The Difference Between Aspergers and Autism?

There is a great deal of confusion when it comes to the differences between Aspergers and autism. It seems that even medical professionals have difficulty determining a clear line between the two conditions. Often, it boils down to simply categorizing individuals according to the specific traits they exhibit, such as how they use language. However, there are some individuals who assert that Aspergers and autism are actually the same condition and should both fall under the heading of autism.

It's important to understand pervasive developmental disorders (PDDs) when trying to determine the differences (or lack thereof) between Aspergers and autism. PDDs are neurobiolocal disorders that include a wide spectrum of conditions, including Aspergers and autism. PDDS are marked by much delayed or significantly lacking social and language skills. A person with a PDD will usually have problems communicating with others and understanding language. Often, individuals with these conditions ignore or fail to understand facial expressions, and they may not make eye contact as most individuals expect in social situations.

Autism is the most well known of the conditions classified as PDDs. Autistic individuals look just like everyone else. It is their behavior that is different, and they appear withdrawn and often resist change. They tend to throw tantrums, shake, flap or move their bodies in odd ways and laugh or cry for what seems like no reason.

Individuals with autism may play in a way that it considered odd and exhibit obsessive attachments to certain objects. They may act as if they are deaf, ignore verbal cues, repeat certain words over and over again, or be entirely non-verbal. In those who are verbal, a lack of ability to start a conversation is often evident.

Aspergers is often considered within the spectrum of autism. An individual with Aspergers may exhibit odd or abnormal verbal communication skills. He/she may also avoid peer relationships, lack interest in others, fail to return emotional feelings, form obsessive attachments to subjects of interest and have repetitive behaviors. He/she may exhibit repetitive movements, such as flapping or twisting. Interestingly, individuals with Aspergers generally do not experience delays in language or cognitive development, and they are often very curious about their environment.

It is important to note that not all individuals with Aspergers and autism lack the ability to function normally. Some are considered highly functioning and are capable of caring for themselves and interacting socially. However, these individuals are usually seen as odd or eccentric because they still have behaviors that don't mesh with what most individuals consider normal.

Since Aspergers and autism are seen as so similar, some individuals draw a line between the two at language development and social awareness. It seems that those with Aspergers typically have more normal language development, though many still have disordered language and communication skills. Individuals with Aspergers also tend to be more interested in and aware of social interactions than those with autism. However, social skills must be taught and even practiced, as they generally don't come naturally to individuals with this syndrome.

My Aspergers Child

Aspergers in Females

A young lady who has participated for several years in a social group for adults with high functioning autism and Asperger’s Syndrome sponsored at our TEACCH Center in Asheville, recently remarked, “There aren’t a heck of a lot of ladies who have Asperger’s Syndrome or autism. The majority are males, and although we get along with the guys, there are some issues that they are never going to understand. I wish there was more information specifically for ladies who have autism.” Her comment prompted the initiation of the first ladies’ group at the Asheville TEACCH Center. While talking with this lady, who is in her 20’s, I was reminded of my own early adulthood. I remember the strong support of “ladies’ consciousness-raising groups” that sprouted up on college campuses and in living rooms in the 60’s and 70’s. While struggling for and demanding equality between the sexes in the society at large, we discovered that there were important distinctions that needed to be honored. Together we explored and defined what “being a lady” was about, in the company of other young ladies searching for self-awareness. Being a member of a ladies’ “CR” (Consciousness-Raising) group was educational, exciting, exhilarating, emotional, relevant…and never boring.

According to Tony Attwood and other professionals in the field, ladies with high functioning autism and Asperger’s Syndrome may be an under diagnosed population. If this is true, some of the reasons may be attributed to gender differences.

Are there behaviors that are seen in females with Asperger’s Syndrome, but not in males, that we haven’t yet identified as part of the profile… or certain gender-related behavior that might fool us into ruling out the diagnosis? What about the “pretend play” that has been observed in many young females at our center, which on the surface appears to be quite creative and imaginative? There seem to be many females (on the spectrum) who are enamored with princesses, fantasy kingdoms, unicorns, and animals¬¬. How many diagnosticians observe these interests and skills as imagination, and rule out a diagnosis based on these behaviors? Might this interest in imaginary kingdoms and talking animals be more common among females than males, yet still exist alongside other autistic/Aspergers traits?

And what about one typical response to confusion or frustration--hitting or other such outward expressions of frustration? Does this type of acting out occur more often in males with autism than in females? Is confusion or frustration simply easier to identify in males than females because we already look for it? Among the general population, it is commonly thought that males do “act out” more than females. (You sometimes hear teachers complain there are too many males in his or her class, and its impact on the class’ personality!) Is it easier to identify males as having autism because these behaviors are more obvious, than females who may experience inward or passive signs of aggression?

Professionals whose task it is to diagnose individuals with autism or Asperger’s Syndrome need to learn more about the full range of qualities and personality differences unique to females and ladies on the spectrum.

And what about the females’ and ladies’ route to self-understanding? Indeed, several ladies I have worked with who have Asperger’s Syndrome have talked about the unique challenges they experience because they constitute a “minority” within this special group of society.

I believe that in order to gain self understanding, each person with - or without - autism needs to see his or her own reflection in the world. I call this ‘seeing one’s place.’ For people with autism or AS, who already are challenged in this area, it becomes imperative that they meet, listen to, talk with, read about, and learn from others with autism. What happens as a result of this coming together is that they are able to see their ‘reflection’ and better understand their own unique styles of thinking and being. Ladies with autism, although benefiting greatly from getting to know other people with autism, often find that they might be the only female (or one of a very few ladies) in the group.

