Aspergers Syndrome (AS) is in the category of developmental disorders of the Autism Spectrum Disorders (ASD) that is under the umbrella of Pervasive Developmental Disorders or PDD. It is different from Autism because there is not a specific delay of language or cognitive development, but does share the clumsiness (tripping, bumping, dropping things, etc.) aspects, although these are not particular to the diagnosis.
Why call it Aspergers?
It is named after Hans Asperger who, in 1944, described children in his pediatric practice who lacked nonverbal communication skills, were non-empathetic with their peers, and were physically clumsy. It is sometimes referred to as a high functioning autism.
Treatment
Aspergers Syndrome is treated mainly through behavioral therapy that is designed to work on communication skills, social skills, coping mechanisms, and helping with obsessions and repetitive routines. Most people with AS learn to cope with their differences, but may need support and encouragement to maintain their independence.
A typical treatment program for a child with Aspergers Syndrome includes:
The training of social skills for more effective interpersonal interactions
Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions, and to cut back on obsessive interests and repetitive routines
Medication, for coexisting conditions such as depression and anxiety
Occupational or physical therapy to assist with poor sensory integration and motor coordination
Social communication intervention, which is specialized speech therapy to help with the pragmatics of the give and take of normal conversation
The training and support of parents, particularly in behavioral techniques to use in the home
Kids with Aspergers don't usually share the withdrawn isolation of children with autism and will openly, but often very awkwardly, approach and engage others in social situation. However, their inability see things through others eyes, and the tendency to go overboard going on and on about their latest obsession, makes them appear selfish, uncaring and insensitive toward other people. This is not necessarily true, they just don't realize how they are perceived or that other people have different interests and feelings than they do.
Many of the children with Aspergers will actually memorize reactions in specific social situations, and recite definitions or examples of emotion, but have a very hard time acting on any of that knowledge in a real situation. Or they will use a rigid application of the specific social rules they have memorized. This can come across as forced eye contact, or the plastered on smile, or laughing at the wrong time. They want friends and do seek out social contact, but over the years their failures in these situations can be devastating.
Kids with Aspergers will sometimes develop very focused and intense interest in something or some activity, that will completely dominate their time and their life, almost to the exclusion of everything else, and they will try to draw whoever they can into the same interest. This is usually seen as normal childhood interest and behavior at first, until the obsessive qualities become apparent and problems relating to anything or anyone else starts happening.
Diagnosis
The diagnosis uses the identification of the stereotypical and repetitive behaviors as a central part of how it is diagnosed, but confirmation is done by ruling out anything else that can cause the same symptoms. The motor behaviors that are observed are things like the hand flapping or twisting, complex whole body movements and walking on tip toes, repeating the same word or sound over and over again are all typical repetitive behaviors of AS.
Other Issues
Your child may display symptoms that aren't a part of an Aspergers Syndrome diagnosis, but still affect the child and your whole family. They may have perception difficulties, and problems with fine or gross motor skills, handling emotions, and difficulty sleeping. Many kids on the spectrum (Autism Spectrum) have trouble with SI, or Sensory Integration, and can be overly sensitive or under sensitive to sound light, touch, texture, taste, smell, pain, temperature and other things that stimulate the senses. It may feel soft and nice to you, but to them, it can be actually painful.
Children with Aspergers are more likely to have sleep problems, including difficulty in falling asleep, waking up often at night, and early morning awakenings. Aspergers is also associated with alexithymia, which means having problems identifying and describing ones emotions. My daughter certainly has emotions and feelings, but she has no idea how to describe them or even what they are, or why they are there. Very frustrating.
Special Education
Children with AS may require special education services because of their social and behavioral difficulties, although many attend regular education classes. Teens and tween with Aspergers may have difficulty with self-care, organization and disturbances in social and romantic relationship. They are usually very smart, but the inability to properly express and the awkwardness of social contact keep many from leaving home as adults, although some gain independence in work and domicile, even marrying and raising a family. Teen and preteen years are hard enough on kids without social difficulties, but can be very traumatic for a kid dealing with Aspergers.
Coexisting Conditions
Anxiety with AS is very common, and is usually centered on change or transition. That is why a consistent schedule is so important. Anxiety and stress during social situations is inevitable because of the constantly changing nature of humans and relationships and situations, there isn't a single right thing to do in every situation. Stress and anxiety will show up usually as a behavior, such as withdrawal, an obsession, hyperactivity, or even aggressive or oppositional behavior.
Depression, and other mood disorders, can be the end result of the constant stress and frustration of failing to properly socialize and make friends. Medication and behavior therapy can be used to deal with co-existing problems such as anxiety, depression, inattention, obsessive compulsion, and aggression.
Getting the family involved by helping them to understand what is going on with their child or brother or sister, will have a big impact on the child's future. It will also help with being able to deal with everything that is involved in dealing with a child with Aspergers Syndrome and bring some semblance of normalcy back to the family. Getting help early and involving the whole family as a built in support system has the best effect on long term outcomes for a child with Aspergers Syndrome.
Judson Greenman, advocate and father of four very special girls started these websites as a way of sharing the joys and challenges of Raising Special Kids - from one parent to another. See it all at http://www.my-special-kids.com and http://www.anieleirose.org
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