HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

Education and Counseling for Individuals Affected by Autism Spectrum Disorders

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The Six Characteristics of Asperger's Syndrome

There are basically six "areas of difficulty" associated with High-Functioning Autism (HFA) and Asperger's that you will need to consider.

1. Difficulty with Reciprocal Social Interactions
2. Impairments in Language Skills
3. Narrow Range of Interests and Insistence on Set Routines
4. Motor Clumsiness
5. Cognitive Issues
6. Sensory Sensitivities

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Parenting Aspergers Teens: Changes in Adolescence

Because they tend to be loners and have odd mannerisms, Aspergers teens can be shunned from popular groups of kids -- and can be the focus of teasing. Even so, these young people develop feelings for others they become attracted to, though they can’t always express their feelings correctly. This can lead to frustration and anger in the adolescent who develops his first tentative relationships. They are more likely to face rejection from their peers and be left with a low self-esteem as a result.

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Adult Diagnosis of Aspergers and High-Functioning Autism

"I have a new boyfriend who is handsome, but quirky. I'm wondering if he has Asperger Syndrome. I wouldn't hold that against him if he has this disorder, but knowing that he does - if he does - would sure explain a lot of things for me. Is there a way to know for sure before approaching him on this matter?"

As more and more doctors - and society in general - understand more about Aspergers and High-Functioning Autism, the condition is being diagnosed in grown-ups as well as kids. Sometimes the diagnosis doesn’t come out in adults until their own son or daughter is diagnosed with an Autism Spectrum Disorder.

Typical symptoms associated with Aspergers in adults include: 
  • adhering strongly to routines and schedules
  • an average or above average intelligence
  • difficulty controlling their feelings
  • difficulty empathizing with others
  • difficulty thinking abstractly
  • difficulty understand the emotions of others
  • missing the subtleties of facial expression, eye contact and body language
  • poor conversational ability
  • some inappropriate social behaviors
  • specializing in specific fields or hobbies

If your boyfriend has several of these traits, then he may want to seek an official diagnosis. 

A way for you to approach the matter is to lead with strengths. Most people with Aspergers have significant areas of strength (even if this has not been translatable into tangible success). Bring up areas of strength with your boyfriend. Next, tactfully point out the areas in which he may be struggling. Then, suggest to him that there is a name for that confusing combination of strengths and challenges, and it may be Aspergers.

Like kids with Aspergers, these adults are often seen as odd. In years past, such individuals muddled along in society - sometimes on the fringes – while others were diagnosed with different types of mental illnesses. Now that Aspergers and High-Functioning Autism have been brought into the public light by cases of people who either have succeeded despite the disorder or committed crimes as a result of having previously undiagnosed Aspergers, more adults are being picked-up and treated for the condition.

Often these aren’t adults specifically asking for help for suspected Aspergers, but rather have anxiety and/or depression, issues around self-esteem, or other mood issues that bring them to doctors or therapists that are now making the correct underlying diagnosis.

By finding the correct underlying diagnosis, more help can become available even to those who’ve likely had the diagnosis their entire lives – but were unnoticed or labeled something else.

==> Living With Aspergers: Help for Couples

 
Comments:

•    Anonymous said… I'm an adult and I am certain that I have an undiagnosed autism spectrum disorder. I'm despressed and frustrated at this time because there seems to be no way of getting affordable autism testing and assessment from a qualified professional. I have spent many hours trying to make phone and internet inquiries into making this happen. My desire is to start a petition to President Obama to release funds for more services to be made assessible to adults, including autism testing. But I need to find someone who will give me permission to use a photo with the message "Children with autism become adults with autism" to make that happen. I have one daughter who is high-functioning and is on the spectrum and a biological dad (now deceased) who is believed to have been on the spectrum.
•    Anonymous said…  I have three places I am totally comfortable..my pub..my job and my own company.I was diagnosed at the aga of 52 by Dr Stephen Underwood in Australia.It was my ex who pushed me toward my being diagnosed and I still miss her very much but I have become comfortable with how my life will evolve..It takes an exceptional person to take on a telationship with an aspie.
•    Anonymous said…  talk to green maxville and associates in st.louis mo.they are helping me with my high functioning autism.i have health care usa managed care plan through mo health net.it is medicaid.having 10 sessions of behavior therapy and some comm therapy.my number is 314 792 4482.you not alone.i am 36 yr old adult.
•    Anonymous said…  I have long suspected I'm an undiagnosed aspergers. I have all the criteria listed. Unfortunately, I believe I was an absolute terrible baby and child with inexperienced parents and so suffered terribly through my childhood. This means that when I approach someone for help their focus goes to my abusive childhood rather than helping me with my aspergers symptoms now. Does anyone have any ideas or suggestions for the best way for me to get some help and understanding?
•    Anonymous said…  I too was a "terrible child," abused by my mom, coaches, teachers and kids in school. I believed that there was something wrong with me, they told me I was "weird." That was my diagnosis. Despite, I did grow up to become a super successful adult (i guess high functioning autism). I am still not diagnosed and thought very highly of the skills for success I've developed. In my work I am a Certified High Performance Coach. Few years ago I received a Masters Degree in Spiritual Psychology. The tools I've learned through the program have changed my life, especially around relating to other people, empathy, compassion, relationships, and communication. I can't say that now I love large gatherings or enjoy small talk conversations and never feel socially awkward, no, all of that is present in my life. However, I am creating meaningful connections, change people's lives, enjoy beautiful relationships and most important, feel fulfilled and happy! Perhaps, I could be of service to you and support you with the tools that have helped me in my own life so profoundly! I would be happy to hear from you. Please don't hesitate to email me at coach underscore faye at me dot com. Sending you love and light on your journey.


Best Comment: "I did finally find a counselor who deals with adults with aspergers. I had no problem finding counselors who dealt with kids, but adults is a whole other matter. Actually finding someone who could do a diagnosis was easy. The larger companies around here (with multiple counselors) typically all had a diagnostic section that handled that sort of thing. Its the treatment side of things that got dicey. Reading the online blogs and websites, I think that will change over time. Relatively speaking, Asperger's and HFA are pretty new disorders. It didn't even exist in the DSM until I was in high school! I imagine there are a lot of adults out there dealing with these issues, and as time progresses, more and more clinicians will become better equipped to handle it."

 

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How can children with Aspergers cope with anger and depression?

Unfortunately, anger and depression are both issues more common in Aspergers and HFA than in the general population. Part of the problem stems from a conflict between longings for social contact and an inability to be social in ways that attract friendships and relationships. Even very young "Aspies" seem to know that they are not the same as their peers, and this gets emphasized in the social arena of the classroom. Many cases of depression, in fact, begin in elementary school (usually due to bullying and being an "outcast"). Anger, too, stems from feeling out of place and being angry at one’s circumstances in life.


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Aspie Anger Control

"Is it common for children with Asperger's Syndrome to be rather explosive? My daughter can fly off the handle in a heartbeat for what seems to be rather trivial matters (to me anyway)."

Children with Aspergers and High-Functioning Autism easily can have as much of a problem controlling their anger as other children. Because children and teens with Aspergers have difficulty understanding emotions and their impact on others, however, they often have more difficulty than other children reigning in their anger.

In addition, teens with Aspergers aren’t living in a void in which they don’t understand that they’re different from other kids. Often teased by their peers, they can have incipient anger they don’t understand and can’t easily control.

Helping these children and teens with anger control issues requires direct communication about the affect of their anger on others as well as methods of improving their low self-esteem and poor sense of self-worth, which is often at the root of the child’s anger.

Anger that’s acted-out badly needs to be treated like any other unwanted behavior. Some form of reasonable consequence directed at getting the point across that the behavior is wrong needs to be combined with a pragmatic discussion of the meaning behind the anger and other ways to control the anger. Remember that what punishes the Aspergers child can be much different from what punishes other children.

If the anger seems to be a part of your child’s frustration over how he/she is being treated by others or from depressive feelings, finding better avenues to discuss what is really going on can help him/her deal with the issues without using anger as an outlet. Most Aspergers children are of greater than average intelligence and have the resources to understand the relationship between their anger and the underlying social issues their dealing with.

In situations where the anger seems to be an overwhelming issue, families should not hesitate to speak with a family therapist or other psychotherapist for help. 

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children and Teens 


 COMMENTS:

•    Anonymous said... As the saying goes "if you've seen one kid with autism you've seen one kid with autism". They are all different just as neuro-typical kids are. The daycare our son was at starting noticing issues with transitions at 2 yrs old. Had him evaluated at home and they saw no issues because he was at home. Long story short the daycare kept us informed and said he would not do well in the 3yr old class due to its size and structure. Had him evaluated again by having a doc give us forms for all his caretakers old and new daycare to fill out including us. He narrowed it down to aspergers or ADHD. Tried rydalin for one day and it sent him over the edge (which it will do if you are not ADHD) Been in speech and OT ever since then and we take courses and read up as well and he's doing beautifully. Can still see the asperger issues but they are getting milder all the time.
•    Anonymous said... I am blessed, I have enough ASD myself that I "get it" when my 15 yr old totally goes Bonkers over NOTHING! We have to work to find the triggers, hard since they don't often Share what they feel. They really do have a Reason for their explosions, We just don't always know what the reason is! Hard work developing communication so we can understand their reasons, but its worth the work!
•    Anonymous said... its all just trial and error. You'll have periods of regression and then again of progressio just don't give up, ull find what works for ur family.
•    Anonymous said... Mine def has explosive anger and he is 5...
•    Anonymous said... mine does, at the drop of a dime.
•    Anonymous said... Mine doesn't get upset about anything. He gets a little ticked sometimes but never angry explosive. He is very mellow in fact. Does that mean he doesn't have AS?
•    Anonymous said... Mine is also quite explosive.
•    Anonymous said... Mine sure does and often about the dumbest/weirdest things!
•    Anonymous said... My 8 year old has for years with nothing helping so far.
•    Anonymous said... My son did throughout elementary and most of middle school. He is now 15 and through many talks, discussions and maturity, he seems to be controlling his anger/frustration rather well. I have always been open and honest with him about how others can be, why they can be that way and how he is "different" than most kids his age. In time he kinda grew into his own, better understood himself and his own actions and I'm so proud of him. I would explain to him why things would effect him the way they do but he was never to use having Aspergers as an excuse to not be in control of his own actions and emotions. We have an open relationship and he knows he can talk to me about anything. That has been our biggest tool I think. He also did receive consequences when he would misbehave. I don't treat him differently just because he has Aspergers. Also very important. They get treated differently enough as it is.
•    Anonymous said... seems trivial to you - but not to your asperger's child. To them, expectations and perceptions are different than they are to you. It is difficult to think on their level. I almost lost my daughter a few times because of her outbursts, but she is learning and maturing and it is getting easier. Good luck!
•    Anonymous said... this sounds like the methods we are using with our son too. He's only 7 & it's only just begun to improve, but it's so great to read your post & hear how well it's worked for your son at 15, gives me hope! His sensory & social difficulties 1st became apparent around age 2, w/ diagnosis starting at age 4. Up until last summer we had never discussed with him what his diagnosis were or what they meant. He had a bad meltdown at a store one day & as much as I tried to hold it together, when the clerk got in his face & scolded him (making the meltdown escalate drastically of coarse), I LOST it! Ended up yelling at the clerk & blurting out "my son has Autism & thanks to you this meltdown is about to get a thousand times worse! In the future please keep your comments & opinions to yourself unless you know for sure what you're dealing with!" Needless to say, I felt awful later (once I calmed down & got him to a safe place) for lashing out at that complete stranger! But...it turned out to be a blessing in disguise! Since he had heard every word I said to her, he asked "mommy what is Autism & am I going to be ok?" The dreaded question & praying I could answer it correctly... We talked for a while about it & that seemed to be a turning point for him! It helped him understand why he feels the way he feels sometimes & that has helped him deal with those feelings. We never allow it to be an excuse for bad behavior, & there are always consequences when that happens, I think accountability for actions is very important because that is "the real world". A few months later, I heard him explain (as best he could) to a Neuro typical child that he had something called Autism & that's why he needed a break away from them to calm down! Priceless!