When I asked the ladies we see at our center if they would be interested in being in a ladies’ group, I had hoped that the group could fill a gap in our services. I also hoped that I would learn more about what it means to be a lady with autism. The more I meet with these ladies, the more I realize we have far to go in understanding the unique challenges that ladies with autism or Aspergers face.

One lady explained that, from her perspective there is subtle interaction between two sets of issues. “Problems related to the [autism] spectrum are combined with problems of society’s expectations of ladies. How one looks, what one wears, how one is supposed to relate socially, that a lady is supposed to have a natural empathy towards others, expectations about dating and marriage…” Ladies are affected by autism in the same ways as are their male counterparts; however, they are doubly challenged by the added assumptions that society places on the female gender.

At the risk of stereotyping, any man who is a rational thinker, and not emotionally in tune with others, is often thought of as having “typical male behavior” (think of the TV show “Tool Time”). A female exhibiting these same personality traits might be regarded as odd, annoying, cold, or depending on the situation, even mean-spirited. Autism, with its particular effects on personality, causes one to appear more rational and less emotionally responsive or empathetic to others. Ladies with autism note that these expectations indeed may weigh more heavily on them, just because they are ladies.

At the first meeting, the group members requested specific topics for discussion, topics that they encounter in daily life or ones which they are currently pondering. These topics included issues that are relevant to ladies at large such as personal safety; dating and sex; or being taken advantage of when your car needs repair. Other issues they raised were felt by group members to possibly be more significant for ladies with autism, but common to all--being pressured to conform by getting married; to “act like a lady”; and issues about one’s appearance--to have to “look a certain way”.

However, there were topics that all agree are a direct result of being a lady with autism, such as common behavioral and social expectations by the society at large. At the top of the list were the expectations of being sensitive to others and displaying empathy.

Ladies with autism have expressed that they feel that more is expected from them than from their male counterparts, simply because of their gender. Members of the group felt these expectations to be sensitive and empathetic, typically attributed to ladies, are unfair and difficult to meet. Discussion centered on how these behaviors require skills like the ability to accurately read and respond to body language, along with the inherent desire to “take care of others, emotionally”. Interestingly, after discussing these issues, the first requested topic to explore was reading body language and how to tell if someone is trying to take advantage of you.

The topic that generated the biggest emotional response from the group was the personal experience of feeling like one was “being treated like a child”. Parents, in general, are often more protective of their daughters than their sons. Daughters with autism talked about feeling overly protected into womanhood. In many cases, this is needed, although without understanding the parent’s perspective, the adult daughter can feel unfairly babied. Some ladies talked about the resentment they felt toward people, who for many years had been trying to teach them “socially appropriate” ways of acting. “Enough already!” was a common response.

The desire to be respected as an individual, and as a lady, was voiced clearly and strongly. Although this desire is probably equally shared among grown men with autism, the ladies voiced these desires clearly, with deep emotion and passion, when talking with other ladies.

Online Parent Support

Diagnosis of Aspergers: What Parents Need To Know

Several factors complicate the diagnosis of Aspergers (AS), an autism spectrum disorder (ASD). Like other AUTISM SPECTRUM DISORDER forms, Aspergers is characterized by impairment in social interaction accompanied by restricted and repetitive interests and behavior; it differs from the other AUTISM SPECTRUM DISORDERs by having no general delay in language or cognitive development. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between ASPERGERS and other AUTISM SPECTRUM DISORDER forms or even whether ASPERGERS exists as a separate syndrome, and over- and under-diagnosis for non-technical reasons. As with other AUTISM SPECTRUM DISORDER forms, early diagnosis is important, and differential diagnosis must consider several other conditions.

Criteria—

Aspergers Disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by six main criteria:

1. criteria are not met for another specific pervasive developmental disorder or schizophrenia
2. no significant delay in cognitive development, self-help skills or adaptive behaviors (other than social interaction)
3. no significant delay in language development
4. qualitative impairment in social interaction
5. restricted, repetitive and stereotyped behaviors and interests
6. significant impairment in important areas of functioning

The World Health Organization ICD-10 criteria are almost identical to DSM-IV:[2] ICD-10 adds the statement that motor clumsiness is usual (although not necessarily a diagnostic feature); ICD-10 adds the statement that isolated special skills, often related to abnormal preoccupations, are common but are not required for diagnosis; and the DSM-IV requirement for clinically significant impairment in social, occupational, or other important areas of functioning is not included in ICD-10.[3][4]

Reliability—

The diagnoses of ASPERGERS or high-functioning autism (HFA) are sometimes used interchangeably; the same youngster can receive different diagnoses depending on the screening tool.[5] Diagnoses may be influenced by non-technical issues, such as availability of government benefits for one condition but not the other.[6] Advocacy and parent support organizations have proliferated around the concept of ASPERGERS, and there are indications that this has resulted in more frequent diagnoses of ASPERGERS, which may be given as a "residual diagnosis" to kids of normal intelligence who do not meet diagnostic criteria for autism but have some social difficulties.[7] Under-diagnosis and over-diagnosis are problems in marginal cases; the increasing popularity of drug treatment options and the expansion of benefits has given providers incentives to diagnose AUTISM SPECTRUM DISORDER, resulting in some over-diagnosis of kids with uncertain symptoms. Conversely, the cost of screening and diagnosis and the challenge of obtaining payment can inhibit or delay diagnosis.[8]

