“Oh my! It’s raining cats and dogs out there!” A second-grade girl remarked as she stared out of a classroom window. Another child, wide-eyed and twirling her braid, turned and stared in shock and disbelief at the raindrop scattered windowpane. “What do you mean, those poor puppies!?” she cried. “Nooooo….” scoffed another classmate, “There are NO ANIMALS. She means it’s raining REALLY HARD.” The concerned child saddened about the well-being of the possible tumbling animals outside, slumped down in her chair, trying to avoid the gaze of everyone. Her eyes welled with tears, and she remained silent throughout the rest of the class. She continued to twirl her hair with more vigor. Soon the sun began to shine via the droplets on the windowpane, and she stopped twirling her hair to stare at the beautiful array of light. “This is a prism, a spectrum of light.” She whispered to herself.

Children with Autism Spectrum Disorders have their own unique struggle. Like the spectrum of light, Autism diagnosis defines a broad range of conditions that demonstrate marked struggles with language (expressive/receptive), repetitive/restrictive behaviors, social skills, and nonverbal communication. This vignette of an interaction between three 8-year-old children provides an example of a receptive language issue. For this little girl, she struggled to understand an idiom likening the raindrops to “cats and dogs falling from the sky.” Dr. Stephen Shore stated, “If you met one person with Autism, you have met one person with Autism.” He is an author, a professor of Education, and a member of the board of Autism Speaks, an organization created to educate and advocate for those affected by Autism throughout their lifespan. His quote incites awareness that while a child may be diagnosed with autism, their presentation and needs will be unique. (APA, 2013)

Autism Speaks shares statistics and trends that have shown a steady increase in the diagnosis of autism spectrum disorders (ASD). Diagnosis has become more comprehensive in recent years. Awareness and early detection have been associated with an increase in the frequency of diagnosis. The Centers for Disease Control (CDC) reported in 2021 that 1 in 44 children was diagnosed with an autism spectrum disorder in the United States. Autism affects children across all socioeconomic statuses and minority groups. Minority groups are diagnosed at a later age and at a lesser frequency than other demographic groups. Families face multiple challenges after diagnosis. These include parents having difficulty maintaining ‘out of the home’ employment while becoming full-time advocates for their children. The additional cost of providing treatment and care per child with ASD is approximately $60,000 per year (Autism Speaks, 2017).

Risk Factors of Military Children with Autism

While 1 in 44 children in the general population is reported to be diagnosed with Autism, the statistics are not entirely clear for military children. In 2020, TRICARE reported that across all branches of service, 34,361 military children were diagnosed with an autism spectrum disorder, with about 60% being children of active-duty Service members. It is suspected that these numbers are underreported (Klin et al., 2015). Military children with Autism and their families face unique stressors and struggles compared to their civilian counterparts. Military families must secure a treatment provider and participate in testing, diagnosis, treatment, and educational support while remaining mission-focused.  Stress is escalated with uncertainties about deployment, war, and geographic separation from their support systems in permanent changes of duty station (PCS) (OAR, 2019).

Case Study/Expertise

Although there have been many systemic improvements in services for military children, there are still barriers that exist due to the high mobility nature of military life. Most military families move every 2-4 years, requiring parents to establish new care providers for their children once they arrive at their new location. For children who require specialized care, it is even more daunting. After months of treatment in their current duty station, they are required to “go back to the end of the line” once they locate a new service provider. High frustration levels were also reported due to a lack of satisfaction with the quality of the care their child receives at their new provider. Families not only geographically isolated from their previous providers, but military parents with children with autism reported higher stress levels and social isolation across qualitative research after relocation and during separation (Klin, et al, 2015).

Deployment cycles lead to increased behavioral and emotional issues for military children. Parents have reported that once their child’s problematic behaviors have stabilized after their parent has deployed, their behaviors may increase once again once the parent returns from deployment. Children exhibit increased emotional withdrawal and repetitive behaviors when their Service member parent is deployed. It has been reported that the parent left behind to manage the care of the entire household can experience feelings of guilt and worry about providing adequate parenting alone (Davis and Finke, 2015).

Permanent Change in Duty Station (PCS) also takes a unique toll on the military child with autism. Friendship and social interaction are protective factors and good for overall mental health. Military children move frequently and must make new friends in their new hometown and school. Autistic children innately struggle with making social connections, making it harder to establish new positive social connections with peers. Autistic children were reported to be lonelier and more withdrawn after relocating to their new location (Davis and Finke, 2015).

