Mental Health Services

AuSM's highly trained, certified therapists have committed their careers to helping individuals with autism understand their diagnosis and address both the challenges and gifts that it can bring. 

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AuSM Mental Health Services 
Barbara L. Photo 
Sara Pahl, MS, BCaBA, NCC

Beth Pitchford, MA
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Dear Sara,

My 15-year-old son spends all of his time playing video games. This seems to be the only thing he wants to do! School and social situations are very difficult for him, and while the games seem to be something he needs to decompress, I am worried if this is really helping or allowing him to isolate further. 
- Feeling Trapped

Dear Feeling Trapped,

There are a few things to consider when deciding if gaming is becoming a problem. Gaming may be a coping strategy for your son because it is a strength area that reduces negative feelings from difficult situations such as social interactions or homework. Positive social interactions may be happening for your son while he games because the social world can be easier to navigate online than in real-time for someone with ASD. The visuals and concreteness of the games and the online world are also things that seem to be helpful or intriguing for people with ASD. 

That said, many adults with autism struggle with self-managing gameplay or Internet use. They may lose track of time, and can forget important things while playing. Some say they can isolate easily because disengaging from the computer and choosing to engage with others or leave the house takes them away from the calming environment of the computer. Leaving the house can seem difficult and often unpleasant.

Helpful strategies some adults employ include using alarms on their phones or text reminders to help them self-manage. Sometimes they will use only one device for leisure and one for more day-to-day business. If they continue to struggle, sometimes they will eliminate an app from their phone so they are not as easy drawn to the game or social media. Sometimes it is a matter of what is a priority for the person versus a priority for others, and deciding what is more important.

For your son in particular, here are some suggestions:

1) Find out the why. Talk with your son, watch your son playing, or try to understand what he really enjoys about the games (without annoying him). Learn about what is reinforcing about the games your son is playing. Is it the strategy involved? Is it the music and the visuals? Ask about the characters or the goals. The more you know about the games your son is playing, the more you will have something in common to talk about. You may be able to find out more about what he is trying to cope with or escape from and what excites him. Listen or watch more than talk. This is important so that you can help offer other alternatives in the future that also may become coping strategies or suggestions for other leisure activities that your son may want to try. 

2) Try to avoid threatening to take away technology as a punishment. Do you say this daily: "The games will be gone or taken away if you don't....!" If this is the case, then the conversation needs to be changed. Generally, when you punish by removing the games, you are the one whose behavior is reinforced because the unwanted behavior decreases immediately. This will work for roughly one or two times, but unfortunately, it will lead to more power struggles, endless negotiations, emotional responses, and potentially aggression. Make sure the conversation around games includes more than using them as a consequence.

(3) Be a healthy screen role model. As parents and healthy models, begin to define a healthy day. I recommend that each family decide what is a healthy amount of screen time for everyone in the family. Look at how much screen time everyone is currently engaged in, and get everyone's thoughts. There may need to be differences set out for different ages and responsibilities, but if that can be made as clear as possible, and as visual as possible, it will be helpful in the future. Decide if there is a difference between passive activities (watching videos) versus interactive activities (Skyping or writing a paper).  You may assign different values or allowed amounts of times for those kinds of activities. 

(4) Take some data in order to decide what's realistic and decrease emotions when talking about the subject. The data should be about the whole family including how much time are you on your phone and Facebook, TV, gaming devices, and the computer. Do you feel you have a healthy relationship with screen time? Is there something you would like to change yourself? Model and write these down so they are clear for everyone to see. 

(5) Make your son part of the process. Ask your son to look at the data and decide what he thinks is a healthy amount of time. If there is a big discrepancy, work toward a compromise. No one person should be singled out, and everyone should be more willing to buy into some changes if everyone is changing. If you solely pick the number of hours with no input from your son, you are likely to get push back. Use the data as information to guide decisions and keep him as part of the process.

(6) Sample other activities that may have similar value to what your son likes about gaming. Maybe make an agreement to try something three to five times before deciding if you like or dislike that activity. For example, try geocaching, and after the fourth or fifth attempt, ask him if he thinks he would like to try this again. Honor if he does not think so and then brainstorm another activity to sample.

(7) Set clear expectations and agreements, but don't be afraid to make changes as needed. Set up regular family business meetings to make these changes and reward self-management with more independence. This should include immediate rewards and longer term bonuses. Be clear what happens if the expectations are not followed. Some individuals may do better with a social story, power card, or video modeling as a way to demonstrate what is expected and the positive consequences.  

Remember that no matter how you prepare you are going to reduce time of something preferred. Make sure to try to explain how this process, in the long run, gives your son more freedoms. Instead of having others monitor him, he will be able to self-monitor.

Finally, if other activities that used to be exciting or engaging for your son are no longer approached, there has been an increase of arguing, or everyone is tip toeing around your son, that may be a red flag. That is a good time to seek a mental health professional's help. 
-Sara Pahl
The AuSM Mental Health Services Team offers therapy and support:
  • Diagnostic, functional or behavioral assessments for children, adolescents, and adults
  • Individual therapy
  • Family therapy
  • Developmental therapy
  • Behavior consultation
  • Marriage and couples therapy
  • Training for organizations and service providers
To inquire about our services or to make an appointment please contact AuSM at 651.647.1083 or e-mail 
Established in 1971, the Autism Society of Minnesota (AuSM) is a self-funded organization committed to education, advocacy and support designed to enhance the lives of those affected by autism from birth through retirement.