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Aspergers and Comorbid Conditions

"Is it common for a child with Asperger Syndrome to also have other disorders? My son had been diagnosed with ADHD, but now they think he may also have Asperger Syndrome."

Children with Aspergers and High-Functioning Autism are known to have several comorbid conditions. Comorbid conditions are those conditions or diseases that go along with having Aspergers. One of these conditions is known as ADHD or attention deficit hyperactivity disorder. Sometimes, these children can be misdiagnosed as only having the more common ADHD, with the Aspergers being missed.

Obsessive compulsive disorder can be a comorbidity with Aspergers. In some cases, this doesn’t show-up until the Aspergers child is an adult. What both conditions have in common is the need for order, and the presence of compulsive, sometimes irrational, repetitive behaviors. Some scientists believe that there is a neurological relationship between the two conditions.

Because those with Aspergers know they are different and have difficulty relating to others, they often suffer from acute or chronic depression. Others can have anger or violent symptoms out of frustration for being “out of place”. There have been reports of suicide and suicide-attempts among those with Aspergers. The symptoms of depression can respond to antidepressant therapy and also to psychological therapy, aimed at helping the Aspergers individual feel more accepted and acceptable to others.

In addition, seizures are a common comorbidity of Aspergers with some researchers believing that up to 30 percent of Aspergers children also have a seizure disorder. Medication can work in some cases, while other sufferers require specialized brain surgery to be free of seizures. While the Aspergers itself has no known cure or medications specifically designed for it, many of the comorbidities can be treated effectively. Not only can seizures and depression be treated, but the ADHD and obsessive compulsive symptoms have known medical therapies directed at helping them. Using these medications can often make Aspergers symptoms more tolerable and increases the functioning of the individual who is experiencing it.

The Aspergers Comprehensive Handbook


 COMMENTS:

•    Anonymous said... Mine has both. Diagnosed about 5 years with ADHD and with Aspergers when he was 8.
•    Anonymous said... Mine was diagnosed with Aspergers, then they mentioned he also has ADHD.
•    Anonymous said... My 11 yr old grandson was diagnosed bipolar when he was 3 & as Aspergers in elementary school.
•    Anonymous said... My 7 year old son has ADHD and Asperger's and according to his neurologist this is very common.
•    Anonymous said... My son also has anxiety and depression disorders to deal with, which are getting markedly worse with puberty.
•    Anonymous said... My son has adhd and Aspergers
•    Anonymous said... My son has been diagnosed with Tourette Syndrome and Asperger's. I have also noticed a worsening now that he is 10.
•    Anonymous said... my son was diagnosed with ADHD at 7 and Aspergers at 11 sometimes I think you can spot when things arent straight forward not that things are ever straight forward with any condition as such, i just mean there can be extra behaviours that can point to other conditions like Aspergers
•    Anonymous said... My son was diagnosed with ADHD at age five and Aspergers at age seven.
•    Anonymous said... My take (based on my experience) is depression is more of a causality of the conditions these kids must deal with, and not a direct chemical disorder in the brain(the conventional cause of depression). I wasn't diagnosed with ADD until college, and never formerly diagnosed with aspergers, but have and show many of the traits. Depression was a result of my inability to properly socialize with others. Left unabated it leads to apathy, and was only abated by my family's strong support.
•    Anonymous said... My take on this is that Asperger/autism (ASD) is the primary neurologic condition, and that these other diagnoses are just symptom clusters that frequently appear in people with ASD. That said, treating the symptoms can help overall function so in that way it's helpful/sensical to have another diagnosis. But it's not a new "disorder."
•    Anonymous said... Technically, according to the DSM, you can't be diagnosed with ADHD and a spectrum disorder on Axis 1, although some psychologists do it. It is a tough call for some evaluators because ADHD symptoms definitely are often seen with Autism. Paired with social isolation,or self-stimming behaviors, the default diagnosis is the spectrum disorder.
•    Anonymous said... Yes. Depression... and my kiddo too is getting worse with puberty. They diagnosed him with apraxia to explain his speech slowness, I took him in for ADD testing in 4th grade and that's when they finally diagnosed him with Asperger's... which explained ALL of the observations I'd had... and yes Kristina, it's getting worse, or at least different, with puberty...
•    Anonymous said... Yes... ADHD then Aspergers then Sensory Integration.


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Aspergers and Medication

"Are there any medications on the market to treat a child Asperger's Syndrome? If so, which ones have had the greatest benefit to those with the disorder?"

Because there is no identifiable biochemical problem in Aspergers Syndrome or High-Functioning Autism, and because many researchers believe the syndrome is a result of fundamental changes in the brain structure, medications will probably never treat or cure it. On the other hand, there are several medications that have been found to control some of the symptoms of Aspergers Syndrome or the comorbidities found with the condition.

A medication called atomoxetine has been found to improve some of the aspects of Aspergers Syndrome that mimic those of attention deficit disorder. Several studies have used the drug to reduce symptoms of irritability, social withdrawal and repetitive speech seen in this disorder.

Medications normally directed toward treating obsessive compulsive disorder have been tried in children with Aspergers Syndrome who have shown obsessive and compulsive tendencies. While the medication doesn’t treat some of the core symptoms of Aspergers Syndrome, it has been shown to improve OCD symptoms.

Antidepressants can be attempted in those Aspergers individuals who suffer from secondary depression. The depression isn’t generally a part of the Aspergers Syndrome itself, but is found as a result of some of the distressing life circumstances often found in Aspergers Syndrome. Many of these children and teens know that they do not fit in with others, and while some prefer social isolation, others lament their lack of ability to get comfortable dealing with others. This and other issues of self-esteem, etc., can lead to depression, which is often manageable with antidepressant medication.

Finally, people with Aspergers Syndrome often suffer from debilitating insomnia. While it’s best to use non-drug ways of controlling the symptoms, some people can make use of sleeping medication that doesn’t have to be addicting. Sometimes a short course of sleeping medication can get the individual back into a regular sleeping pattern.

Medications directed at anxiety may be necessary when the person with Aspergers suffers from nervousness or irritability surrounding their life situations. "Aspies" can become quite distressed by things not being the same or as expected, and anti-anxiety medication can help with this.

In truth, there is no single medication or class of medications that works to treat many of the core symptoms of Aspergers Syndrome. Some of the secondary or related symptoms can be effectively managed, however, with certain psychotropic medications.



Best comment:

Medication will help in very specific ways. Medication helps in reducing panic attacks, anxiety and aggression and explosive behavior. AS kids have restricted interests by definition of the disorder. They focus in on details on whatever it is they are talking about. Even with medication. But it helps to have the medication reduce some the stress. A good book to refer to for doses for AS kids is "Clinical Treatment of Autism" by Dr. Eric Hollander (From Mt. Sinai Autism Center) For example, AS kids start at low doses of Zoloft (25mg up to 50mg) or Prozac (10mg up to 20mg).

What else is needed is a different approach. Many activities need to be rehearsed in very small steps over years of exposures. And with a positive reinforcement plan. I have found Yale University Parent and Child Conduct Clinic very helpful. I have been trained by them on the phone over the last two years.

Here are some strategies:

1) Avoid stores with him until you can work on a behavior plan with him on this. When you have time, he needs to be taught to shop from a list, stick to a budget, ignore items he sees that are not on the list and that shopping is a reward to be earned by doing both. Tagging along with parents shopping is going to be irritating to him for a long time in the future.

2) Only pair him up with kids that are younger or not challenging personalities. Make the social activity predictable (movie, with defined snacks), or (park and a drink and chips we bring with) or (bowling 2 games and a snack and drink). Rehearse the social activity. And praise all positive behavior. Often as they get older, they will start to be able to be more flexible with peers.

3) Practice talking at meals about pleasant things that others are interested in. Don't allow dinners to be all special interests all the time. Practice at some meals taking an interest in the parent’s interests or other members of the family. This is a skill that takes time to develop. If he was shut out of conversation all day at school, then dinner may be his time to talk about his interests. It may have to wait until a less stressful time of the year to practice this skill.

3) Church is going to be difficult. All those people and the noise from all directions. It is an irritating place for many AS kids. My daughter goes to Sunday school (and I have taught the class for 8 years) not church services (except for Christmas and Easter when there is lots of music and we attend the children's mass).

I think parent's need support from a behaviorist. Parents of typical kids and teachers will not understand that these kids need very small steps and exposures to life in general.

Teachers and school staff will push too hard, it is only a certified behaviorist of autistic kids that understand behavior shaping is a slow process of gradual change with positive supports.

A better day for your son would be:

1) Lunch at his favorite place with you only. Agree on your limits ahead of time. The less limits the less irritated he will be. So pick an affordable place with food choices that you approve of.

Practice menu choices. Without a fight. Practice budget. When he can go to the lunch place without a meltdown over menu choices he is ready for your boyfriend to be there and then his son.

The goal of this exercise is to have a positive social experience. Don't expect to go to a busy noisy rushed place at lunch on Saturday with a group of people and expect him to be well behaved. It all has to be rehearsed and practiced.

2) Find him a church setting where there is very small Sunday school groups for kids his age. Let the teacher know he needs support and understanding.

3) Melatonin tablets are very helpful for relaxing AS kids at bedtime. This really works. The Mayo Clinic recommends them an hour before bedtime. I forgot the dose I use for my daughter, look at the Mayo Clinic web site on Asperger kids and medications. It has made a huge difference for my daughter. She use to get very anxious and had a busy mind at bedtime. Now she is asleep within an hour.

4) Follow this plan: One outing a day, one place, and allow 1 hour or more. Don't rush him to leave. Give him a warning. Offer a small reward if he leaves calmly when it is time.

There is so much to share about parenting an AS child. This is a rushed summary, and I am rushing through the details. But it is meant to give you an idea of the strategies that work. You will find a behaviorist very helpful. Yale was affordable for me. $75 for 45 min and I did get some money from insurance back. 


