Welcome to the November edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to [email protected].

Q: My son is 23, currently lives at home and has been aware of his diagnosis of Asperger’s for many years. He is a pretty accomplished guy, but struggles constantly with anxiety, confidence, and independence. Nevertheless, he chose to spend a year away from home in a residential living skills vocation program, which he really enjoyed. He has nearly completed his Bachelor of Commerce degree, and has also, albeit reluctantly, obtained his driver’s license.

My question revolves around driving. He’s got his license, but it’s been like pulling teeth to persuade him to keep practicing the skills he’s learned. His great reluctance to drive by himself has led me to try following or leading him in our extra car while he learns to drive longer and longer distances. My hope was to have him feel confident enough to drive himself to places he can’t get to by walking or by bus. He grows in skill but negates any progress he makes. I am at my wit’s end and wonder if this is a losing battle. Any thoughts?

A: A losing battle? No. However, it does sound like, despite your son’s driving skills improving, anxiety is playing a large part in his resistance to driving independently. In general, skills can take longer and require more repetition for the autism brain to master (and let’s face it, driving is a VERY complex skill with a lot of variables to learn). If you are worried about anxiety impacting this and other parts of your son’s life, your son’s primary care provider may be able to make a recommendation for a mental health evaluation, which will provide you with diagnostic clarification and a treatment plan. It is also important to think about the stick with which we measure success. In the end, not everyone is a driver. More and more folks these days choose to walk and take public transportation, which may be what your son opts to do. Ultimately, I hear you saying that independence is the goal, and this can likely be achieved, driving or not.

Q: I recently read that kids with Autism convert sensory input into picture or video memory. Is this true? If so, is singing to my child a good thing or should I be having my child watch videos instead? Do videos harm him? What kind of limits should I place on singing songs or watching videos?

A: Thank you for writing in. Generally speaking, given the “autism brain’s” varying challenges with language (which is an abstract process), the use of pictures (which are more concrete than the spoken word) can aid in understanding and communication. That doesn’t mean, however, that singing to your child or listening to songs is harmful or not worth doing. Speaking to and singing to (any) child increases the vocabulary that they are exposed to, which is good for any child’s language development. One could argue that increased language exposure for a child with language challenges is especially important. You might add to the singing experience by showing your child pictures, using hand gestures, or using puppets or props that coincide with the song lyrics. Reading and simply talking to your child can also be helpful.

Videos are another way of providing visuals to your child, and children with ASD tend to focus more heavily on video content than even the same actions happening live in front of them. Unlike reading, talking or singing though, there is a guideline that limits screen time; the American Academy of Pediatrics has historically recommended limiting screen time for children ages 2-18 to two hours or less per day. If you think about it, less time spent on screens means more time for learning, observing, exploring, interacting, and playing—all things that help promote development in any child.

In sum, sing and read and talk to your child to your heart’s content; do modify how much you use screens. Happy playing!