their inner thoughts and feelings by typing rather than talking; they don’t need skills with eye contact, or to be able to read a face or understand changes in vocal tone or body language when engaged in a ‘conversation’ on the Internet. The chat line or Internet conversation can include other autistic people who have genuine empathy and may offer constructive suggestions to repair a mood or situation.

Thinking tools

Another type of implement, such as a screwdriver or wrench, or a repair manual, can be used to represent a category of tools that can be used to change thinking or provide knowledge. The autistic person is encouraged to use his or her intellectual abilities to control feelings such as anxiety by using a variety of techniques such as self-talk or an internal dialogue such as, ‘I can control my feelings’, ‘I can stay calm’, or, ‘be a mirror, not a magnifying glass’. By using words and thoughts that are reassuring and encourage self-confidence and emotional resilience, the autistic person is encouraged to create a ‘force field,’ ‘suit of armour’ or ‘umbrella’ for emotional protection.

A thinking strategy is the creation of ‘antidotes to poisonous thoughts. The procedure is to think of a comment that neutralizes or is an antidote to negative (poisonous) thoughts. For example, the negative thought, ‘I can’t do it’ (poisonous thought) can be neutralized by the antidote, ‘If I stay calm, I will be quicker at finding the solution’; or ‘I’m a loser’ can be neutralized by the antidote, ‘but I’m a winner at Minecraft.’ A list is created of the person’s negative or poisonous thoughts, and the parent or teacher helps create a personalized antidote to each thought. Cognitive Behaviour Therapy (CBT) focuses on discouraging maladaptive thinking and encouraging adaptive thinking and CBT has been adapted to accommodate the characteristics of autism (Scarpa, Williams White and Attwood 2013). The maladaptive thinking associated with autism is a tendency to catastrophise (meltdown) or supress (engage in a special interest) and CBT encourages adaptive thinking such as self-soothing, perceiving alternative perspectives and the disclosure of feelings to others.

Academic or intellectual achievement

A tool that can be used with autistic children and adults to reduce anxiety and improve mood and resilience, is the achievement of academic success or acquiring knowledge on the Internet. When an autistic child is anxious or agitated in class, the teacher may instruct the child to complete an academic activity that he or she enjoys, and for which the child has a natural talent, such as solving mathematic problems, spelling, playing an instrument or drawing. This is in contrast to typical children, who would probably try to avoid academic tasks when stressed. Adults may reduce stress and improve their mood and self-esteem by seeking knowledge via the Internet or reading.

Additional tools: Sensory sensitivity, nutrition and sleep

The exploration and analysis of the causes of anxiety may include sensory sensitivity (Green & Ben-Sasson 2010). Experience has indicated that repeated exposure to the sensory experience does not easily lead to habituation and a reduction in sensitivity. Sensory sensitivity appears to be a life-long characteristic of autism, with adults creating life circumstances to avoid some sensory experiences or, with maturity, learning to consciously endure and tolerate such experiences, even though they may be just as aversive as they were during childhood. An occupational therapist may be able to provide advice on strategies to reduce or tolerate sensory sensitivity. For example, auditory sensitivity can be for both sounds of a particular pitch or volume, or general noise levels, and can include difficulty filtering out background sounds to focus on a teacher’s or line manager’s voice. Anxiety can occur due to the possibility of not being able to hear important instructions. Specific sounds can be avoided, or encountered less frequently, such as someone shouting; or being prepared and supported for particular events, such as fire alarm testing. A Sensory Integration Programme created and conducted by an occupational therapist may reduce sensory sensitivity.

Clinical experience and advice from mature autistic adults suggest that physical and emotional well-being can be improved by reducing the amount of junk food consumed and having a good diet with nutritious food (Attwood, et al., 2014). While junk food is popular, well-advertised and easy to acquire, and can provide some comfort in the short term, the problems, which range from unstable mood to weight gain, outweigh the perceived benefits. Healthy food does contribute to a healthy mind.