 More comments:

•    Anonymous said...  1. It's not a 'disorder' 2. No there is no suitable medication 3. Start finding ways to ease the anxieties, not turn children into Zombies with drugs. Rant over
•    Anonymous said...  Allison, My almost 12yr old grandson has been on Risperdol since he was 3. He has had no side effects other than weight gain which is under control with diet. His parents did take him off one summer & everyone, including our Aspie, was miserable due to daily meltdowns. Monitor closely but don't let peers pressure you to DC meds for no good reason.
•    Anonymous said...  Catapres nightly to assist sleep (age 7)
•    Anonymous said...  Dietary changes, ABA & OT therapy, and counseling have all been beneficial for our son/family. Our son no longer does OT, counseling is on an as needed basis and he'll most likely be done with ABA therapy too. As for the diet, that is a lifestyle change. We've also found great support through our church family & getting him involved with youth group & more structured type activities that he enjoys.
•    Anonymous said...  Everyone is entitled to their opinion, so this is mine. Why do people get so tetchy over words? Who cares what it is called as long as no offensive words are used. Why are people so against medication? Surely it is up to the individual parent. I know for sure I would much rather my daughter be stable than having her slit her wrists all the time because her mother didn't think she was worth enough to help her with medication. Many other therapies have been tried but failed because of her lack of communication ability be it verbal or otherwise. I would not deny my daughter calpol if she had a headache and would not wish for her to suffer the pain instead so who am I to deny her a chance of an anxiety free life just because of my belief against medication! Rant over!!
•    Anonymous said...  Go to the Amen clinic. They are wonderful!
•    Anonymous said...  I always caution, when considering medication for children, people to make sure they clearly weigh the pros and cons. Some medications for social issues (depression/anxiety) end up seeming to work and then backfire with symptoms that are even more aggravating including suicidal tendencies or violent outbursts. For so many medication works for many things, but since, as the article says, autism has not been found to be any particular imbalance that can be corrected, it may well be the best option is for us to make our environments more aspie/autism friendly than to try to force change at a medicinal level in them.
•    Anonymous said...  I would suggest starting with therapy, and see what direction that sends you in. There are so many medications you can put them on but lots of them have many cons.
•    Anonymous said...  I would suggest therapy also. Our son is not on any meds, but has been seeing a therapist for 2 years, and it has made a world of difference in his behavior. Medication may help some, but for us, we want that to be the very last option we choose.
•    Anonymous said...  My boy uses meds to help with his focus at school. I have had to educate our school a lot about reinforcing bad behavior. Education is the key. I would probably use meds even if we homeschooled. He tells me it is liked having steering and breaks. He feels more in control.
•    Anonymous said...  My daughter was on Risperdol and went off the deep end. She hasn't been on any meds (except melatonin) since age 7. Now shes in full blown puberty and NEEDS anti anxiety meds. No amount of therapy has helped, and she could hurt herself or someone else if she can't calm down.
•    Anonymous said...  My son began taking medication for anxiety when he was a teen. It has helped a ton. He still gets anxious, but it is not completely debilitating anymore. The medication side effects are very minimal as he takes a low dose.
•    Anonymous said...  My son is an aspie that also has adhd. He's six and takes vyvanse and tenex. I hated putting him on meds but sometimes you just have to.
•    Anonymous said...  Risperdol has been a life saver for my 14 year old son with Asperger's. His aggression has reached scary proportions and this med has helped with his anger and meltdowns. He also takes Lexapro for his high anxiety. I agree that it's the parent's choice...we all want the best for our children medicine or not. I honestly do not think my son could live with our family if he wasn't on medication.
•    Anonymous said...  risperdol has been a life saver for us as well, though with my son only being 5 years old I'm not sure how long I'll be willing to keep him on it, at least not for long term, we're thinking to just use it for the months he's in school. He also takes Fluvox for his OCD which has really helped him as well.
•    Anonymous said...  There is no medication for Asperger's. There are, however, medications for comorbid diagnoses such as OCD or ADHD. For Asperger's in and of itself, there is none.

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Aspergers and Family-Stress

"I have two boys, one of which has Aspergers. My husband has been diagnosed as well. I often feel like I'm in a constant state of playing mediator (and sometimes feel like I'm parenting 3 children, rather than 2 children and one adult). Is this common for Aspergers families, and what can I do to reduce our stress?"

Being a member of a family in which one or more members have Aspergers (High-Functioning Autism) can be extremely stressful at times. Sometimes it seems as if the entire family focus is on the Aspergers child and on the various tantrums and behaviors that come with it. Family members, and especially parents, can feel a low level of anxiety in anticipation of what could happen next.

It’s vital to take steps as a parent or sibling to take time for yourself away from the situation when things feel overwhelming. Take turns with the other parent so you each have peaceful times away from the situation. If possible, spend one on one time with other children in the home. This will reduce their stress level as well.

Get plenty of sleep. If your Aspergers child has difficulty sleeping, speak with his/her doctor to find ways to help your child sleep better so you can get your sleep, too. Don’t be afraid to take naps so you have enough rest to cope with whatever comes.

Don’t skip meals and eat as healthy as you can. If your child is on a special diet, make sure that the rest of the family and you get the type of nourishment that suits you best and revives your energy levels.

Consider exercising with or without your child. Take walks or bicycle rides to calm your nerves and increase your body’s endorphin levels. Stress levels automatically decrease with exercising just a few times per week.

Some herbal supplements like kava kava, valerian root and St. John’s Wort have relaxation and calming properties. In serious situations, these herbs can come in handy when you just can't seem to stem the anxiety on your own.

If the family appears to be in crisis over the stress and anxiety of some of its members, family therapy can be very helpful. Individual therapy is also an option for those family members needing extra help. Often the therapist can coach you in the coping skills necessary to stay healthy and to raise your Aspergers child as best as is possible.

My Aspergers Child: Preventing Meltdowns


COMMENTS:

•    Anonymous said... I expect it is common. My husband is not diagnosed, but I have certainly come to understand him better since our son's diagnosis. I just wish I knew better what to do about our problems.
•    Anonymous said... I feel the same way most of the time.
•    Anonymous said... i too have aspergers hubby and 2 a/s grown kids,yes i too felt the same,now all grrown up,just me and hubby now and life not so hard,i had councelling[for aspergers family]and got a career,but its still very hard,
•    Anonymous said... not to be funny here, but my two pdd kids are aged 5 and 6 and i have a typical 21 y.o. and a typical husband BUT I feel I am always parenting the husband... That is commen in many families! I also play mediator!!! men are men!

More comments below…

Books to share with your AS child...

Children with ASD struggle when trying to learn social skills, and the lack of social skills may have a bigger impact on their life than any other aspect. Peers can bully them for their differences and it is important that these children learn these skills as early as possible to minimize the effects of bullying and rejection from peers. Knowing these skills will help them be stronger people and make them less vulnerable to the actions of others.

Children learn from stories that share the same experiences that they may be having. Reading to your ASD child also provides the opportunity to provide the repetition that they need to absorb learning of new skills. It also provides the opportunity to role play skills that they don't seem to comprehend simply from the story. Further, the reading of these stories lets ASD children that they are not alone in the challenges that they face.

Diane Murrell, the author of two stories is the parent of children with ASD and has a first-hand understanding of the challenges they face. Tobin Learns to Make Friends teaches some of the skills necessary to make friends.

Children with ASD want to make and keep friends but often lack the skills to do so. Murrel highlights some of the skills necessary using incidents of shouting, crowding, sharing, borrowing, interrupting, taking turns, being kind, having good manners, and following rules.

Also by the same author -- Oliver Onion - The Onion Who Learns to Accept and Be Himself -- builds on the friendship building skills that were learned in "Tobin Learns to Make Friends." This book is aimed at children aged 4-10 and helps children with ASD accept who they are.

Suitable Careers for Adults with Aspergers

"Are there some careers that people with Aspergers Syndrome do well in compared to others? My son (high functioning) will graduate from high school in a few weeks, and I am feeling a bit concerned about his future. His one and only interest currently is computers."

Because adults with Aspergers (High-Functioning Autism) have normal to high intelligence, they often go into some very interesting and lucrative careers when they get older. In many cases, the field they enter is related to one or more of those things they were fixated on as a child. For example, if an Aspergers child has a fixation on the weather, he or she can think about a career in meteorology.



Other careers include working in the music industry. Aspergers individuals often develop striking musical abilities and can then work in this field as a later career. 
 
Careers involving mathematics or science are also common in Aspergers. This can include becoming an accountant, working in economics or scientific research, working as a university professor or other mathematical or scientific area. Often, the interest in math and science are natural gifts for these children, and the transition from avocation to vocation is usually a seamless one.

Careers in writing are not uncommon for Aspergers individuals. Writing is a solitary task, and often times, the Aspergers individual can learn to use words on a page to create books, articles and other material that overcomes their natural need to think in pictures.

Usually, the process of exploring careers needs to be done sooner for Aspies than with other individuals. Talking with guidance and career counselors is a good idea in order to explore possible options. Tours of different careers or shadowing a scientist or mathematician may help the Aspergers adolescent to get an idea of which type of career would be the best for him/her.

Older Aspergers teens should be doing plenty of reading about careers and jobs specific to those with Aspergers. Two books, Aspergers Syndrome Employment Workbook: An Employment Workbook for Adults with Aspergers Syndrome (paperback) and Employment for Individuals with Aspergers Syndrome and Non-Verbal Learning Disability by Yvona Fast are available in some bookstores or at www.amazon.com. There are plenty of ideas as to how to begin searching for an appropriate career in these publications.

There is nothing to limit a young person to just the areas listed above. Many Aspies have found success in other areas of employment. Pay attention to your child’s strengths and weaknesses, as well as the interests he/she exhibits.

==> Launching Adult Children With Aspergers: How To Promote Self-Reliance


 COMMENTS:

•    Anonymous said... As Jon Willis said. His was computers as well and he has done that and managed to build onto it. Go with the flow while building up experience and courage to step out a little bit more. Aspies can do and will achieve. Mary Camp-Autism. Have you read this ?
•    Anonymous said... Bill Gates and Mark Zuckerburg are a part if an initiative to get high schools to start teaching code, which is something that a lot of aspergers kids really understand! Computers are a great career track for anyone!
•    Anonymous said... Contact the school. Does he have an IEP? If so, they can refer to voc rehab for transitional services. My daughter has ASD. She is very bright but could not cope in some classrooms & has IEP even with A's & B's. Every state has a Voc Rehab. They will be a job coach for him so he can test different jobs or they will offer college support. Both in effort to prepare him for the work force. Its a fed gvt program funnelled down to the states. Ultimately its an effort to rehab folks with disabilities so they can earn a living and not spend life on ssi/ssd
•    Anonymous said... Have you watched the documentary on John Robinson,?
•    Anonymous said... I am quite sure that there are specialists in this area who assess those with ASD to assist in working out their strengths for this purpose!
•    Anonymous said... I know that is covered in the adult assessment here in Australia. Not sure about other places though. I wish you and your son all the best!!
•    Anonymous said... It has long been suggested that Bill Gates is an aspie. Computers will be enough if he decides to go that route.
•    Anonymous said... I've found that "growing up" is subjective, and often times, over rated. I don't think of it as moving out of my comfort zone, rather extending it into other areas.
•    Anonymous said... Many tech careers, engineering, art for some, a lot of aspie symptoms improve or refine with age and the aspie gifts start-a-shinin'
•    Anonymous said... My husband has Aspergers and he works in IT. He doesn't talk on the phone but in these times of smart phones he can be contacted pretty much anytime anywhere by email. It took him a long time to find a workplace in which he felt comfortable but I think that's the case for many people Aspergers or not!
•    Anonymous said... My husband has finally discovered Library Studies: cataloguing and little human contact!
•    Anonymous said... My son's therapist told me that most kids do better after high school.because they can focus on their interest, not a bunch of stuff they could careless about. Computers arent going away, so I would see about grants and scholarships to an ITT or other tech school for certifications and job position placement.
•    Anonymous said... Nothing wrong with a Career in computing, can command big bucks if you are lucky.
•    Anonymous said... Ps IT is often great for folks with ASD. Almost a perfect fit. Check out on youtube the documentary i watched on discovery on the story about John Robison. It will touch you & inspire you. It's called Ingenious Minds: John E. Robison. I am betting your son is much like him. Your son will be successful just hang in. I was where you are a year ago. My daughter is now in college. She does struggle every day but she is doing it one day at a time. Good luck to you & I hope the info is helpful
•    Anonymous said... Recently (last few years) I found out that I myself have aspergers. Since being diagnosed as a type one diabetic, I've been forcing myself into situations and roles that I find myself initially shying away from our despising the thought of, just to conquer my own psyche. Before being diagnosed with t1D, I had a crippling fear of needles, which as you can imagine I had to overcome quite quickly. This has become the mantra to my life. "You can do what your brain Screams you cannot. You only have to try." I'm now working in a face to face and phone based sales and solution position, and I'm loving it so far. I still occasionally get the old urges to retreat into my computer for solace and familiarity, but the more and more I squash those urges, the easier it becomes to face new challenges everyday. Any job, or role, would suit an ASD fine as a career, but they have to get comfortable with the idea of having challenging situations which trigger the "panic station" response to be overcome. It is possible, but to begin with it's not easy.
•    Anonymous said... The thing is, aspie kids have challenges but are most often quite gifted human beings. Geek chic baby. I think Sheldon on TBBT is wildly popular because he nails it in a lot of endearing ways.
•    Anonymous said... With many Aspergers people it takes longer to what some people would say"grow up" and be mature enough to take on roles away from our comfort zone.

More comments below…

How to deal with bullying of the Aspergers child...

"My child with Aspergers just revealed to me that he has been bullied by one particular peer since the start of the school year. I guess my son didn't mentioned it before because he didn't realize until recently that this other student was actually doing something "wrong" and hurtful (go figure). Is it too late to address this issue now that there are only a few weeks of school left? What should I do?"

Children with Aspergers and High-Functioning Autism often exhibit behaviors that are peculiar enough to hold the attention of children who do not have the best interests of the child in mind. Besides simple teasing, bullying of Aspergers children can happen in situations in which they have little ability to protect themselves.

Fortunately, if such bullying happens in school, it can be managed more easily (provided your child divulges that it is going on). Most schools are cracking down on bullying and are treating such behavior as assault and punishable by legal means. Parents have every right to speak with the principal, teacher or counselor in order to ask their help in controlling the bullies. Some schools have behavioral support staff whose job is to get to the bottom of behavior issues and crack down on bullies.

Teach your child to walk away from bullies, preferably before they get started. Help him/her learn to recognize those situations that may lead to bullying (e.g., after school, on the playground, during lunch, etc.), and teach him/her to be more vigilant and stay near adults in such circumstances.

Sometimes, just having another friend around may reduce the incidence of bullying. If your child has problems making friends on his/her own, facilitate friendships with mature, understanding children who can both be a friend to your child and can help out if bullies try to tease or hurt your child. Facilitating friendships may mean inviting a child over for a meal or for some games or television. It may mean taking the two kids to a movie or on a shopping trip.

Bullies are a fact of life for many (if not most) children with Aspergers. The more a parent can do to intervene with the help of other adults (and other children), and the more a parent can teach the Aspergers child mechanisms for self-preservation that don’t include fighting back, the better able the youngster can be in dealing with this difficult situation.

The Aspergers Comprehensive Handbook 


 COMMENTS:

•    Anonymous said... A lot of times the "bullies" are just regular kids that are reacting in the usual ways to the ASD reactions to being overstimulated & overcrowded. For example - Z tends to touch/bother the kid in front of her when in line, so the teacher always moves her to the front. The other kids think that's not fair, so at lunch and recess they make a point not to allow Z to play with them, and they say hurtful things to Z.  Z repeats over and over that she likes cats, and says peanut butter at the most random/inappropriate times. This makes other children uncomfortable around her. The class clown makes the other kids laugh by making snide comments about Z. Laughter helps make them feel more comfortable, even if it comes at the expense of the one they laugh at. In a wholly NT society, the group shunning of such behavior would make the child doing it stop and think about how doing things differently and being called "teacher's pet" is a bad way and they would most likely stop and conform to the norm. But for an ASD child this is extremely difficult to grasp, and not only that, it is completely wrong to expect an ASD child to "act normal". Teachers can try to combat this by educating the children about the child's condition, but it is hard for them to understand (and teachers themselves barely understand half the time) and it is tiring, takes up a ton of time, and they get extremely frustrated with Z because she is a distraction more often than not. It's not Z's fault she's a distraction, she is simply reacting to the pressure of being in a classroom with florescent lights, 20+ children all talking/moving at once, and the torture of having to sit still in one place for too long. The way the school handled our situation was to put her in a smaller class with other kids with behavioral issues, i.e., the Alternative School. The social stigma surrounding going to the Alternative School means that neighborhood kids who used to play with Z now will not, because their mommies and daddies say that only bad kids go to the Alternative School. So the shunning goes on and on and on. At least at the Alternative School, there are fewer kids in the classroom (7 children instead of 20+). She gets more one on one time with the teacher and has a chance to actually learn.
•    Anonymous said... Absolutely NOT too late. A lot of times Aspies dont realize it is bullying because they are so used to not fitting in..
•    Anonymous said... I fear this happens more than we know.
•    Anonymous said... It took two years before I realised how bad the bullying was at my daughter's first school. Not until she was suicidal at 9 years old. the school denied the problem, telling me she was making it up. So much bullying goes under a teacher's notice. I now home school, after three schools and a constant attack on her self-worth and the stress of coping with crowds and noise and lack of proper support. For the first time she is now making friends and keeping them, feeling safe around teens now she is not having to deal with them full time.
•    Anonymous said... It's never too late
•    Anonymous said... it's never too late to mention this to the teachers... and help the other child realize he is wrong with his behavior too!
•    Anonymous said... my daughter has had probelms at school with one girl who also has her own probelms as she is in care this girl is alot older and has so far laughed at my child who has aspergers , locked her in a room , pulled a chair from under her so she hurt herself , my child has always forgiven her as she wants to be friends and be part of the group , last week though this girl bent her hands back and really hurt her , she has been excluded now and as she leaves school this year , the school only allowing the girl in when her personal tutor in , and only half days, since she been gone my daughter has really been happy , and is fitting in with the other kids in her small inclusion group , and all her tics have gone as shes not got the anxiety from the last few months with this girl, i would confront the teacher and talk it though good luck x
•    Anonymous said... Never too late. My eldest has just been on a camp and my husband went as well and a few of girls from my son's class mentioned that there are a couple of kids giving my youngest a hard time. He has not told us nor has he reacted. Told his teacher when I took him to school Thursday as my son told me 1 child which was no surprise and by that afternoon it had been dealt with and his teacher is going to ask the girls who else is doing it so they can be dealt with. I am very lucky at the school we are at as there are a lot of kids, mainly girls who watch out and report bullying of my 2 boys when they see it, and school do something without having to catch the bullies in the act. Our last school we had issues for 2 years and always got the excuse we have to catch them at it, it was verbal so very hard to catch, we took our kids out of that school.
•    Anonymous said... That is very true! Or they get so used to being bullied that they assume everyone is doing it and they give up!
•    Anonymous said... This sounds so familiar and terrible. I don't understand how children can be so cruel, but mostly I don't understand how schools that say that understand and want to help don't really do anything proactive. And the understanding they give lasts for one incident only. My boy is in yr 8 and has been strangled, beaten up and held down by 3 boys, dragged along the ground. And so many other little tormenting things in he class room. He's been suspended 4 times since starting high school because there view is if my boy were able to take no for an answer and not try to interact with others they wouldn't resort to hurting him to get their point across. So in part they feel he's responsible for the kids hurting him so he gets suspended. Go figure!!!!

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Can Aspergers be inherited?

"Can Aspergers be inherited? Our son was recently diagnosed, and now I am wondering if my husband has it too ...their behaviors are very similar."

Aspergers (high functioning autism) is a neurobiological disorder in which known areas of the brain are affected in ways scientists do not yet understand. Aspergers is considered to be inherited in a complex fashion—more complicated than disorders like color-blindness or Huntington’s disease. The recurrence rate for the disorder in siblings of affected children is approximately 2% to 8%, much higher than the rate in the general population, but much lower than in single-gene diseases.

Researchers are getting closer to finding a genetic basis behind autism spectrum disorders. Rett’s syndrome is an autistic disorder for which the exact genetic cause is believed to have been found. In Aspergers, studies suggest problems in several chromosomal (genetic) regions, including areas on the chromosomes 2q, 7q and 15q. While the 7q region is considered the most promising area of study, research studies involving this chromosome in Aspergers have failed to observe its linkage to this region.

For reasons doctors do not know, there are far more boys "diagnosed" than girls (although there may be as many girls with Aspergers as boys, males get diagnosed with the disorder more often). Scientists have evaluated whether or not Aspergers represents an X-linked genetic disorder—one passed down generally from a mother to a son. Unfortunately, there have been cases of father to son transmission of the condition, which means that the disease cannot be X-linked.

In at least one case, two parents with Aspergers had a child that also had Aspergers, but did not have a severe case of the disorder, nor did the child have autism. In another case, identical twins both had Aspergers, but this is not always the case.

While some scientists support the idea that at least a portion of Aspergers isn’t genetic at all, there have been no specific findings associating the syndrome with any environmental condition, including a lack of association of the disease with pregnancy characteristics and pregnancy complications.

The Aspergers Comprehensive Handbook

Aspergers and Primary Comorbid Conditions

"When a child has Aspergers Syndrome, what additional disorders is he/she likely to have?"

The answer to this question is often contingent upon the age of the child. Children with Aspergers or High-Functioning Autism most often have obsessive-compulsive disorder as a primary comorbid condition, whereas Aspergers teens seem to suffer most with depression. We'll look at each of these in turn:

Obsessive-Compulsive Disorder--

Researchers have found that certain psychiatric disorders are more common in those who have Aspergers. One of these is obsessive-compulsive disorder or OCD. In fact, some researchers feel that Aspergers is a subset of OCD. This is especially true when the Aspergers child grows to adulthood. They may have problems with intrusive, obsessive thoughts and might perform certain ritualistic behaviors to control these obsessive thoughts. In some cases, the disorder can be very debilitating.

Medications have been used in those with OCD and Aspergers with some success. The medications stop some of the intrusive thinking and reduce the numbers and severity of compulsive behaviors while the core features of Aspergers do not change much.