Procedure—

Developmental screening during a routine check-up by a general practitioner or pediatrician may identify signs that warrant further investigation. This will require a comprehensive team evaluation to either confirm or exclude a diagnosis of ASPERGERS. This team usually includes a psychologist, neurologist, psychiatrist, speech and language pathologist, occupational therapist and other professionals with expertise in diagnosing kids with ASPERGERS.[4][5] Observation occurs across multiple settings; the social disability in ASPERGERS may be more evident during periods when social expectations are unclear and kids are free of adult direction.[9] A comprehensive evaluation includes neurological and genetic assessment, with in-depth cognitive and language testing to establish IQ and evaluate psychomotor function, verbal and nonverbal strengths and weaknesses, style of learning, and skills for independent living. An assessment of communication strengths and weaknesses includes the evaluation of nonverbal forms of communication (gaze and gestures); the use of non-literal language (metaphor, irony, absurdities and humor); patterns of speech inflection, stress and volume; pragmatics (turn-taking and sensitivity to verbal cues); and the content, clarity and coherence of conversation.[5] Testing may include an audiological referral to exclude hearing impairment. The determination of whether there is a family history of autism spectrum conditions is important.[10] A medical practitioner will diagnose on the basis of the test results and the youngster’s developmental history and current symptoms.[5] Because multiple domains of functioning are involved, a multidisciplinary team approach is critical;[2] an accurate assessment of the individual's strengths and weaknesses is more useful than a diagnostic label.[9] Delayed or mistaken diagnosis is a serious problem that can be traumatic for people and families; diagnosis based solely on a neurological, speech and language, or educational attainment may yield only a partial diagnosis.[2]

Advances in genetic technology allow clinical geneticists to link an estimated 40% of AUTISM SPECTRUM DISORDER cases to genetic causes; in one study the diagnostic yield for ASPERGERS, PDD-NOS and atypical autism was similar to that for classic autism.[11] Genetic diagnosis is relatively expensive,[11] and genetic screening is generally impractical. As genetic tests are developed several ethical, legal, and social issues will emerge. Commercial availability of tests may precede adequate understanding of how to use test results, given the complexity of the genetics.[12]

Early diagnosis—

Moms & dads of kids with ASPERGERS can typically trace differences in their kid's development to as early as 30 months of age, although diagnosis is not made on average until the age of 11.[10] By definition, kids with ASPERGERS develop language and self-help skills on schedule, so early signs may not be apparent and the condition may not be diagnosed until later childhood. Impairment in social interaction is sometimes not in evidence until a youngster attains an age at which these behaviors become important; social disabilities are often first noticed when kids encounter peers in daycare or preschool.[9] Diagnosis is most commonly made between the ages of four and eleven, and one study suggests that diagnosis cannot be rendered reliably before age four.[9]

Differential diagnosis—

Aspergers can be misdiagnosed as a number of other conditions, leading to medications that are unnecessary or even worsen behavior; the condition may be at the root of treatment-resistant mental illness in adults. Diagnostic confusion burdens people and families and may cause them to seek unhelpful therapies. Conditions that must be considered in a differential diagnosis include other pervasive developmental disorders (autism, PDD-NOS, childhood disintegrative disorder, Rett disorder), schizophrenia spectrum disorders (schizophrenia, schizotypal disorder, schizoid personality disorder), attention-deficit hyperactivity disorder, obsessive compulsive disorder, depression, semantic pragmatic disorder, multiple complex developmental disorder and nonverbal learning disorder (NLD).[2]

Differentiating between ASPERGERS and other AUTISM SPECTRUM DISORDERs relies on the judgment of experienced clinicians.[9] There is much overlap between ASPERGERS and NLD: both have symptoms of precocious reading, verbosity, and clumsiness, but they differ in that kids with ASPERGERS have restricted interests, repetitive behaviors, and less-typical social interactions.[13] Tourette syndrome (TS) should also be considered in differential diagnosis: "It is in non-retarded, rigid people on the autistic spectrum, especially those with so-called Aspergers, that differences with less severely affected people with TS and OCD may become blurred, or that both disorders may coexist."[14] Other problems to be considered in the differential diagnosis include selective mutism, stereotypic movement disorder and bipolar disorder[10] as well as traumatic brain injury or birth trauma, conduct disorder, Cornelia De Lange syndrome, fetal alcohol syndrome, fragile X syndrome, dyslexia, Fahr syndrome, hyperlexia, leukodystrophy, multiple sclerosis and Triple X syndrome.[15]

Multiple sets of diagnostic criteria—

The diagnosis of ASPERGERS is complicated by the use of several different screening instruments.[5][16] In addition to the DSM-IV and the ICD-10 criteria, other sets of diagnostic criteria for ASPERGERS are the Szatmari et al. criteria[17] and the Gillberg and Gillberg criteria.[18]

Compared with the DSM-IV and ICD-10 criteria, the requirements of normal early language and cognitive development are not mentioned by Szatmari et al., whereas speech delay is allowed in the Gillberg and Gillberg criteria. Szatmari et al. emphasize solitariness, and both Gillberg and Szatmari include "odd speech" and "language" in their criteria. Although Szatmari does not mention stereotyped behaviors, one of four described stereotyped functions is required by DSM-IV and ICD-10, and two are required by Gillberg and Gillberg. Abnormal responses to sensory stimuli are not mentioned in any diagnostic scheme, although they have been associated with ASPERGERS.[3] Because DSM-IV and ICD-10 exclude speech and language difficulties, these definitions exclude some of the original cases described by Hans Asperger. According to one researcher, the majority of people with ASPERGERS do have speech and language abnormalities, and the recent DSM–IV says that "the occurrence of 'no clinically significant delays in language does not imply that people with Aspergers have no problems with communication' (American Psychiatric Association, 2000, p. 80)".[2] The Gillberg and Gillberg criteria are considered closest to Aspergers original description of the syndrome;[2] the aggression and abnormal prosody that other authors say defined Aspergers clients are not mentioned in any criteria.[4][9][19]