We recognize that autism is associated with a range of sleep disorders (Chen et al 2021; Kotagal, & Broomall, 2012;). Sleep has many functions, one of which is to refresh mind and body. The sleep cycle associated with autism can be unusual, for example, taking some time to actually fall asleep (especially if worried about events of the day, or fearfully anticipating the next day), with a tendency for there to be a disturbance of the depth and quality of sleep subsequently. While attention to, and modification of, sleep routines, and medications such as Melatonin, can all help establish a reasonable sleep cycle, if problems persist, a referral to a sleep clinic may be needed. Having restful and deep, uninterrupted sleep can lead to an improvement in the ability to manage emotions such as anxiety.

Summary for the emotional toolbox

We recognise that autistic children and adults will have difficulties managing and expressing feelings which become increasingly significant throughout childhood, and especially in the adult years. Autistic adults often rate problems with anxiety and depression as having a far greater effect on their daily lives than making and keeping friends and getting and keeping a job (Attwood, et al., 2014). Thus, we need to recognize the importance of emotion repair at home, school and at work.

References

Attwood, T. Evans C. & Lesko A. (2014). Been There. Done That. Try This!: An Aspie’s Guide to Life on Earth. London: Jessica Kingsley Publishers.

Betts, D. E., & Betts, S. W. (2006). Yoga for children with autism spectrum disorders: a step-by-step guide for parents and caregivers. London, Jessica Kingsley Publishers.

Bolls, U. D., & Sewell, R. (2013). Meditation for Aspies: Everyday Techniques to Help People with Asperger Syndrome Take Control and Improve Their Lives. London: Jessica Kingsley Publishers.

Chen et al (2021) Sleep problems in children with Autism Spectrum Disorder: A multicenter survey. BMC Psychiatry 21:406

De Bruin, E. I., Blom, R., Smit, F. M., Van Steensel, F. J., & Bögels, S. M. (2015). MYmind: Mindfulness training for Youngsters with autism spectrum disorders and their parents. Autism, 19(8), 906-914.

Fox et al 2014, Neuroscience & Biobehavioural Review, (Apr), 20140409.

Green, S. A., & Ben-Sasson, A. (2010). Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: is there a causal relationship?. Journal of Autism & Developmental Disorders, 40(12), 1495-1504.

Hardy, S. T. (2014). Asanas for Autism and Special Needs: Yoga to Help Children with their Emotions, Self-Regulation and Body Awareness. London.  Jessica Kingsley Publishers.

Kotagal, S., & Broomall, E. (2012). Sleep in children with autism spectrum disorder. Pediatric Neurology, 47(4), 242-251.

Lang, R., Regester, A., Lauderdale, S., Ashbaugh, K., & Haring, A. (2010). Treatment of anxiety in autism spectrum disorders using cognitive behaviour therapy: A systematic review. Developmental Neurorehabilitation, 13(1), 53-63.

Mitchell, C. (2013). Mindful Living with Asperger’s Syndrome: Everyday Mindfulness Practices to Help You Tune in to the Present Moment. London. Jessica Kingsley Publishers.

Scarpa, A., Williams White, S. and Attwood T. (Eds) (2013) CBT for Children and Adolescents with High Functioning Autism Spectrum Disorders. New York, The Guilford Press

Computer gaming and COVID

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Computer gaming and COVID

The following article is Tony’s chapter from the new book:
Life After Lockdown: Resetting Perceptions of Autism Strategies and Reflections

Edited by Rebecca Silva, Ruth Prystash, Rene DeLoss, and Carol Burmeister (Foreword by Peter Vermeulen)

Available to purchase here

The past year has marked us as one of the only generations to experience a global pandemic. The pandemic kept people at home, something that suited many autistic individuals. But it also limited the opportunities for social and emotional growth for autistic teens and young adults, and one of the obvious outlets became computer games. These games were already intensely important to many autistic youth, but now they became more so, as there was little else to occupy their minds and their time. Computer games can be beneficial, but they can also be addictive. This is a story that needs to be told, because nobody else is talking about it.