Depression--

Because those with Aspergers suffer from social deprivation and feelings of inadequacy, they seem to have a higher incidence of depression as well. The depression becomes a secondary complication of having Aspergers and comes as a result of unmet needs and lack of meaningful communication—things that most people have little difficulty in getting for themselves. Antidepressant medication may be helpful in this type of depression as can psychotherapy directed at the unique problems of the Aspie.

Dealing with Sensory Problems in Aspergers Children

 "My daughter was recently diagnosed with Aspergers, so I am new to this whole thing. She is very picky, for example, will only wear certain clothes, only eat certain foods, doesn't tolerate loud noises, and on and on. Is this normal for children with Aspergers?"

The occurrence of sensory issues and intolerance is very typical for children with Aspergers and High-Functioning Autism. Parents of these children often recognize early that there are some "odd" problems with their child. The child may have a hyperactive startled response to various kinds of noises, and some of these children walk around acting deaf because they have had to tune out the excessive noise around them. Some children report auditory problems and find themselves unable to listen to someone speak or carry on a conversation in noisy or busy places.

Aspergers children also have difficulty with tactile stimulation. They may exhibit a startle response when touched or feel uncomfortable when held. They may be overwhelmed when dealing with the wearing of new clothing that their body hasn’t become accustomed to. The child may prefer certain textures of clothing, such as soft, loose cotton.

There can be difficulty tolerating certain textures or tastes of food. Parents need to be aware of this when trying new foods or when the child enters a new eating environment, such as school lunches or eating at the homes of others.

Coping with some of these sensory difficulties often means having an understanding of the common problems and trial and error regarding the specific problems your child has. For example, new clothing may need to be washed a few times until they are softer and easier to wear. Some female children cannot tolerate the rubbing of their legs together and so need to wear pants and not dresses.

The proper middle ground between sensory deprivation and a noisy, chaotic environment needs to be found and maintained whenever possible. Exposing the child to dozens of screaming children at daycare may not always be the best option for the child with Aspergers syndrome.

Parents also need to find the most effective way to give affection to their child without creating more anxiety. Cuddling with your child may be less of an option than just verbally showing approval. Parents can show their affection in ways that are less stressful to the child yet still give the same comfortable message.

As your child ages, he or she may have greater insight into what kinds of things they can tolerate and which things they cannot. Until then, parents need patience and creativity in finding the right middle ground that leaves the child as comfortable as possible.

Autism Spectrum Disorders (Pervasive Developmental Disorders)

 All About Autism Spectrum Disorders

Moms and dads are usually the first to notice unusual behaviors in their youngster. In some cases, the baby seemed "different" from birth, unresponsive to individuals or focusing intently on one item for long periods of time. The first signs of an Autism Spectrum Disorder (ASD) can also appear in kids who seem to have been developing normally. When an engaging, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or indifferent to social overtures, something is wrong. Research has shown that moms and dads are usually correct about noticing developmental problems, although they may not realize the specific nature or degree of the problem.

ASD range from a severe form, called autistic disorder, to a milder form, Aspergers. If a youngster has symptoms of either of these disorders, but does not meet the specific criteria for either, the diagnosis is called pervasive developmental disorder not otherwise specified (PDD-NOS). Other rare, very severe disorders that are included in the ASD are Rett syndrome and childhood disintegrative disorder.

Rare Autism Spectrum Disorders—

Rett Syndrome:

Rett syndrome is relatively rare, affecting almost exclusively females, one out of 10,000 to 15,000. After a period of normal development, sometime between 6 and 18 months, autism-like symptoms begin to appear. The little girl's mental and social development regresses—she no longer responds to her moms and dads and pulls away from any social contact. If she has been talking, she stops; she cannot control her feet; she wrings her hands. Some of the problems associated with Rett syndrome can be treated. Physical, occupational, and speech therapy can help with problems of coordination, movement, and speech.

Scientists sponsored by the National Institute of Youngster Health and Human Development have discovered that a mutation in the sequence of a single gene can cause Rett syndrome. This discovery may help doctors slow or stop the progress of the syndrome. It may also lead to methods of screening for Rett syndrome, thus enabling doctors to start treating these kids much sooner, and improving the quality of life these kids experience.

Childhood Disintegrative Disorder:

Very few kids who have an ASD diagnosis meet the criteria for childhood disintegrative disorder (CDD). An estimate based on four surveys of ASD found fewer than two kids per 100,000 with ASD could be classified as having CDD. This suggests that CDD is a very rare form of ASD. It has a strong male preponderance. Symptoms may appear by age 2, but the average age of onset is between 3 and 4 years. Until this time, the youngster has age-appropriate skills in communication and social relationships. The long period of normal development before regression helps differentiate CDD from Rett syndrome.

The loss of such skills (e.g., vocabulary) is more dramatic in CDD than they are in classical autism. The diagnosis requires extensive and pronounced losses involving motor, language, and social skills. CDD is also accompanied by loss of bowel and bladder control and oftentimes seizures and a very low IQ.

What Are the Autism Spectrum Disorders?

The ASD are more common in the pediatric population than are some better known disorders such as diabetes, spinal bifida, or Down syndrome. Prevalence studies have been done in several states and also in the United Kingdom, Europe, and Asia. A recent study of a U.S. metropolitan area estimated that 3.4 of every 1,000 kids 3-10 years old had autism. This wide range of prevalence points to a need for earlier and more accurate screening for the symptoms of ASD. The earlier the disorder is diagnosed, the sooner the youngster can be helped through treatment interventions. Pediatricians, family doctors, daycare providers, educators, and moms and dads may initially dismiss signs of ASD, optimistically thinking the youngster is just a little slow and will "catch up." Although early intervention has a dramatic impact on reducing symptoms and increasing a youngster's ability to grow and learn new skills, it is estimated that only 50 percent of kids are diagnosed before kindergarten.

All kids with ASD demonstrate deficits in 1) social interaction, 2) verbal and nonverbal communication, and 3) repetitive behaviors or interests. In addition, they will often have unusual responses to sensory experiences, such as certain sounds or the way objects look. Each of these symptoms runs the gamut from mild to severe. They will present in each individual youngster differently. For instance, a youngster may have little trouble learning to read but exhibit extremely poor social interaction. Each youngster will display communication, social, and behavioral patterns that are individual but fit into the overall diagnosis of ASD.

Kids with ASD do not follow the typical patterns of child development. In some kids, hints of future problems may be apparent from birth. In most cases, the problems in communication and social skills become more noticeable as the youngster lags further behind other kids the same age. Some other kids start off well enough. Oftentimes between 12 and 36 months old, the differences in the way they react to individuals and other unusual behaviors become apparent. Some moms and dads report the change as being sudden, and that their kids start to reject individuals, act strangely, and lose language and social skills they had previously acquired. In other cases, there is a plateau, or leveling, of progress so that the difference between the youngster with autism and other kids the same age becomes more noticeable.

ASD is defined by a certain set of behaviors that can range from the very mild to the severe. The following possible indicators of ASD were identified on the Public Health Training Network Webcast, Autism Among Us.

Possible Indicators of ASD:

•    Does not babble, point, or make meaningful gestures by 1 year of age
•    Does not combine two words by 2 years
•    Does not respond to name
•    Does not speak one word by 16 months
•    Loses language or social skills

Some Other Indicators:

•    At times seems to be hearing impaired
•    Doesn't seem to know how to play with toys
•    Doesn't smile
•    Excessively lines up toys or other objects
•    Is attached to one particular toy or object
•    Poor eye contact

Social Symptoms

From the start, typically developing infants are social beings. Early in life, they gaze at individuals, turn toward voices, grasp a finger, and even smile.

In contrast, most kids with ASD seem to have tremendous difficulty learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many do not interact and they avoid eye contact. They seem indifferent to other individuals, and often seem to prefer being alone. They may resist attention or passively accept hugs and cuddling. Later, they seldom seek comfort or respond to moms and dads' displays of anger or affection in a typical way. Research has suggested that although kids with ASD are attached to their moms and dads, their expression of this attachment is unusual and difficult to "read." To moms and dads, it may seem as if their youngster is not attached at all. Moms and dads who looked forward to the joys of cuddling, teaching, and playing with their youngster may feel crushed by this lack of the expected and typical attachment behavior.

Kids with ASD also are slower in learning to interpret what others are thinking and feeling. Subtle social cues—whether a smile, a wink, or a grimace—may have little meaning. To a youngster who misses these cues, "Come here" always means the same thing, whether the speaker is smiling and extending her arms for a hug or frowning and planting her fists on her hips. Without the ability to interpret gestures and facial expressions, the social world may seem bewildering. To compound the problem, individuals with ASD have difficulty seeing things from another person's perspective. Most 5-year-olds understand that other individuals have different information, feelings, and goals than they have. A person with ASD may lack such understanding. This inability leaves them unable to predict or understand the actions of others.

Although not universal, it is common for individuals with ASD also to have difficulty regulating their emotions. This can take the form of "immature" behavior such as crying in class or verbal outbursts that seem inappropriate to those around them. The individual with ASD might also be disruptive and physically aggressive at times, making social relationships still more difficult. They have a tendency to "lose control," particularly when they're in a strange or overwhelming environment, or when angry and frustrated. They may at times break things, attack others, or hurt themselves. In their frustration, some bang their heads, pull their hair, or bite their arms.

Communication Difficulties

By age 3, most kids have passed predictable milestones on the path to learning language; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it clear that the answer is "no."

Some kids diagnosed with ASD remain mute throughout their lives. Some infants who later show signs of ASD coo and babble during the first few months of life, but they soon stop. Others may be delayed, developing language as late as age 5 to 9. Some kids may learn to use communication systems such as pictures or sign language.

Those who do speak often use language in unusual ways. They seem unable to combine words into meaningful sentences. Some speak only single words, while others repeat the same phrase over and over. Some ASD kids parrot what they hear, a condition called echolalia. Although many kids with no ASD go through a stage where they repeat what they hear, it normally passes by the time they are 3.

Some kids only mildly affected may exhibit slight delays in language, or even seem to have precocious language and unusually large vocabularies, but have great difficulty in sustaining a conversation. The "give and take" of normal conversation is hard for them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. Another difficulty is often the inability to understand body language, tone of voice, or "phrases of speech." They might interpret a sarcastic expression such as "Oh, that's just great" as meaning it really IS great.

While it can be hard to understand what ASD kids are saying, their body language is also difficult to understand. Facial expressions, movements, and gestures rarely match what they are saying. Also, their tone of voice fails to reflect their feelings. A high-pitched, sing-song, or flat, robot-like voice is common. Some kids with relatively good language skills speak like little adults, failing to pick up on the "kid-speak" that is common in their peers.

Without meaningful gestures or the language to ask for things, individuals with ASD are at a loss to let others know what they need. As a result, they may simply scream or grab what they want. Until they are taught better ways to express their needs, ASD kids do whatever they can to get through to others. As individuals with ASD grow up, they can become increasingly aware of their difficulties in understanding others and in being understood. As a result they may become anxious or depressed.