The DSM-IV and ICD-10 diagnostic criteria have been criticized for being too broad and inadequate for assessing adults,[20] overly narrow (particularly in relation to Hans Aspergers original description of people with ASPERGERS),[2][21] and vague;[16] results of a large study in 2007 comparing the four sets of criteria point to a "huge need to reconsider the diagnostic criteria of ASPERGERS".[3] The study found complete overlap across all sets of diagnostic criteria in the impairment of social interaction with the exception of four cases not diagnosed by the Szatmari et al. criteria because of its emphasis on social solitariness. Lack of overlap was strongest in the language delay and odd speech requirements of the Gillberg and the Szatmari requirements relative to DSM-IV and ICD-10, and in the differing requirements regarding general delays.[3] A small 2008 study of kids referred with a tentative diagnosis of Apergers found poor agreement among the four sets of criteria, with one overlap being only 39%.[22] In 2007 Szatmari et al. suggested a new classification system of AUTISM SPECTRUM DISORDER based on familial traits found by genetic epidemiology.[23]

Differences from high-functioning autism—

Although people with Aspergers tend to perform better cognitively than those with autism, the extent of the overlap between Aspergers and high-functioning autism is unclear.[7][24] Overall, relatively few differences are reported between Aspergers and autism on parameters related to causation. A standard assumption is that Aspergers and autism have a common cause, and are variable expressions of the same underlying disorder.[25] A 2008 review of classification studies found that results largely did not support differences between the diagnoses, and that the most salient group characteristics came from IQ characterizations.[24] The current AUTISM SPECTRUM DISORDER classification may not reflect the true nature of the conditions.[26] A panel session at a 2008 diagnosis-related autism research planning conference noted problems with the classification of ASPERGERS as a distinct subgroup of AUTISM SPECTRUM DISORDER, and two of three breakout groups recommended eliminating ASPERGERS as a separate diagnosis.[27]

A neuropsychological profile has been proposed for ASPERGERS;[28] if verified, it could differentiate between ASPERGERS and HFA and aid in differential diagnosis. Relative to HFA, people with ASPERGERS have deficits in nonverbal skills such as visual-spatial problem solving and visual-motor coordination,[29] along with stronger verbal abilities.[30] Several studies have found ASPERGERS with a neuro-psychologic profile of assets and deficits consistent with a nonverbal learning disability, but several other studies have failed to replicate this.[29] The literature review did not reveal consistent findings of "nonverbal weaknesses or increased spatial or motor problems relative to people with HFA", leading some researchers to argue that increased cognitive ability is evidenced in ASPERGERS relative to HFA regardless of differences in verbal and nonverbal ability.[31]

References—

1. ^ ^{a b c} Baskin JH, Sperber M, Price BH (2006). "Asperger syndrome revisited". Rev Neurol Dis 3 (1): 1–7. PMID 16596080.
2. ^ ^{a b c d e f g} Fitzgerald M, Corvin A (2001). "Diagnosis and differential diagnosis of Asperger syndrome". Adv Psychiatric Treat 7 (4): 310–8. doi:10.1192/apt.7.4.310. http://apt.rcpsych.org/cgi/content/full/7/4/310.
3. ^ ^{a b c d e f} McPartland J, Klin A (2006). "Asperger's syndrome". Adolesc Med Clin 17 (3): 771–88. doi:10.1016/j.admecli.2006.06.010 (inactive 2008-06-22). PMID 17030291.
4. ^ ^{a b c d e} Mattila ML, Kielinen M, Jussila K et al. (2007). "An epidemiological and diagnostic study of Asperger syndrome according to four sets of diagnostic criteria". J Am Acad Child Adolesc Psychiatry 46 (5): 636–46. doi:10.1097/chi.0b013e318033ff42. PMID 17450055.
5. ^ ^{a b c d e} National Institute of Neurological Disorders and Stroke (NINDS) (July 31, 2007). Asperger Syndrome Fact Sheet. Retrieved 24 August 2007.
6. ^ ^{a b c} Foster B, King BH (2003). "Asperger syndrome: to be or not to be?". Curr. Opin. Pediatr. 15 (5): 491–94. doi:10.1097/00008480-200310000-00008. PMID 14508298.
7. ^ ^{a b} Ehlers S, Gillberg C (1993). "The epidemiology of Asperger's syndrome. A total population study". J Child Psychol Psychiat 34 (8): 1327–50. doi:10.1111/j.1469-7610.1993.tb02094.x. PMID 8294522. "Truncated version". http://asperger.org/Publications/Ehlers_and_Gillberg_Article.asp. Retrieved on 2008-06-
8. ^ ^{a b} Klin A (2006). "Autism and Asperger syndrome: an overview". Rev Bras Psiquiatr 28 (suppl 1): S3–S11. doi:10.1590/S1516-44462006000500002. PMID 16791390. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en.
9. ^ ^{a b} Schaefer GB, Mendelsohn NJ (2008). "Genetics evaluation for the etiologic diagnosis of autism spectrum disorders". Genet Med 10 (1): 4–12. doi:10.1097/GIM.0b013e31815efdd7. PMID 18197051. Lay summary – Medical News Today (2008-02-07).
10. ^ American Psychiatric Association (2000). "Diagnostic criteria for 299.80 Asperger's Disorder (AD)". Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision (DSM-IV-TR) ed.). ISBN 0890420254.
11. ^ Attwood, T (2003). Is There a Difference Between Asperger's Syndrome and High Functioning Autism? (PDF). Sacramento Asperger Syndrome Information & Support. Retrieved on 2007-08-15.
12. ^ Brasic, JR. Pervasive Developmental Disorder: Asperger Syndrome. eMedicine.com (April 10, 2006). Retrieved 15 July 2007.
13. ^ McMahon WM, Baty BJ, Botkin J (2006). "Genetic counseling and ethical issues for autism". Am J Med Genet C Semin Med Genet 142C (1): 52–7. doi:10.1002/ajmg.c.30082. PMID 16419100.
14. ^ Rapin I (2001). "Autism spectrum disorders: relevance to Tourette syndrome". Advances in neurology 85: 89–101. PMID 11530449.
15. ^ Shattuck PT, Grosse SD (2007). "Issues related to the diagnosis and treatment of autism spectrum disorders". Ment Retard Dev Disabil Res Rev 13 (2): 129–35. doi:10.1002/mrdd.20143. PMID 17563895.
16. ^ Stein MT, Klin A, Miller K, Goulden K, Coolman R, Coolman DM (2004). "When Asperger's syndrome and a nonverbal learning disability look alike". J Dev Behav Pediatr 25 (3): 190–5. doi:10.1097/00004703-200406000-00008. PMID 15194904.

