ads and school phobia

[SOUTH5]

Hello, our 11 year old son has ASD. He started secondary school in september,we though he was getting on okay for the first few weeks, which was a great comfort to us as he has never really settled at school before, due to one thing or another. However we are now having endless problems with him, fear of every thing, always panicking, pysically being sick, ect, he has been sent home from school a fair few times now because he has been sick in class or the toilet. He is sick at home too. On friday while waiting to start his Judo class he was sick on the floor in front of every one, because he was worried about the class he was joinning,he has been going for 2 years now, so he knows most people, but because his teacher had told him the week before he had to go into the upper class as he is now to old and far to big to stay in the group he was in , im sure he may be getting school phobia, we have had a meeting with the school so far so good they are trying to help, and we have a Doctors appointment tomorrow,(unknown to our son) my husband and myself are going with out him at this stage..Is all this usual for children with ASD when changing from Primary to Secondary school, or is it possible im right with my idea, any help is much needed, life for our whole family is very hard at the moment as all our time and energy is on Tom, and our other 3 children are just pulling alone for the ride.... yours..a very worried mum.

[Sally44]

As you know, having a diagnosis of ASD means that your child will find any changes to routine or changes in surroundings/environment or expectations will cause him alot of stress.  My son when younger used to vomit if I turned the TV off, or took a toy off him, or took him out of the house etc etc.  He is much better now (he's 7).  But I suspect that firstly, your son is at a new school.  He is at an age when children are expected to be much more independent, and maybe he needs the supports and structures for longer, or for them to be withdrawn more gradually.
It is also worth considering anything before you tell him.  So having to move into another group is bound to be very stressful for him.  So it needs to be thought about and planned before it is even mentioned to him.  So a gradual cross over might be easier to achieve as well as talking to him about growing up and how people need to move into groups of a similar ability as they get better at something.  Use Social Stories etc.  He may find transitions very stressful and probably the vomiting is related to the 'fight or flight' reflex showing that he is in an high state of anxious arousal.
As he is also verbal talk to him about his fears and take things a step at a time.  By taking small steps he will reach the same goal.  It doesn't have to be an immediate change if that upsets him.
His behaviour is a true reflection of his level of stress so just go with that.  Lower the expectations and slow down any transitions with step by step changes that are fully discussed and understood before they happen.
I know it is hard when you have other children.  Maybe you could involve them in the process as they will probably have a greater insight into his difficulties being of the same age.

[William H Ahearn, Ph.D., BCBA]

The situation you describe is certainly concerning.  Vomitting when faced with difficult situations is not uncommon with any child but probably occurs more often in children with developmental issues (ASD and other disorders).  You mention several scenarios in which it is quite possible that your son is having this behavior when faced with something he would rather not do.  This response might effectively remove him from something he finds unpleasant (challenging demands at school, a new judo class).  There are a number of potential effective interventions that have been shown to be effective for behavior that serves this function.  However, it would be important to conduct a functional behavioral assessment to be more certain.  I suggest that you contact a certified behavior analyst to help conduct an assessment and implement a functionally appropriate intervention.  Certified behavior analysts in your area can be found by logging on to www.bacb.com, click into the consumer information section and search for a Board Certified Behavior Analyst in your area.

Best of luck.