Repetitive Behaviors

Although kids with ASD usually appear physically normal and have good muscle control, odd repetitive motions may set them off from other kids. These behaviors might be extreme and highly apparent or more subtle. Some kids and older individuals spend a lot of time repeatedly flapping their arms or walking on their toes. Some suddenly freeze in position.

As kids, they might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play. If someone accidentally moves one of the toys, the youngster may be tremendously upset. ASD kids need, and demand, absolute consistency in their environment. A slight change in any routine—in mealtimes, dressing, taking a bath, going to school at a certain time and by the same route—can be extremely disturbing. Perhaps order and sameness lend some stability in a world of confusion.

Repetitive behavior sometimes takes the form of a persistent, intense preoccupation. For example, the youngster might be obsessed with learning all about vacuum cleaners, train schedules, or lighthouses. Often there is great interest in numbers, symbols, or science topics.

Problems That May Accompany ASD:

1.    Fragile X syndrome- This disorder is the most common inherited form of mental retardation. It was so named because one part of the X chromosome has a defective piece that appears pinched and fragile when under a microscope. Fragile X syndrome affects about two to five percent of individuals with ASD. It is important to have a youngster with ASD checked for Fragile X, especially if the moms and dads are considering having another youngster. For an unknown reason, if a youngster with ASD also has Fragile X, there is a one-in-two chance that boys born to the same moms and dads will have the syndrome. 6 Other members of the family who may be contemplating having a youngster may also wish to be checked for the syndrome.

2.    Mental retardation- Many kids with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a youngster with ASD may do well on the parts of the test that measure visual skills but earn low scores on the language subtests.

3.    Seizures- One in four kids with ASD develops seizures, often starting either in early childhood or adolescence. 5 Seizures, caused by abnormal electrical activity in the brain, can produce a temporary loss of consciousness (a "blackout"), a body convulsion, unusual movements, or staring spells. Sometimes a contributing factor is a lack of sleep or a high fever. An EEG (electroencephalogram—recording of the electric currents developed in the brain by means of electrodes applied to the scalp) can help confirm the seizure's presence. In most cases, seizures can be controlled by a number of medicines called "anticonvulsants." The dosage of the medication is adjusted carefully so that the least possible amount of medication will be used to be effective.

4.    Sensory problems. When kid's perceptions are accurate, they can learn from what they see, feel, or hear. On the other hand, if sensory information is faulty, the youngster's experiences of the world can be confusing. Many ASD kids are highly attuned or even painfully sensitive to certain sounds, textures, tastes, and smells. Some kids find the feel of clothes touching their skin almost unbearable. Some sounds—a vacuum cleaner, a ringing telephone, a sudden storm, even the sound of waves lapping the shoreline—will cause these kids to cover their ears and scream. In ASD, the brain seems unable to balance the senses appropriately. Some ASD kids are oblivious to extreme cold or pain. An ASD youngster may fall and break an arm, yet never cry. Another may bash his head against a wall and not wince, but a light touch may make the youngster scream with alarm.

5.    Tuberous Sclerosis- Tuberous sclerosis is a rare genetic disorder that causes benign tumors to grow in the brain as well as in other vital organs. It has a consistently strong association with ASD. One to four percent of individuals with ASD also have tuberous sclerosis.

The Diagnosis of ASD

Although there are many concerns about labeling a young youngster with an ASD, the earlier the diagnosis of ASD is made, the earlier needed interventions can begin. Evidence over the last 15 years indicates that intensive early intervention in optimal educational settings for at least 2 years during the preschool years results in improved outcomes in most young kids with ASD.

In evaluating a youngster, clinicians rely on behavioral characteristics to make a diagnosis. Some of the characteristic behaviors of ASD may be apparent in the first few months of a youngster's life, or they may appear at any time during the early years. For the diagnosis, problems in at least one of the areas of communication, socialization, or restricted behavior must be present before the age of 3. The diagnosis requires a two-stage process. The first stage involves developmental screening during "well youngster" check-ups; the second stage entails a comprehensive evaluation by a multidisciplinary team.

Screening

A "well child" check-up should include a developmental screening test. If your youngster's pediatrician does not routinely check your youngster with such a test, ask that it be done. Your own observations and concerns about your youngster's development will be essential in helping to screen your youngster. Reviewing family videotapes, photos, and baby albums can help moms and dads remember when each behavior was first noticed and when the youngster reached certain developmental milestones.

Several screening instruments have been developed to quickly gather information about a youngster's social and communicative development within medical settings. Among them are the Checklist of Autism in Toddlers (CHAT), the modified Checklist for Autism in Toddlers (M-CHAT), the Screening Tool for Autism in Two-Year-Olds (STAT), and the Social Communication Questionnaire (SCQ)12 (for kids 4 years of age and older).

Some screening instruments rely solely on parent responses to a questionnaire, and some rely on a combination of parent report and observation. Key items on these instruments that appear to differentiate kids with autism from other groups before the age of 2 include pointing and pretend play. Screening instruments do not provide individual diagnosis but serve to assess the need for referral for possible diagnosis of ASD. These screening methods may not identify kids with mild ASD, such as those with high-functioning autism or Aspergers.

During the last few years, screening instruments have been devised to screen for Aspergers and higher functioning autism. The Autism Spectrum Screening Questionnaire (ASSQ), the Australian Scale for Asperger's Syndrome, and the most recent, the Childhood Aspergers Test (CAST), are some of the instruments that are reliable for identification of school-age kids with Aspergers or higher functioning autism. These tools concentrate on social and behavioral impairments in kids without significant language delay.

If, following the screening process or during a routine "well youngster" check-up, your youngster's doctor sees any of the possible indicators of ASD, further evaluation is indicated.

Comprehensive Diagnostic Evaluation

The second stage of diagnosis must be comprehensive in order to accurately rule in or rule out an ASD or other developmental problem. This evaluation may be done by a multidisciplinary team that includes a psychologist, a neurologist, a psychiatrist, a speech therapist, or other professionals who diagnose kids with ASD.

Because ASDs are complex disorders and may involve other neurological or genetic problems, a comprehensive evaluation should entail neurologic and genetic assessment, along with in-depth cognitive and language testing.8 In addition, measures developed specifically for diagnosing autism are often used. These include the Autism Diagnosis Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS-G). The ADI-R is a structured interview that contains over 100 items and is conducted with a caregiver. It consists of four main factors—the youngster's communication, social interaction, repetitive behaviors, and age-of-onset symptoms. The ADOS-G is an observational measure used to "press" for socio-communicative behaviors that are often delayed, abnormal, or absent in kids with ASD.

Still another instrument often used by professionals is the Childhood Autism Rating Scale (CARS). It aids in evaluating the youngster's body movements, adaptation to change, listening response, verbal communication, and relationship to individuals. It is suitable for use with kids over 2 years of age. The examiner observes the youngster and also obtains relevant information from the moms and dads. The youngster's behavior is rated on a scale based on deviation from the typical behavior of kids of the same age.

Two other tests that should be used to assess any youngster with a developmental delay are a formal audiologic hearing evaluation and a lead screening. Although some hearing loss can co-occur with ASD, some kids with ASD may be incorrectly thought to have such a loss. In addition, if the youngster has suffered from an ear infection, transient hearing loss can occur. Lead screening is essential for kids who remain for a long period of time in the oral-motor stage in which they put any and everything into their mouths. Kids with an autistic disorder usually have elevated blood lead levels.

Customarily, an expert diagnostic team has the responsibility of thoroughly evaluating the youngster, assessing the youngster's unique strengths and weaknesses, and determining a formal diagnosis. The team will then meet with the moms and dads to explain the results of the evaluation.

Although moms and dads may have been aware that something was not "quite right" with their youngster, when the diagnosis is given, it is a devastating blow. At such a time, it is hard to stay focused on asking questions. But while members of the evaluation team are together is the best opportunity the moms and dads will have to ask questions and get recommendations on what further steps they should take for their youngster. Learning as much as possible at this meeting is very important, but it is helpful to leave this meeting with the name or names of professionals who can be contacted if the moms and dads have further questions.

Available Aids

When your youngster has been evaluated and diagnosed with an ASD, you may feel inadequate to help your youngster develop to the fullest extent of his or her ability. As you begin to look at treatment options and at the types of aid available for a youngster with a disability, you will find out that there is help for you. It is going to be difficult to learn and remember everything you need to know about the resources that will be most helpful. Write down everything. If you keep a notebook, you will have a foolproof method of recalling information. Keep a record of the doctors' reports and the evaluation your youngster has been given so that his or her eligibility for special programs will be documented. Learn everything you can about special programs for your youngster; the more you know, the more effectively you can advocate.

For every youngster eligible for special programs, each state guarantees special education and related services. The Individuals with Disabilities Education Act (IDEA) is a Federally mandated program that assures a free and appropriate public education for kids with diagnosed learning deficits. Usually kids are placed in public schools and the school district pays for all necessary services. These will include, as needed, services by a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide.

By law, the public schools must prepare and carry out a set of instruction goals, or specific skills, for every youngster in a special education program. The list of skills is known as the youngster's Individualized Education Program (IEP). The IEP is an agreement between the school and the family on the youngster's goals. When your youngster's IEP is developed, you will be asked to attend the meeting. There will be several individuals at this meeting, including a special education teacher, a representative of the public schools who is knowledgeable about the program, other individuals invited by the school or by you (you may want to bring a relative, a youngster care provider, or a supportive close friend who knows your youngster well). Moms and dads play an important part in creating the program, as they know their youngster and his or her needs best. Once your youngster's IEP is developed, a meeting is scheduled once a year to review your youngster's progress and to make any alterations to reflect his or her changing needs.

If your youngster is under 3 years of age and has special needs, he or she should be eligible for an early intervention program; this program is available in every state. Each state decides which agency will be the lead agency in the early intervention program. The early intervention services are provided by workers qualified to care for toddlers with disabilities and are usually in the youngster's home or a place familiar to the youngster. The services provided are written into an Individualized Family Service Plan (IFSP) that is reviewed at least once every 6 months. The plan will describe services that will be provided to the youngster, but will also describe services for moms and dads to help them in daily activities with their youngster and for siblings to help them adjust to having a brother or sister with ASD.

Treatment Options

There is no single best treatment package for all kids with ASD. One point that most professionals agree on is that early intervention is important; another is that most individuals with ASD respond well to highly structured, specialized programs.

Before you make decisions on your youngster's treatment, you will want to gather information about the various options available. Learn as much as you can, look at all the options, and make your decision on your youngster's treatment based on your youngster's needs. You may want to visit public schools in your area to see the type of program they offer to special needs kids.

Guidelines used by the Autism Society of America include the following questions moms and dads can ask about potential treatments:
  • Are there assessment procedures specified?
  • Has the treatment been validated scientifically?
  • How will failure of the treatment affect my youngster and family?
  • How will the treatment be integrated into my youngster's current program?
  • Will the treatment result in harm to my youngster?