· ^ Willemsen-Swinkels SH, Buitelaar JK (2002). "The autistic spectrum: subgroups, boundaries, and treatment". Psychiatr Clin North Am 25 (4): 811–36. doi:10.1016/S0193-953X(02)00020-5. PMID 12462862.

· ^ Szatmari P, White J, Merikangas KR (2007). "The use of genetic epidemiology to guide classification in child and adult psychopathology". Int Rev Psychiatry 19 (5): 483–96. doi:10.1080/09540260701563619. PMID 17896229.

· ^ Szatmari P (2000). "The classification of autism, Asperger's syndrome, and pervasive developmental disorder". Can J Psychiatry 45 (8): 731–38. PMID 11086556. http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2000/Oct/Classification.asp.

· ^ Reitzel J, Szatmari P. "Cognitive and academic problems." In: Prior M, editor. Learning and behavior problems in Asperger syndrome. New York: Guilford Press; 2003. p. 35–54, as cited in McPartland J, Klin A (2006), p. 774.

· ^ Miller JN, Ozonoff S (2000). "The external validity of Asperger disorder: lack of evidence from the domain of neuropsychology". Journal of abnormal psychology 109 (2): 227–38. doi:10.1037/0021-843X.109.2.227. PMID 10895561. as cited in McPartland J, Klin A (2006), p. 775.

· ^ Mayes SD, Calhoun SL, Crites DL (2001). "Does DSM-IV Asperger's disorder exist?". Journal of abnormal child psychology 29 (3): 263–71. doi:10.1023/A:1010337916636. PMID 11411788.

· ^ Kopra K, von Wendt L, Nieminen–von Wendt T, Paavonen EJ (2008). "Comparison of diagnostic methods for Asperger syndrome". J Autism Dev Disord 38 (8): 1567–73. doi:10.1007/s10803-008-0537-y. PMID 18324466.

· ^ Hippler K, Klicpera C (2003). "A retrospective analysis of the clinical case records of 'autistic psychopaths' diagnosed by Hans Asperger and his team at the University Children's Hospital, Vienna". Philos. Trans. R. Soc. Lond., B, Biol. Sci. 358 (1430): 291–301. doi:10.1098/rstb.2002.1197. PMID 12639327. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1693115.

· ^ Gillberg IC, Gillberg C. "Asperger syndrome-some epidemiological considerations: A research note." J Child Psychol Psychiatry. 1989 Jul;30(4):631–38. PMID 2670981

· ^ Ghaziuddin M, Mountain-Kimchi K (2004). "Defining the intellectual profile of Asperger Syndrome: comparison with high-functioning autism". Journal of autism and developmental disorders 34 (3): 279–84. doi:10.1023/B:JADD.0000029550.19098.77. PMID 15264496. ; Ehlers S, Nydén A, Gillberg C, et al. (1997). "Asperger syndrome, autism and attention disorders: a comparative study of the cognitive profiles of 120 children". Journal of child psychology and psychiatry, and allied disciplines 38 (2): 207–17. doi:10.1111/j.1469-7610.1997.tb01855.x. PMID 9232467. as cited in McPartland J, Klin A (2006), p. 775.

· ^ First MB (2008). "Autism and Other Pervasive Developmental Disorders Conference (February 3–5, 2008)". American Psychiatric Association. http://psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/ConferenceSummaries/AutismConference.aspx. Retrieved on 2008-10-29.

· ^ Baron-Cohen S, Wheelwright S, Robinson J, Woodbury-Smith M (2005). "The Adult Asperger Assessment (AAA): a diagnostic method" (PDF). Journal of autism and developmental disorders 35 (6): 807–19. doi:10.1007/s10803-005-0026-5. PMID 16331530. http://www.autismresearchcentre.com/docs/papers/2006_BCetal_AAA.pdf.