Magellan Federal Best Practices

As mission partners, Magellan Federal Military & Family Life Counselors (MFLCs) can become the help multiplier for these special families. MFLCs may serve as referral linkages, connecting families to the life-changing services locally or at their next duty station before moving. MFLCs may create an Autism Resource Connect (ARC)—a smooth connection to autism resources for military families from one base to the next. This proposed program component can partner with base resources to maintain an updated roster of local providers to ensure that before, during, and after the process of permanent changes of duty station (PCS), families can ensure a comprehensive and smooth transition to local support. Utilizing the current Military Family Life Counseling network of counselors, resource lists can be maintained locally and can be shared with their counterparts at other installations.

Although MFLCs do not provide direct support for the child diagnosed with autism, their families may benefit from the non-medical counseling support. MFLCs can provide support through individual, marriage, and family counseling. MFLCs can also connect with local Exceptional Family Members Programs (EFMPs) to provide MFLC briefings/presentations to families currently within the program advising of support that can be provided to the family unit. Although the child with exceptional needs is out of the MFLC program scope, the parents and siblings are not.

Another gap that appears to exist in care for these military families is the support of the siblings of children with autism. School MFLCs have particularly great advantages in identifying and serving these unique children. Siblings of children with autism, particularly older siblings, tend to externalize stress and frustration through negative behaviors. MFLCs situated in middle schools and high schools may be instrumental in providing support for these children. These siblings empirically have shown higher tendencies to experience loneliness, academic struggle, and aggression (Walton & Ingersoll, 2015).  MFLCs can create spaces of peer support in the groups.

In April, we celebrate the Month of the Military Child. We wear purple in support and solidarity-creating awareness of the unique challenges of the military child. Military children and families affected by autism experience these challenges compounded by navigating life’s daily routine challenges. While awareness is wonderful, awareness is the first step. Magellan Federal supports children diagnosed with an autism spectrum disorder and their families by bridging gaps in support and care. Specifically, MFLCs provide briefings and psychoeducation regarding available services to supportive base programs. Autism is a life-long disability. With support, every individual can reach their potential. The outcomes for children are exponentially better with early diagnosis and intervention. MFLCs can make a difference. One Team. One Mission.

Resources

OAR. A Guide for Military Families(2019) https://operationautism.org/wp-content/uploads/2019/12/A_Guide_for_Military_Families.pdf

Autism Speaks www.autismspeaks.org

Exceptional Family Member Program https://www.militaryonesource.mil/special-needs/efmp/

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

Autism Speaks(2019). Autism and Health Report https://www.autismspeaks.org/sites/default/files/2018-09/autism-and-health-report.pdfb

Davis, J., & Finke, E. (2015). The Experience of Military Families with Children with Autism Spectrum Disorders During Relocation and Separation. Journal of Autism and Developmental Disorders, 45(7), 2019-2034.

Klin A, Wetherby AM, Woods J, Saulnier C, Stapel-Wax J, Klaiman C, Jones W, Rubin E, Scahill L, Call N, Bearss K, Gunter C, Courtemanche CJ, Lemieux A, Cox JC, Mandell DS, Van Decar JP, Miller RA, Shireman CL. Toward innovative, cost-effective, and systemic solutions to improve outcomes and well-being of military families affected by autism spectrum disorder. Yale J Biol Med. 2015 Mar 4;88(1):73-9. PMID: 25745376; PMCID: PMC4345541.

OAR. A Guide for Military Families(2019) https://operationautism.org/wp-content/uploads/2019/12/A_Guide_for_Military_Families.pdf

Walton, K.M &Ingersoll, B.R. (2015) Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protector Factors.

April is the Month of the Military Child, which celebrates and acknowledges the children of our service members. While living with a military family member can make children resilient and strong, this lifestyle can sometimes make them more susceptible to bullying in a school setting.

The Army’s Adolescent Support and Counseling Services (ASACS) program is a wonderful resource for military families looking for bullying awareness and prevention tactics. The ASACS program provides confidential counseling for adolescents and families to help them thrive while supporting a loved one stationed overseas.

Magellan Federal provides 23 ASACS counselors and four Clinical Supervisors at 22 Department of Defense schools worldwide and is intimately familiar with bullying issues that are prevalent within the military adolescent population. If you are a teacher, counselor, parent, or caregiver, here are some effective techniques our counselors have used to educate and help safeguard military children against bullying.