COVID’s impact on the autistic teen or young adult

Many individuals have begun displaying an increase in routines and rituals, heightened sensory sensitivity, and more engagement with special interests. These are all ways of coping with anxiety. People have been cooped up together for the past year, which can be difficult for a person with autism who craves solitude. There may even be anxiety about what will happen when we begin to have more face-to-face contact and are forced to endure crowds again.

There is a misconception that people with autism lack empathy. The opposite is actually true: Autistic individuals are often acutely aware of other people’s mental states. The news speaks of a killer virus and the rising numbers of dead; children worry about their family members’ health. There has been more free time at home this year for the anxiety to percolate and one way to alleviate that anxiety is the computer game.

Computer gaming—a perfect fit for autism

There are a number of factors that make computer games extremely popular with people on the spectrum. Gaming provides a sense of achievement and identity. It allows you to show your capabilities independent of autism. The main issues of autism are social-conversational, but in gaming you have no real socialization and you have no conversation, so you have basically bypassed autism. Gaming is a natural talent because it suits the autistic cognition. However, it also involves considerable practice. A person can become a master of a skill that requires great ability but also practice. It is the same for a child with computer games. They are talented at computer games, and are motivated to practice. If you want to measure the intelligence of an autistic child, watch them play computer games. The game bypasses their autism, they are highly motivated, and you can see how quickly and effectively their brain works.

If you are not good socially and you are not good at sports, your intellect is very important to you, and you want to prove how smart you are. You want to demonstrate your intelligence and you want other people to appreciate that intelligence. With gaming you have a sense of achievement that is truly gratifying, especially as it is valuable to your peer group.

Autistic teens are searching for identity. Who am I? Why am I here? What is the meaning of life? Where do I fit in? I know I’m supposed to be like everyone else, but I’m not. I want a sense of identity and self-worth that is defined by something that is valued by my peers. The computer game does that. It gives a sense of identity to someone who is searching. The computer game becomes a way of fitting in. It becomes your identity when you have few ways to define that identity. And autism can make a person very lonely. Without social skills, it is sometimes hard to fit in to most same-age groups. Bullying and being excluded can leave autistic teens feeling isolated, while gaming provides a connection with fellow gamers who actually seek you out, rather than shun you.

Computer games give you immediate feedback. As many as 75% of those with ASD also display characteristics of ADD and ADHD. Computer gaming suits those characteristics, as it is based on immediate feedback on one’s performance without any waiting, which autistic people often dislike. Unlike school, where you may be waiting on feedback from a teacher, the game provides immediate feedback.

People are excited to see you online and that kind of genuine, deep welcome is intoxicating to someone with autism. Someone in your peer group actually wants to know you, and is pleased that you are there. Rather than the students who sometimes bully and tease and reject and humiliate, these gamers want to know you and are proud to be your friend. They give you compliments and admiration. But more than that, with your gaming skills, you also become a teacher to some, a mentor to others. You advise them. You are wise. You are talented. You are someone special.

In e-sports, a subgroup of gaming, there are leagues with teams and supporters; logos and colors; managers and favorite players. Players are bought and sold. There are e-sport competitions held in convention centers with thousands of people watching gamers. And in this world, you, the autistic individual, are the person the team wants to recruit. You are a hero in that world. Finally, you have a social network where you shine.  

Gaming as a coping mechanism

During COVID, anxiety and depression increased for many people, including people on the spectrum. A computer game is a thought blocker for anxiety and depression. When you are engaged in the game, you don’t feel anxious and you don’t feel depressed. Instead, you suppress and compress your thoughts and feelings. Computer games are more powerful than medications or cognitive behavioral therapy because they encourage the classic autistic characteristics of avoidance and suppression. When you are playing the game, you are in a bubble. Your problems disappear and you don’t care about anything else, but when you switch off the game, those feelings come back. Parents become frightened to see how angry their child becomes when asked to turn off the computer. What is actually happening isn’t really anger: It is the fact that their powerful feelings have not been dissolved or resolved. Once the game is gone—boom! The feelings are back, and they flood you with fear and despair.