· ^ ^{a b} Witwer AN, Lecavalier L (2008). "Examining the validity of autism spectrum disorder subtypes". J Autism Dev Disord 38 (9): 1611–24. doi:10.1007/s10803-008-0541-2. PMID 18327636.

· ^ ^{a b} Klin A, Volkmar FR (2003). "Asperger syndrome: diagnosis and external validity". Child Adolesc Psychiatr Clin N Am 12 (1): 1–13. doi:10.1016/S1056-4993(02)00052-4. PMID 12512395. http://www.childpsych.theclinics.com/article/PIIS1056499302000524/fulltext.

^ Szatmari P, Bremner R, Nagy J (1989). "Asperger's syndrome: a review of clinical features". Canadian journal of psychiatry. Revue canadienne de psychiatrie 34 (6): · 554–60. PMID 2766209.

My Aspergers Child

What To Do When Your Child Has Been Diagnosed With Asperger's Syndrome

For many moms & dads, finding out that your kid has Aspergers can be a mixed blessing. On one hand, a positive diagnosis gives rise to the prospect of management and greater certainty as to the factors at play in your kid's life. On the other, most moms & dads are unprepared for the changes having a kid with Aspergers invariably brings.

We've compiled a list of the top 10 steps to take if you think your kid may have Asperger, or if you've had your kid diagnosed with the condition:

1. Be honest with yourself. At times rearing a kid with Aspergers can cause you anger, sadness, anxiety, frustration and depression. Be open to understanding that you will at times feel all these feelings, and allow that authenticity to give rise to the possibility that you will take care of your own needs. In doing so, you can more effectively tend to the needs of others. Don't feel the need to explain or justify your actions to others. However you cope with the situation is exactly the way you are supposed to.

2. Contact community services and inquire as to whether you are eligible for some type of Family Benefit as a parent of a kid with Aspergers. Your pediatrician or general practitioner should be able to advise you on this.

3. Contact your local Autism Association and ascertain what services are provided through the service. Make use of private and government resourced services.

4. Permit yourself to take stock of your situation from a place of positivity. With diagnosis comes some certainty, as you and your kid are now dealing with a known quantity. There's nothing wrong with taking each day at a time, and understanding that you can now make a difference to your kid's life which you could not in the absence of a diagnosis. You're kid has always had Aspergers ...the day your kid receives a diagnosis is the first step in the right direction.

5. If your kid is at school contact the Principal and advise them of the diagnosis. Many schools are aware of and in fact provide information on Aspergers and school counseling designed to assist with the condition. In addition, ask your kid's school whether they are aware of any parent workshops for Aspergers students. If your kid is older, home study and tutoring may be an option. It is important to be assertive in ensuring that your school can properly cater for your kid's needs, and ideally this can be achieved by working within the school protocols. There is no need for you to underestimate your kid's potential and certainly this attitude ought be reflected in their educational institution. Involve yourself where possible in your kid's educational and learning environments.

6. Invest in your own education. There is a vast quantity of information on Aspergers available both online, and in the form of medical literature. Sign up for information seminars, online e-courses, and if you are looking for immediately available information give consideration to investing in an ebook written by an expert on Aspergers. Knowledge is power.

7. Involve your family in the process and do your best to maintain objectivity. A kid with Aspergers may have certain special and additional needs, however they are for the most well functioning individuals who can thrive with appropriate and measured care. Try and maintain a balance between focusing on providing that care, and being a spouse and parent to the rest of your family.

8. Make inquiries with your doctor for a referral to a pediatrician who has experience with Aspergers. Having professional assistance can make an enormous difference to how effectively you can help your kid cope with Aspergers. Permit those professionals you consult to guide you through the process and make the most of their advice.

9. Make inquiries within your local community as to the support groups available for those with Aspergers and for moms & dads of kids with Aspergers. Sharing your situation with others who are in a position to fully appreciate it can make an enormous difference.

10. Remember to smile. You have a kid. One day...they just might be the ones looking after you.

My Aspergers Child

Aspergers Behavior

Question

It is frustrating not being able to change or modify behaviors such as diet, social skills, and motivation. Are there any new techniques you could recommend?

Answer

Most children with Asperger’s Syndrome struggle with social skills, communication, and a limited diet. The causes of these struggles: social, communication, and behavioral problems, along with sensory issues, can create the desire for isolation and a lack of motivation. Children with Asperger’s easily drop into a lonely state of depression, making the original problems that much worse.

Behavior modification is the most popular area of concentration when treating kids with Asperger’s Syndrome. Social skills therapy and living skills therapy are widely available and do bring about effective progress in most cases. However, you are looking for something new to try.

Motivation is the key to improving your child’s circumstances. Actually, motivation is a factor anytime you are seeking to modify any child’s unwanted behaviors. Now motivation in itself is definitely an old concept, but using motivation in a new way will create the wanted result for your child.

Old Motivation

As parents, we often use set motivators to achieve the behavior we feel is appropriate. The concentration has been placed on the behavior, which sets a negative tone to the process of change. You can’t blame a child for reacting negatively to a negative tone.

* Punishment-“If you don’t do ______, then you will get ______!” We all use this at one time or another and over the course of time, it has proven to be an ineffective motivator.
* Rewards or bribery- “If you do ______ today, I’ll buy you a ______.” We’re guilty of this one, too. This probably creates more confusion and greed than motivation over time.