Educate with Games with Prizes

Create a bullying awareness event to open a discussion about what bullying looks like and how to take action. Have students write down what they would do if their friend was bullied on a sticky note wall and participants spun a wheel to answer questions about bullying scenarios to win a prize. This helps children understand how to identify bullying and actionable skills they can call upon to get help.

Encourage Role Play
We have also found success with conducting lessons on healthy communication through role play. Ask kids to create skits to demonstrate different communication styles. These will help participants identify assertive, aggressive, passive-aggressive, and passive communication, body language, and appropriate social filters to promote healthy communication and dialogue.
Then discuss how other communication styles could be hurtful and why social filters help to improve relationships and decrease instances of bullying.

Organize a Kindness Event
Organizing a school-wide prevention activity can help promote kindness and gratitude on a greater scale. Encourage students to write notes to friends, students, teachers, and staff about what they appreciated about that person. One of our recent events had about 700 messages written!

Schedule Ongoing Discussions
Conduct mini lessons on topics such as bullying prevention and empathy building. Setting aside a scheduled time to chat about bullying-related topics will keep it top of mind and build trust. These talks can also be used as an alternative to detention.

Bullying is a serious issue for military children, who may be more vulnerable in school settings due to their unique lifestyle. As caregivers, educators, and advocates, we must collaborate to provide resources and support to create a safe and inclusive environment for all children. By implementing these effective techniques, such as educating through games, encouraging role play, organizing kindness events, and scheduling ongoing discussions, we can equip military children with the necessary skills to identify and stand up to bullying. Let’s continue to prioritize the safety and well-being of our military children, not just in April — but every day.

Our nation recognizes April as the Month of the Military Child, celebrating and acknowledging the children of our service members. Through the Adolescent Support and Counseling Services (ASACS) program, overseas middle and high school youth enrolled at Department of Defense Schools have access to in-school counseling and prevention education lessons at no charge. Whether or not ASACS services are available in your area, it’s worth taking a look at the challenges military children often face, and the resources available to support their mental health.

The Challenges Military Children Face

Military children must learn to be resilient because their households may relocate every 2 to 3 years — sometimes overseas and to new cultures. For many kids, this is a difficult challenge. Middle school and high school are particularly challenging ages, where social connections, friendships, and romantic relationships become more important.

A term has been developed to describe children who spend formative years growing up outside their parents’ native culture—Third Culture Kids. Military children often represent this demographic when they relocate to other countries, which can translate into culture shock and create unique challenges that typical American teens may not experience.

In addition to being susceptible to frequent family moves, COVID-19 has impacted everyone across the globe, and our military children are no exception. They faced attending virtual schools in communities where they are already feeling isolated due to being in a new country and community. We have seen mental health concerns like depression, anxiety, and alcohol and drug use increase due to the pandemic, and many parents and students do not often seek help. But here is how they can and should.

Support Services for Overseas Youth

The key to effectively transitioning military children to their new surroundings is working with a counselor on their terms. Magellan Federal delivers the Adolescent Support and Counseling Services (ASACS) program on more than 14 locations in 6 countries.  ASACS is a school and community-based program providing counseling and educational prevention-based services that are confidential for students in grades 6 -12.

Magellan Federal counselors focus on issues unique to military children such as transitioning to new environments, coping with stress and challenges associated with moves, and alcohol and drug prevention. Additionally, our counselors support these young individuals with all the other “typical” issues teens face.

As the demand for mental health services has increased, getting on a waitlist for psychological services is a real challenge for students. So often, many students are ineligible for on-base counseling due to staffing limitations, and off-base options are usually nonexistent or not adequate for English-speaking students. Through ASACS, Magellan Federal provides tailor-made, in-school counseling and prevention education lessons at no charge to overseas middle and high school youth enrolled at Department of Defense Schools. The Magellan Federal staff works with students and teachers to identify an appropriate time so that the student is staying in class as much as possible. Our team develops counseling schedules, ensuring kids receive timely, critical emotional and behavioral support while maintaining academic requirements. Because of our programming, parents do not need to leave work early and drive to accommodate a counseling session, positively impacting family engagement.

It’s important to address the unique needs of military children overseas during formative years, to proactively ease their transition and bolster confidence and resiliency. ASACS services are available to any military ID card holder student and their families. To connect with your regional ASACS counselor contact your child’s school at the front desk or the guidance department or contact Allison Welliver at WelliverAL@MagellanFederal.com to inquire about local services.