A substitute for social interaction

In autism social emotional reciprocity is a core issue. In a computer game, you don’t have a real conversation going on. You don’t have to worry about reciprocity, you don’t have to read body language, and you don’t have to be involved in social chit-chat. One of the interesting things is that there are often chat lines in computer games, and they provide a means to communicate through typing, rather than talking. Clinically, that can be very valuable. When a client sends me an email, I may receive far more information and insight into the individual’s world than I do in person, because it involves typing, not talking. There is a greater fluency and disclosure of thoughts, feelings, and revelations of the self through typing, rather than talking.

The games have very clear and simple rules that aren’t like social rules. Social rules are inconsistent and complex, and there are always exceptions. Neurotypical kids do things that that are against the rules and get away with it, even though you’re not supposed to get away with it! But in gaming, there are simple rules that are always enforced. There is no inconsistency and no uncertainty, so you are secure in the rules of the game.

A sense of pleasure and enjoyment

If you ask a neurotypical about the greatest moments of excitement and joy in their life, it usually involves another person–giving birth, getting married, falling in love. But with autism, other people can be a source of confusion, so pleasurable memories rarely involve them. Computer gaming, on the other hand, gives you experiences of pleasure and enjoyment when there are very few in your life. This is incredibly intoxicating. Gaming is addictive because it feeds into pleasure-seeking and enjoyment. For someone who may have few pleasures in life, experiencing such a high level of excitement—perhaps the greatest enjoyment you have ever received—is euphoric.

Creating an alternative world

In the real world of daily life, the teen with autism is often not respected or included. But here in the computer game, you are in a world where you are both respected and included. The special interests of people on the spectrum are often an attempt to find a world in which to belong. Anime, Pokemon, Manga–another culture, another country, another time in history where you fit in. Science fiction–you go to another planet where you are recognized and valued. The game creates an alternative world where you have a sense of belonging. The real world may not value you or respect you, but in this world you are remarkable, and that’s why you want to stay.

Avatars are virtual selves that you can create in a computer game. An avatar allows you to experiment with personality, analyzing the interests and people who are important in your life. This is what most teenagers do in the real world. I’m going to be an adult, so what kind of adult am I going to be?  Who do I value, who are my heroes, and can I borrow some of their characteristics? In a computer game you can experiment with that even further. If you’re concerned about your weight, your avatar is slim; if you’re concerned that you’re not smart enough, then your avatar is a genius. It is very powerful.

The dangers of computer gaming

Immersion into computer gaming can mean that individuals are not learning to cope with emotions. Instead, they’re learning to avoid them. They are compressing and suppressing, and are not processing their feelings appropriately. This means that when they start playing the games in earnest, their emotional maturity freezes and levels off. Emotional regulation is stunted. Individuals learn to rely on the game rather than the actual social skills which will serve them in the real world.

When we look at the long term effects of gaming, we see medical issues. Individuals become overweight, with poor eating habits. Junk food is quick and easy while you are on the computer. Some individuals will spend enormous amounts of time online—from 10- 16 hours per day. There is a lack of exercise and exposure to sunlight, so health effects arise.

It is also very disruptive to sleep patterns. One of the effects of extended screen time is that a person’s thoughts increasingly spiral once the game is turned off. Thoughts become incoherent and chaotic, and sleep becomes more and more elusive. That’s why there should be no screen time for one to two hours before bed. In autism, sleep is always been a problem, from infancy on through senior adulthood. Sleep is important for processing intellectual information and processing emotions. When you have a good night’s sleep, inappropriate behaviors diminish. With too little sleep, the opposite is true.

One of the inherent dangers in gaming is a potential tie-in to gambling. In computer games there are commodities called loot boxes. These loot boxes pop up during a game, offering the opportunity to purchase something that may or may not contain useful items. Most boxes have ordinary items, but the gamer will continue to buy them, lured by the possibility of scoring something big. The odds of it having what it advertises are very rare, but the possibility keeps gamers buying more, and so gambling becomes embedded in games. Parents should be aware of this connection, as it is one more avenue to addiction.