New Motivation

Motivators should be positive. It feels good to see your child happily learning or cooperating in desired behaviors. Motivators that appeal to the individual child should be used for maximum results. Motivation is definitely personal. What motivates one child will not work for every child.

* Special Interests-Using your child’s special interests both at home and at school can generate positive responses in all situations. For example, your child’s love of trains can be used to encourage eating at home. Train themed dinnerware or even themed foods may be used to entice the reluctant eater.

* Routines-Keeping your child’s routines constant will improve his outlook. He’ll know what to expect at any given time, lessening the stress he feels.

Finally, “The Motivation Breakthrough” by Richard Lavoie is the perfect resource for someone looking for new techniques to motivate their child with Asperger’s Syndrome. The author provides proven, effective tools and strategies parents and teachers can use to encourage any child to learn and achieve success.

My Aspergers Child

Asperger's Children and Behavior Problems

Disciplining kids displaying Aspergers-characteristic behavior will often require an approach which is somewhat unique to that of other kids. Finding the balance between understanding the needs of a youngster with Aspergers and discipline which is age appropriate and situationally necessary is achievable when applying some simple but effective strategies. These strategies can be implemented both at home and in more public settings.

General Behavior Problems—

Traditional discipline may fail to produce the desired results for kids with Aspergers, primarily because they are unable to appreciate the consequences of their actions. Consequently, punitive measures are apt to exacerbate the type of behavior the punishment is intended to reduce, while at the same time giving rise to distress in both the youngster and mom or dad.

At all times the emotional and physical wellbeing of your youngster should take priority. Often this will necessitate removing your youngster from a potentially distressing situation as soon as possible. Consider maintaining a diary of your youngster's behavior with a view to ascertaining patterns or triggers. Recurring behavior may be indicative of a youngster taking some satisfaction in receiving a desired response from peers, moms & dads or teachers.

For example, a youngster with Aspergers may come to understand that hurting another youngster in class will result in his being removed from class, notwithstanding the associated consequence to his peer. The solution may not be most effectively rooted in punishing the youngster for the behavior, or even attempting to explain the situation from the perspective of their injured peer, but by treating the root cause behind the motivation for the misbehavior...for example, can the youngster be made more comfortable in class so that they will not want to leave it?

One of the means to achieve this may be to focus on the positive. Praise for good behavior, and reinforcement by way of something like a Reward Book, can assist. The use of encouraging verbal cues delivered in a calm tone are likely to elicit more beneficial responses than the harsher verbal warnings which might be effective on kids who are not displaying some sort of Asperger characteristic. If necessary, when giving directions to cease a type of misbehavior, these should also be couched as positives rather than negatives. For example, rather than telling a youngster to stop hitting his brother with the ruler, the youngster should be directed to put the ruler down.

Obsessive or Fixated Behavior—

Almost all kids go through periods of development where they become engrossed in one subject matter or another, but kids with Aspergers often display obsessive and repetitive characteristics, which can have significant implications for behavior.

For example, if an Aspergers youngster becomes fixated upon reading a particular story each night, they may become distressed if this regime is not adhered to, or if the story is interrupted. Again, the use of a behavior diary can assist in identifying fixations for your youngster. Once a fixation is identified, it is important to set appropriate boundaries for your youngster. Providing a structure within which your youngster can explore the obsession can assist in then keeping the obsession within reasonable limits, without the associated angst which might otherwise arise through such limitations. For example, tell your youngster that they may watch their favorite cartoon for half an hour after dinner, and make clear time for that in their routine.

It is appropriate to utilize the obsession to motivate and reward your youngster for good behavior. Always ensure any reward associated with positive behavior is granted immediately to assist the youngster recognizing the nexus between the two.

A particularly useful technique to try to develop social reciprocity is to have your youngster talk for five minutes about a particularly favored topic after they have listened to you talk about an unrelated topic. This serves to help your youngster understand that not everyone shares their enthusiasm for their subject matter.

Bridging the Gap between Aspergers and Discipline and Other Siblings—

For siblings without Aspergers, the differential and what at times no doubt appears to be preferential treatment received by an Aspergers sibling can give rise to feelings of confusion and frustration. Often they will fail to understand why their brother or sister apparently seems free to behave as they please without the normal constraints placed upon them.

It is important to explain to siblings or peers of Aspergers kids and encourage open discussion about the disorder itself. Encouragement should extend to the things siblings can do to assist the Aspergers youngster, and this should be positively reinforced through acknowledgement when it occurs.

Sleep Difficulties—

Aspergers kids are known for experiencing sleep problems. Kids with Aspergers may have lesser sleep requirements, and as such are more likely to become anxious about sleeping, or may find they become anxious when waking during the night or early in the morning.

Combat your youngster's anxiety by making their bedrooms a place of safety and comfort. Remove or store items which might be prone to injure your youngster if they decide to wander at night. Include in the behavioral diary a record of your youngster's sleep patterns. It may assist your youngster if you keep a list of their routine, including dinner, bath time, story and bed, in order to provide structure. Include an image or symbol of them waking in the morning to provide assurance as to what will happen. Social stories have proven to be a particularly successful tactic in decreasing a youngster's anxiety by providing clear instructions on how part of their day is likely to play out.

At School—

Another Asperger characteristic is that kids will often experience difficulty during parts of the school day which lack structure. If left to their own devices their difficulties with social interaction and self management can result in anxiety. The use of a buddy system can assist in providing direction, as can the creation of a timetable for recess and lunch times. These should be raised with class teachers and implemented with their assistance.

