Rachel’s son has Aspergers – except now it is probably more acceptable to say he is on the Autistic Spectrum. This isn’t always helpful as a definition, as he is able to attend a normal school, works well, is good with language etc.

The problems arise from his difficulties with socializing and empathy. He does not really have friends, nor does he care. If children come to call for him, he sends them away. And he is very clear about what he likes and wants. Now that he is 8, he makes his wishes and opinions quite clear. This has resulted in the family adapting to his wishes in a big way.

He does not want to go shopping, so he never does – when they tried, he made such an amazing fuss that the whole store watched. So now one parent does the shopping alone and there are none of thefamily trips that the had imagined. He likes to watch his favourite programmes, so the whole family does. He has memorized the programme guide and he knows when the programmes are on – at that point, he demands to watch. When his older sister is unhappy and crying, or his mum is busy sorting out things in the kitchen, his needs have to be dealt with immediately. Or Else. The melt-down, if they don’t attend to him immediately, is horrible.

Rachel and I have been talking about the problems this causes, especially for his sister Sara. Sara is 10, and we included her in some of the conversations. She has always known that her brother was different, but tended to feel he was doing things on purpose, rather than that he has a problem. She also feels that her parents let him get away with murder and is increasingly about it. At the same time, she feels protective of him at school, and has tried very hard to protect him when she saw he might be being bullied.

Rachel had not realised any of this. She and her husband had been so busy trying to survive that they had sort-of allowed their daughter just to ‘get on with it’. Sara appeared very relieved to be having conversations about all of this. At one point she turned to her mother and said almost with disbelief “you really didn’t know how hard it is at school?”

Rachel and I talked about how to manage some aspects of the boy’s behavior. They already used a visual timetable to explain what was happening every day, but Rachel decide to expand it to include some of his favourite programmes – but also to allow Sara to watch things she wanted to see, by giving him control of the controls only at particular times.

We also talked about teaching him that certain activities were coming to an end, or that he had to wait, by using a Counting System. The parents were going to talk to school and either use the system they used, or develop one alongside them. Often, it is enough to say “I’m going to count to 5, and then…… “ This is difficult to start with, but counting is actually a very safe way for him to be warned that something will start or stop. Eventually this should give Rachel time to finish something she is doing before attending to his needs.

I have also arranged to meet with Sara again to give her a space where she can complain about her brother without feeling mean, and can perhaps learn ti understand him better.