The National Institute of Mental Health suggests a list of questions moms and dads can ask when planning for their youngster:
  • Are there predictable daily schedules and routines?
  • Do staff members have training and experience in working with kids and teens with autism?
  • How are activities planned and organized?
  • How is progress measured? 
  • Will my youngster's behavior be closely observed and recorded?
  • How many kids have gone on to placement in a regular school and how have they performed?
  • How much individual attention will my youngster receive?
  • How successful has the program been for other kids?
  • Is the environment designed to minimize distractions?
  • What is the cost, time commitment, and location of the program?
  • Will my youngster be given tasks and rewards that are personally motivating?
  • Will the program prepare me to continue the therapy at home?

Among the many methods available for treatment and education of individuals with autism, applied behavior analysis (ABA) has become widely accepted as an effective treatment. Mental Health: A Report of the Surgeon General states, "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior." The basic research done by Ivar Lovaas and his colleagues at the University of California, Los Angeles, calling for an intensive, one-on-one youngster-teacher interaction for 40 hours a week, laid a foundation for other educators and researchers in the search for further effective early interventions to help those with ASD attain their potential. The goal of behavioral management is to reinforce desirable behaviors and reduce undesirable ones.

An effective treatment program will build on the youngster's interests, offer a predictable schedule, teach tasks as a series of simple steps, actively engage the youngster's attention in highly structured activities, and provide regular reinforcement of behavior. Parental involvement has emerged as a major factor in treatment success. Moms and dads work with educators and therapists to identify the behaviors to be changed and the skills to be taught. Recognizing that moms and dads are the youngster's earliest educators, more programs are beginning to train moms and dads to continue the therapy at home.

As soon as a youngster's disability has been identified, instruction should begin. Effective programs will teach early communication and social interaction skills. In kids younger than 3 years, appropriate interventions usually take place in the home or a youngster care center. These interventions target specific deficits in learning, language, imitation, attention, motivation, compliance, and initiative of interaction. Included are behavioral methods, communication, occupational and physical therapy along with social play interventions. Often the day will begin with a physical activity to help develop coordination and body awareness; kids string beads, piece puzzles together, paint, and participate in other motor skills activities. At snack time the teacher encourages social interaction and models how to use language to ask for more juice. The kids learn by doing. Working with the kids are students, behavioral therapists, and moms and dads who have received extensive training. In teaching the kids, positive reinforcement is used.

Kids older than 3 years usually have school-based, individualized, special education. The youngster may be in a segregated class with other autistic kids or in an integrated class with kids without disabilities for at least part of the day. Different localities may use differing methods but all should provide a structure that will help the kids learn social skills and functional communication. In these programs, educators often involve the moms and dads, giving useful advice in how to help their youngster use the skills or behaviors learned at school when they are at home.

In elementary school, the youngster should receive help in any skill area that is delayed and, at the same time, be encouraged to grow in his or her areas of strength. Ideally, the curriculum should be adapted to the individual youngster's needs. Many schools today have an inclusion program in which the youngster is in a regular classroom for most of the day, with special instruction for a part of the day. This instruction should include such skills as learning how to act in social situations and in making friends. Although higher-functioning kids may be able to handle academic work, they too need help to organize tasks and avoid distractions.

During middle and high school years, instruction will begin to address such practical matters as work, community living, and recreational activities. This should include work experience, using public transportation, and learning skills that will be important in community living.

All through your youngster's school years, you will want to be an active participant in his or her education program. Collaboration between moms and dads and educators is essential in evaluating your youngster's progress.

The Adolescent Years

Adolescence is a time of stress and confusion; and it is no less so for teenagers with autism. Like all kids, they need help in dealing with their budding sexuality. While some behaviors improve during the teenage years, some get worse. Increased autistic or aggressive behavior may be one way some teens express their newfound tension and confusion.

The teenage years are also a time when kids become more socially sensitive. At the age that most teenagers are concerned with acne, popularity, grades, and dates, teens with autism may become painfully aware that they are different from their peers. They may notice that they lack friends. And unlike their schoolmates, they aren't dating or planning for a career. For some, the sadness that comes with such realization motivates them to learn new behaviors and acquire better social skills.

Dietary and Other Interventions

In an effort to do everything possible to help their kids, many moms and dads continually seek new treatments. Some treatments are developed by reputable therapists or by moms and dads of a youngster with ASD. Although an unproven treatment may help one youngster, it may not prove beneficial to another. To be accepted as a proven treatment, the treatment should undergo clinical trials, preferably randomized, double-blind trials that would allow for a comparison between treatment and no treatment. Following are some of the interventions that have been reported to have been helpful to some kids but whose efficacy or safety has not been proven.

Dietary interventions are based on the idea that 1) food allergies cause symptoms of autism, and 2) an insufficiency of a specific vitamin or mineral may cause some autistic symptoms. If moms and dads decide to try for a given period of time a special diet, they should be sure that the youngster's nutritional status is measured carefully.

A diet that some moms and dads have found was helpful to their autistic youngster is a gluten-free, casein-free diet. Gluten is a casein-like substance that is found in the seeds of various cereal plants—wheat, oat, rye, and barley. Casein is the principal protein in milk. Since gluten and milk are found in many of the foods we eat, following a gluten-free, casein-free diet is difficult.

A supplement that some moms and dads feel is beneficial for an autistic youngster is Vitamin B6, taken with magnesium (which makes the vitamin effective). The result of research studies is mixed; some kids respond positively, some negatively, some not at all or very little.

In the search for treatment for autism, there has been discussion in the last few years about the use of secretin, a substance approved by the Food and Drug Administration (FDA) for a single dose normally given to aid in diagnosis of a gastrointestinal problem. Anecdotal reports have shown improvement in autism symptoms, including sleep patterns, eye contact, language skills, and alertness. Several clinical trials conducted in the last few years have found no significant improvements in symptoms between patients who received secretin and those who received a placebo.

Medications Used in Treatment

Medications are often used to treat behavioral problems, such as aggression, self-injurious behavior, and severe tantrums, that keep the person with ASD from functioning more effectively at home or school. The medications used are those that have been developed to treat similar symptoms in other disorders. Many of these medications are prescribed "off-label." This means they have not been officially approved by the FDA for use in kids, but the doctor prescribes the medications if he or she feels they are appropriate for your youngster. Further research needs to be done to ensure not only the efficacy but the safety of psychotropic agents used in the treatment of kids and teens.

A youngster with ASD may not respond in the same way to medications as typically developing kids. It is important that moms and dads work with a doctor who has experience with kids with autism. A youngster should be monitored closely while taking a medication. The doctor will prescribe the lowest dose possible to be effective. Ask the doctor about any side effects the medication may have and keep a record of how your youngster responds to the medication. It will be helpful to read the "patient insert" that comes with your youngster's medication. Some individuals keep the patient inserts in a small notebook to be used as a reference. This is most useful when several medications are prescribed.

1.    Seizures- Seizures are found in one in four persons with ASD, most often in those who have low IQ or are mute. They are treated with one or more of the anticonvulsants. These include such medications as carbamazepine (Tegretol®), lamotrigine (Lamictal®), topiramate (Topamax®), and valproic acid (Depakote®). The level of the medication in the blood should be monitored carefully and adjusted so that the least amount possible is used to be effective. Although medication usually reduces the number of seizures, it cannot always eliminate them.

2.    Inattention and hyperactivity- Stimulant medications such as methylphenidate (Ritalin®), used safely and effectively in persons with attention deficit hyperactivity disorder, have also been prescribed for kids with autism. These medications may decrease impulsivity and hyperactivity in some kids, especially those higher functioning kids.

3.    Behavioral problems- Antipsychotic medications have been used to treat severe behavioral problems. These medications work by reducing the activity in the brain of the neurotransmitter dopamine. Among the older, typical antipsychotics, such as haloperidol (Haldol®), thioridazine, fluphenazine, and chlorpromazine, haloperidol was found in more than one study to be more effective than a placebo in treating serious behavioral problems.26 However, haloperidol, while helpful for reducing symptoms of aggression, can also have adverse side effects, such as sedation, muscle stiffness, and abnormal movements. Placebo-controlled studies of the newer "atypical" antipsychotics are being conducted on kids with autism. The first such study, conducted by the NIMH-supported Research Units on Pediatric Psychopharmacology (RUPP) Autism Network, was on risperidone (Risperdal®). Results of the 8-week study were reported in 2002 and showed that risperidone was effective and well tolerated for the treatment of severe behavioral problems in kids with autism. The most common side effects were increased appetite, weight gain and sedation. Further long-term studies are needed to determine any long-term side effects. Other atypical antipsychotics that have been studied recently with encouraging results are olanzapine (Zyprexa®) and ziprasidone (Geodon®). Ziprasidone has not been associated with significant weight gain.

4.    Anxiety and depression- The selective serotonin reuptake inhibitors (SSRI's) are the medications most often prescribed for symptoms of anxiety, depression, and/or obsessive-compulsive disorder (OCD). Only one of the SSRI's, fluoxetine, (Prozac®) has been approved by the FDA for both OCD and depression in kids age 7 and older. Three that have been approved for OCD are fluvoxamine (Luvox®), age 8 and older; sertraline (Zoloft®), age 6 and older; and clomipramine (Anafranil®), age 10 and older.4 Treatment with these medications can be associated with decreased frequency of repetitive, ritualistic behavior and improvements in eye contact and social contacts. The FDA is studying and analyzing data to better understand how to use the SSRI's safely, effectively, and at the lowest dose possible.

5.    Several other medications have been used to treat ASD symptoms; among them are other antidepressants, naltrexone, lithium, and some of the benzodiazepines such as diazepam (Valium®) and lorazepam (Ativan®). The safety and efficacy of these medications in kids with autism has not been proven. Since individuals may respond differently to different medications, your youngster's unique history and behavior will help your doctor decide which medication might be most beneficial.

Adults with an ASD

Some adults with ASD, especially those with high-functioning autism or with Aspergers, are able to work successfully in mainstream jobs. Nevertheless, communication and social problems often cause difficulties in many areas of life. They will continue to need encouragement and moral support in their struggle for an independent life.

Many others with ASD are capable of employment in sheltered workshops under the supervision of managers trained in working with persons with disabilities. A nurturing environment at home, at school, and later in job training and at work, helps persons with ASD continue to learn and to develop throughout their lives.

The public schools' responsibility for providing services ends when the person with ASD reaches the age of 22. The family is then faced with the challenge of finding living arrangements and employment to match the particular needs of their adult youngster, as well as the programs and facilities that can provide support services to achieve these goals. Long before your youngster finishes school, you will want to search for the best programs and facilities for your young adult. If you know other moms and dads of ASD adults, ask them about the services available in your community. If your community has little to offer, serve as an advocate for your youngster and work toward the goal of improved employment services. Research the resources listed in the back of this brochure to learn as much as possible about the help your youngster is eligible to receive as an adult.

Living Arrangements for the Adult with an ASD:

1.    Foster homes and skill-development homes- Some families open their homes to provide long-term care to unrelated adults with disabilities. If the home teaches self-care and housekeeping skills and arranges leisure activities, it is called a "skill-development" home.

2.    Independent living- Some adults with ASD are able to live entirely on their own. Others can live semi-independently in their own home or apartment if they have assistance with solving major problems, such as personal finances or dealing with the government agencies that provide services to persons with disabilities. This assistance can be provided by family, a professional agency, or another type of provider.

