It is with a heavy heart that I announce my departure from Seattle Children’s Hospital. It has been such a pleasure and privilege to be on this journey with you all, and I thank you for your loyalty to Ask Dr. Emily, for your authenticity, and for keeping me on my toes with your inquiries. While family and life pull me away from my duties here, I am proud to introduce you to a colleague and dear friend of mine, Dr. Emily Neuhaus. Dr. Neuhaus is a clinical psychologist at the Seattle Children’s Autism Center, who has many years of experience and expertise to share with you all. Coincidentally, the name of the blog gets to stay—this was meant to be!

With confidence, I hand over the Ask Dr. Emily blog to Dr. Neuhaus and bid you all farewell and good luck. Thank you for the many years of meaningful and thoughtful discussion. Keep those questions coming!

Dr. Emily Neuhaus, PhD

Q: My grandson was diagnosed with ASD at 12, when he entered Jr. High. I can really see it now that I know symptoms. He has Asperger’s. Because he hasn’t received any help till now, he is so far behind. It is very difficult for him to understand why suddenly he has so many Dr. appts. He has become somewhat argumentative and is opposing all Dr. appts. I don’t know how to deal with a lot of his behavior other than being supportive. How do I deal with a 15 year old that doesn’t understand?

A: This sounds like a tough spot for both you and your grandson! You’re likely feeling some urgency to get him up to speed with skills and services he needs; meanwhile, he’s likely trying to assert some independence (as all teenagers are). I can see why you’d have disagreements about this!

Overall, your intuition — to be supportive to him — is a great place to start. If you haven’t already, you might consider talking with him about ASD. What does he know about ASD and how does he feel about his diagnosis? Are there any aspects of ASD that he finds challenging or wishes he could change (e.g., feeling bothered by sounds, wishing he had more friends)? If there are, these could be a start to helping him see how the appointments he has can be helpful (e.g., OT helps reduce sensory sensitivity, social skills group helps him make friends). In other words, figuring out what matters to him and showing him how these appointments can support those goals might increase his willingness to participate.

From a practical standpoint, do you have an ongoing provider (e.g., nurse practitioner, therapist, primary care provider) who could help you both prioritize your grandson’s appointments? Families are often overwhelmed by the time commitments of different supports related to ASD, and I can see how your grandson would be frustrated by so many appointments! Maybe you can work with your ongoing provider and your grandson to consider which appointments are most important and whether any can be changed to lessen the burden on your family. If you don’t already have a provider who can help you prioritize care, ask your pediatrician for a referral to a medical or psychological provider with expertise in ASD.

Last, I’d encourage both you and your grandson to connect with other families who’ve been in your shoes and who might offer some support. These are tricky things to balance and you’re not alone in this challenge.