When gaming becomes an addiction

The computer gaming industry has the potential to rob us of some very bright minds, who may get caught up in the addictive side of gaming. When teens begin to avoid things that were recently part of their routine, there may be a problem. If you tell your teen to get off the computer for lunch and they become incredibly agitated, avoiding lunch in order to play the game—that’s a worry. If they become upset when a legitimate request interferes with access to the game, then the depth of engagement is now of considerable clinical concern. Their world revolves around the number of hours they spend on the game, and they become agitated when other activities interfere. For example, you used to have evening meals as a family, spending time together. Now the teen arrives at the table at the last moment, bolts down food, and then, boom. Gone. No conversation. No engagement. The individual withdraws from a variety of activities that used to be important for the family and enjoyable for themselves. The game is taking control. This is common in addiction: instead of the person controlling the game, the game is controlling the person.

One of the first casualties of any addiction is truth. The individual will hide their actual time online, like an alcoholic hides their alcohol. They will also have access to games on their phones. Gaming should absolutely be included in the same category as alcohol and drugs for individuals with autism. These individuals struggle, not with autism, but with emotional regulation. Because the game is so good at moderating intense emotions, they are reluctant to switch to anything else.

Dealing with the addiction

One thing that parents should not do is take away the game as punishment. The games provide the teen or young adult with an identity, coping strategies, a social network—what they live for. If adults remove this without providing the child with other coping mechanisms or alternative activities, this ends up being, not punishment but revenge. Parents will end up escalating the punishment from a day to a week to the threat of totally removing the computer, and the teen will respond with defiance and anger. It can quickly escalate into a civil war which no one wins.

If we want to address the behavior constructively, it is important to carefully identify the issues of behavior management or encouragement of chores or other commitments. There must absolutely be consequences, but they must be appropriate. For example, if a teen does something that upsets his sister, an appropriate response might be to have him take responsibility for one of her chores for a week. The time that is spent on that chore would have been spent on the computer, so it is a means of restricting access through teaching an appropriate replacement. It is possible to use the computer as a reward. For example, if the child does their homework, they can have an extra half hour on the computer. This uses the computer as a reward or an encouragement, rather than as punishment. It also teaches a part of growing up. You want more time on the game, but you’ve got to do your chores. That’s life.

When a parent suspects addiction, they can use logic to deal with it. Get a big piece of paper and list the positives and negatives of computer games with the individual. The positives are that it helps manage emotions and it makes the child popular. So how can we help the individual achieve these things outside the game? We can find more conventional and diverse ways of achieving those things, initially in addition to the computer game and eventually as alternatives. Next list the negatives: being overweight, spending huge amounts of time on the game and nothing else, the lack of honesty, and the lack of constructive ways in their lives to learn to deal with emotions. Help the individual compare these lists and set goals.

In terms of strategy, first get an accurate accounting of the amount of time spent gaming. Instead of aiming for an unrealistic goal, like an entire game-free day, try for something more reasonable. For example, start with reducing time by 15 minutes every day for three weeks. If successful, then decrease by 15 more minutes for three more weeks. Use small steps. Parents must provide alternatives that bring pleasure to the child, like being outdoors or spending time with pets. Families must also try to help the individual increase their social network through constructive means so the individual is actually learning to relate and manage conflict.

There are currently few treatment options for addiction in autistic individuals. Therapy for addiction needs to develop expertise, theoretical models, and a whole range of strategies for gaming addiction, especially for autistic individuals. We need psychiatrists and psychologists who are aware of this and work to modify therapy to accommodate the autistic way of thinking.

Final thoughts

As we continue to deal with the effects of the current pandemic, it’s important to realize that many of our brightest autistic individuals are going into the medical and research fields. These individuals, with their logical brains and skill at analyzing systems, have the ability to understand the behavior of a virus and can use their intellect to help develop cures. The intense focus of which they are capable allows them to tolerate 18-hour days in a lab. Instead of looking at a computer screen, they are looking into a microscope. Let’s hope that we can guide them to those labs, and show them that their brilliance is not only appreciated, but desperately needed, and that they are indeed invaluable members of society.