3.    Institutions- Although the trend in recent decades has been to avoid placing persons with disabilities into long-term-care institutions, this alternative is still available for persons with ASD who need intensive, constant supervision. Unlike many of the institutions years ago, today's facilities view residents as individuals with human needs and offer opportunities for recreation and simple but meaningful work.

4.    Living at home- Government funds are available for families that choose to have their adult youngster with ASD live at home. These programs include Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medicaid waivers, and others. Information about these programs is available from the Social Security Administration (SSA). An appointment with a local SSA office is a good first step to take in understanding the programs for which the young adult is eligible.

5.    Supervised group living- Persons with disabilities frequently live in group homes or apartments staffed by professionals who help the individuals with basic needs. These often include meal preparation, housekeeping, and personal care needs. Higher functioning persons may be able to live in a home or apartment where staff only visit a few times a week. These persons generally prepare their own meals, go to work, and conduct other daily activities on their own.

Research into Causes and Treatment of ASD

Research into the causes, the diagnosis, and the treatment of ASD has advanced in tandem. With new well-researched standardized diagnostic tools, ASD can be diagnosed at an early age. And with early diagnosis, the treatments found to be beneficial in recent years can be used to help the youngster with ASD develop to his or her greatest potential.

In the past few years, there has been public interest in a theory that suggested a link between the use of thimerosal, a mercury-based preservative used in the measles-mumps-rubella (MMR) vaccine, and autism. Although mercury is no longer found in childhood vaccines in the United States, some moms and dads still have concerns about vaccinations. Many well-done, large-scale studies have now been done that have failed to show a link between thimerosal and autism. A panel from the Institute of Medicine is now examining these studies, including a large Danish study that concluded that there was no causal relationship between childhood vaccination using thimerosal-containing vaccines and the development of an ASD, and a U.S. study looking at exposure to mercury, lead and other heavy metals.

Research on the Biologic Basis of ASD

Because of its relative inaccessibility, scientists have only recently been able to study the brain systematically. But with the emergence of new brain imaging tools—computerized tomography (CT), positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI), study of the structure and the functioning of the brain can be done. With the aid of modern technology and the new availability of both normal and autism tissue samples to do postmortem studies, researchers will be able to learn much through comparative studies.

Postmortem and MRI studies have shown that many major brain structures are implicated in autism. This includes the cerebellum, cerebral cortex, limbic system, corpus callosum, basal ganglia, and brain stem.29 Other research is focusing on the role of neurotransmitters such as serotonin, dopamine, and epinephrine.

Research into the causes of ASD is being fueled by other recent developments. Evidence points to genetic factors playing a prominent role in the causes for ASD. Twin and family studies have suggested an underlying genetic vulnerability to ASD.30 To further research in this field, the Autism Genetic Resource Exchange, a project initiated by the Cure Autism Now Foundation, and aided by an NIMH grant, is recruiting genetic samples from several hundred families. Each family with more than one member diagnosed with ASD is given a 2-hour, in-home screening. With a large number of DNA samples, it is hoped that the most important genes will be found. This will enable scientists to learn what the culprit genes do and how they can go wrong.

Another exciting development is the Autism Tissue Program (http://www.brainbank.org), supported by the Autism Society of America Foundation, the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California, Davis, and the National Alliance for Autism Research. The program is aided by a grant to the Harvard Brain and Tissue Resource Center (http://www.brainbank.mclean.org), funded by the National Institute of Mental Health (NIMH) and the National Institute of Neurological Disorders and Stroke (NINDS). Studies of the postmortem brain with imaging methods will help us learn why some brains are large, how the limbic system develops, and how the brain changes as it ages. Tissue samples can be stained and will show which neurotransmitters are being made in the cells and how they are transported and released to other cells. By focusing on specific brain regions and neurotransmitters, it will become easier to identify susceptibility genes.

Recent neuroimaging studies have shown that a contributing cause for autism may be abnormal brain development beginning in the infant's first months. This "growth dysregulation hypothesis" holds that the anatomical abnormalities seen in autism are caused by genetic defects in brain growth factors. It is possible that sudden, rapid head growth in an infant may be an early warning signal that will lead to early diagnosis and effective biological intervention or possible prevention of autism.

Prevalence

In 2007 - the most recent government survey on the rate of autism - the Centers for Disease Control (CDC) found that the rate is higher than the rates found from studies conducted in the United States during the 1980s and early 1990s (survey based on data from 2000 and 2002). The CDC survey assigned a diagnosis of ASD based on health and school records of 8 year olds in 14 communities throughout the U.S. Debate continues about whether this represents a true increase in the prevalence of autism. Changes in the criteria used to diagnose autism, along with increased recognition of the disorder by professionals and the public may all be contributing factors. Nonetheless, the CDC report confirms other recent epidemiologic studies documenting that more kids are being diagnosed with an ASD than ever before.

Data from an earlier report of the CDC's Atlanta-based program found the rate of ASD was 3.4 per 1,000 for kids 3 to 10 years of age. Summarizing this and several other major studies on autism prevalence, CDC estimates that 2–6 per 1,000 (from 1 in 500 to 1 in 150) kids have an ASD. The risk is 3-4 times higher in males than females. Compared to the prevalence of other childhood conditions, this rate is lower than the rate of mental retardation (9.7 per 1,000 kids), but higher than the rates for cerebral palsy (2.8 per 1,000 kids), hearing loss (1.1 per 1,000 kids), and vision impairment (0.9 per 1,000 kids). The CDC notes that these studies do not provide a national estimate.

Fragile X

For an unknown reason, if a youngster with ASD also has Fragile X, there is a one-in-two chance that boys born to the same moms and dads will have the syndrome. Other members of the family who may be contemplating having a youngster may also wish to be checked for the syndrome."

A distinction can be made between a father’s and mother’s ability to pass along to a daughter or son the altered gene on the X chromosome that is linked to fragile X syndrome. Because both males (XY) and females (XX) have at least one X chromosome, both can pass on the mutated gene to their kids.

A father with the altered gene for Fragile X on his X chromosome will only pass that gene on to his daughters. He passes a Y chromosome on to his sons, which doesn’t transmit the condition. Therefore, if the father has the altered gene on his X chromosome, but the mother’s X chromosomes are normal, all of the couple’s daughters would have the altered gene for Fragile X, while none of their sons would have the mutated gene.

Because mothers pass on only X chromosomes to their kids, if the mother has the altered gene for Fragile X, she can pass that gene to either her sons or her daughters. If the mother has the mutated gene on one X chromosome and has one normal X chromosome, and the father has no genetic mutations, all the kids have a 50-50 chance of inheriting the mutated gene.

The odds noted here apply to each youngster the moms and dads have.3
In terms of prevalence, the latest statistics are consistent in showing that 5% of individuals with autism are affected by fragile X and 10% to 15% of those with fragile X show autistic traits.

Medications

On October 6, 2006 the U.S. Food and Drug Administration (FDA) approved risperidone (generic name) or Risperdal (brand name) for the symptomatic treatment of irritability in autistic kids and teens ages 5 to 16. The approval is the first for the use of a drug to treat behaviors associated with autism in kids. These behaviors are included under the general heading of irritability, and include aggression, deliberate self-injury and temper tantrums.

Olanzapine (Zyprexa) and other antipsychotic medications are used “off-label” for the treatment of aggression and other serious behavioral disturbances in kids, including kids with autism. Off-label means a doctor will prescribe a medication to treat a disorder or in an age group that is not included among those approved by the FDA.

Other medications are used to address symptoms or other disorders in kids with autism. Fluoxetine (Prozac) and sertraline (Zoloft) are approved by the FDA for kids age 7 and older with obsessive-compulsive disorder. Fluoxetine is also approved for kids age 8 and older for the treatment of depression.

Fluoxetine and sertraline are antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Despite the relative safety and popularity of SSRIs and other antidepressants, some studies have suggested that they may have unintentional effects on some individuals, especially teens and young adults. In 2004, after a thorough review of data, the Food and Drug Administration (FDA) adopted a “black box” warning label on all antidepressant medications to alert the public about the potential increased risk of suicidal thinking or attempts in kids and teens taking antidepressants. In 2007, the agency extended the warning to include young adults up to age 25. A “black box” warning is the most serious type of warning on prescription drug labeling. The warning emphasizes that kids, teens and young adults taking antidepressants should be closely monitored, especially during the initial weeks of treatment, for any worsening depression, suicidal thinking or behavior, or any unusual changes in behavior such as sleeplessness, agitation, or withdrawal from normal social situations.

Disorders/Vaccinations

The Institute of Medicine (IOM) conducted a thorough review on the issue of a link between thimerosal (a mercury based preservative that is no longer used in vaccinations) and autism. The final report from IOM, Immunization Safety Review: Vaccines and Autism, released in May 2004, stated that the committee did not find a link.

Until 1999, vaccines given to infants to protect them against diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and Hepatitis B contained thimerosal as a preservative. Today, with the exception of some flu vaccines, none of the vaccines used in the U.S. to protect preschool aged kids against 12 infectious diseases contain thimerosal as a preservative. The MMR vaccine does not and never did contain thimerosal. Varicella (chickenpox), inactivated polio (IPV), and pneumococcal conjugate vaccines have also never contained thimerosal.

The Aspergers Comprehensive Handbook

My child has been rejected by his peers, ridiculed and bullied !!!

Social rejection has devastating effects in many areas of functioning. Because the Aspergers child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

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How to Prevent Meltdowns in Aspergers Children

Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's child is totally out-of-control. When it ends, both you and the Asperger’s child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

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Parenting Defiant Aspergers Teens

Although Aspergers is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager with Aspergers are more difficult than they would be with an average teen. Complicated by defiant behavior, the Aspergers teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

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Aspergers Children “Block-Out” Their Emotions

Parenting children with Aspergers and HFA can be a daunting task. In layman’s terms, Aspergers is a developmental disability that affects the way children develop and understand the world around them, and is directly linked to their senses and sensory processing. This means they often use certain behaviors to block out their emotions or response to pain.

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Older Teens and Young Adult Children With Aspergers Still Living At Home

Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with Aspergers face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

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Living with an Aspergers Spouse/Partner

Research reveals that the divorce rate for people with Aspergers is around 80%. Why so high!? The answer may be found in how the symptoms of Aspergers affect intimate relationships. People with Aspergers often find it difficult to understand others and express themselves. They may seem to lose interest in people over time, appear aloof, and are often mistaken as self-centered, vain individuals.

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Online Parent Coaching for Parents of Asperger's Children

If you’re the parent of a child with Aspergers or High-Functioning Autism, you know it can be a struggle from time to time. Your child may be experiencing: obsessive routines; problems coping in social situations; intense tantrums and meltdowns; over-sensitivity to sounds, tastes, smells and sights; preoccupation with one subject of interest; and being overwhelmed by even the smallest of changes.

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Unraveling The Mystery Behind Asperger's and High-Functioning Autism

Parents, teachers, and the general public have a lot of misconceptions of Asperger's and High-Functioning Autism. Many myths abound, and the lack of knowledge is both disturbing and harmful to kids and teens who struggle with the disorder.

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Parenting Children and Teens with High-Functioning Autism

Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

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My Aspergers Child - Syndicated Content