Explain the concept of free time to your youngster, or consider providing a separate purpose or goal for your youngster during such time, such as reading a book, or helping to set up paint and brushes for the afternoon tasks.

In Public—

Kids with Aspergers can become overwhelmed to the point of distress by even a short visit in public. The result is that many moms & dads with Aspergers simply seek to avoid as much as possible situations where their youngster is exposed to the public. While expedient, it may not offer the best long term solution to your youngster, and there are strategies to assist with outings.

Consider providing your youngster with an iPod, or have the radio on in the car to block out other sounds and stimuli. Prepare a social story or list explaining to the youngster a trip to the shops, or doctor. Be sure to include on the list your return home. Consider giving your youngster a task to complete during the trip, or having them assist you. At all times, maintaining consistency when dealing with Aspergers and discipline are key concerns. It pays to ensure that others involved in your youngster's care are familiar with your strategies and techniques, such as those outlined above, and are able to apply them.

Most importantly, don't hesitate to seek support networks for moms & dads with Aspergers, and take advantage of the wealth of knowledge those who have dealt with the disorder before you have developed. The assistance you can gain from these and other resources can assist you in developing important strategies to deal with problems with Aspergers in a manner most beneficial to your youngster.

My Aspergers Child

Dealing with Aspergers Employees: What Employers Need to Know

Your new Aspergers employee has the skills you were looking for and is dedicated to doing the job well. The challenging part for an individual with Aspergers is the less structured, more social aspects of office culture. Small talk, picking up what others are thinking, and being imaginative about solving problems are challenging for individuals with Aspergers. Following are seven straightforward tips to help them thrive:

1. Be open to someone who may be a support person in the personal life of your Aspergers employee with Aspergers. Some moms and dads stay involved a little longer in the life of their adult child, as an advocate in the background. Until your Aspergers employee initiates the conversation about bringing in his advocate, remember to build trust through messages that convey you value his work. Some young people with Aspergers want to do it on their own while others would welcome their support person to coach or help them get independent with some of the more interpersonal aspects of being on the job.

2. Be precise and specific with your instructions. Slang and expressions of speech may not translate to what you want to communicate. Details and examples help. "This is how it should look when it is done."

3. Don’t let the diagnosis ‘aspergers’ or 'autism' be a defining characteristic of your Aspergers employee; it is one aspect of who this person is. The diagnosis becomes important for you to know when it helps you to help your Aspergers employee shine on the job.

4. Encourage co-workers to have a collaborative office culture when it comes to helping out each other. Your Aspergers employee will have strengths that will be an asset to your team. Helping others in the office by lending a hand with one’s own talents helps him connect socially with office mates.

5. Encourage your Aspergers employee to come up with some process strategies for doing his job. For example, he might work well by recording tasks on a template he creates with visuals, spacing or organization that makes good sense to him.

6. Help her relax about asking for help on the job. Disability acts encourage individuals to discuss the modifications they need in the work place. However, there is often hesitation because of the fear that disclosure will be a stigma or put the job in jeopardy. You want to be receptive, should your Aspergers employee want to ask for an accommodation that will help her work better.

7. Try to give a personal heads up if there is a schedule or routine type change that he may not pick up on automatically. An individual with Aspergers will need some extra cueing at times. Keep the focus on the gifts, which brought this person to your work place and motivated you to hire him or her!

Practical Tips to Help Your Aspergers Employee Get Established in Your Office

You have just hired someone who has Aspergers, or perhaps you suspect so, and indeed he or she has very strong skills to match the job description. It is likely that you will be very pleased because individuals with Aspergers tend to have strong focus and commitment to a job well done.

To set up for office place success, you will find it pays off to invest in some training time, early on in some of those skills unrelated to the primary job, but fundamentally important to navigating the day at the office.

Here are seven straightforward strategies to help your new Aspergers employee prosper and produce for your business:

1. Be prepared to give your input with some of the smaller steps you may not typically think of stating. Gradually transfer responsibility and accountability to your Aspergers employee, withdrawing your level of involvement as you see him catching on to the rhythms of your office place.

2. Be very specific about what you expect in general office matters. Help her to know where more and less flexibility is in order and appropriate in the daily flow of the work place. What routines must be done one way only? Observe, make notes and plan for periodic feedback time.

3. Create a ‘cheat sheet’ for phone coverage. If want your Aspergers employee to pinch hit on the phones, have a few generic phrases that work for your workplace, for example, “Can I have someone get back to you with that information?”

4. Don’t be afraid to be blunt. It will be helpful. There is a distinction between ‘blunt’ and ‘rude.’ He will appreciate and understand directness and clarity. If you are finding yourself repeating requests, you can say, “What plan can we come up with to help you establish routines that I have been reminding you about?”

5. Have a set routine for evaluation and feedback sessions. Start the meeting by talking about the qualities you see in your new Aspergers employee. “Here’s where your work is very well done.” Be sensitive to feelings of past failure with social and organizational issues. Your Aspergers employee is probably quite familiar with his weaknesses, having heard about them and struggled with them in some other past setting. You can say “ Here’s where we will work together:”

6. Help her become comfortable with the social culture of your workplace. Individuals with Aspergers tend to want to stay focused on tasks they enjoy. Being specific about when to go for breaks and lunch will be a guide for opportunities to personally connect with co-workers.

7. Logical lists. As you see a routine or task that requires daily attention, log it on a list. Explaining the purpose behind the task may help it to become automatic. Individuals with Aspergers like to make sense out of things.

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