ASPERGER'S SYNDROME: CLINICAL FEATURES

Question

Do you have rating scale or checklist about interpersonal behavior for Aspergers children? Thank you so much for your attention.

Answer

We have included several “checklists” on a variety of parameters below:

ASPERGERS: CLINICAL FEATURES

One of the primary features of Aspergers is their passion for favorite topics or special interests. Some of these areas include:

• astronomy
• dinosaurs
• extraterrestrials
• geography
• history
• machines or machinery
• maps
• math
• metereology
• music
• reading
• science
• social studies
• space travel
• trains
• weather

Socialization deficits—

• Are inflexible and incapable of coping with change
• By school age express desire to fit in socially
• Described as being "in OUR world, but, ON THEIR OWN terms"
• Different from "typical" Autism
• Difficulties making social connections
• Easily stressed and emotionally vulnerable
• Frequently described as “odd” or selfish
• Highly frustrated by their social awkwardness/alienation
• Lack effective interaction skills — not desire
• Lack understanding of human relations and rules of social convention
• Naïve and lack common sense
• Preoccupied with own agenda
• Seldom interested in other's interests/concerns
• Unable to “read” others' needs and perspectives
• Unable to appropriately respond to social cues

Social Problems—

Many Aspergers kid’s social problems are not recognized until they enter preschool. The first things noticed may be a tendency to avoid spontaneous social interactions, to have problems maintaining a conversation and to have a tendency to repeat phrases and make odd statements. They may not make many friends and often have difficulty keeping them. Emotional responses such anger, aggression, or anxiety may be excessive or inappropriate to the situation. ASPERGERS kids also prefer a set routine to frequent changes in the environment.

Social rejection of Aspergers kids—

Because of their social ineptness ASPERGERS kids are often the focus of bullying, scape-goating, hazing and teasing. This often leads to anxiety, feelings of rejection, depression and withdrawal.

Adolescence may bring on crises for ASPERGERS kids because the very social skills they lack are central to adolescent social developmental. Successful adolescents have sensitivities to social nuances and variations in language that nerds lack.

For some teenagers, computers are an alternative from stressful social situations. Computers also provide a more linear, modulated form of socialization that ASPERGERS kids are more skilled and comfortable at handling. Since many ASPERGERS kids become very computer proficient, they become valuable resources to their peers. It also provides a media for social interaction in which they can feel competent and valued.

ASPERGERS adults can lead a normal life. They tend to pursue vocations that relate to their special interests, sometimes with great success, as with Einstein and Newton. Some are able to complete college and even graduate school. However, most will continue to show subtle differences in social style. The social and emotional demands of marriage can be demanding for them.

Use of Language—

• Concrete language rather than abstract
• Difficulty understanding humor
• Early years: repetitive phrases or language or stock phrases from memorized material
• Excessively formal or pedantic language
• Hyper-verbal (highly developed vocabularies)
• Laugh at “wrong time” with jokes or interactions
• Many have good sense of humor
• Misused or not used cultural slang or social idioms
• Problems with taking turns in conversations
• Prosody-speech volume, intonation, inflection, rate is frequently deficient or unusual
• Rote skills are strong
• Some have normal or early language development
others have speech delays, then rapidly catch up, making diagnosis between AS, autism, and speech disorders difficult
• Typically revert to favorite topic area
• Usually like word games and puns
• Weak pragmatic-conversational-skills

TEACHING STRESS REDUCTION SKILLS—

AS kids are:

• are often anxious and worrisome
• easily overwhelmed
• highly sensitive
• often engage in rituals

Practical Suggestions:

• consistent routines
• let them know what to expect
• minimize fears of unknown
• minimize transitions
• prepare them for altered plans, schedules or changes
• provide predictable, safe environments

Examples:

• Introduce to teacher, therapist or para-professional before work begins.
• Learn about youngster's favorite topics or special interests
• Take tour of building youngster will be working or learning in.

AS kids typically display impaired Social Interaction—

Practical Suggestions:

• Create cooperative learning situations
• Educate peers
• Praise classmates when supportive
• Promote empathy and tolerance
• Shield them from bullying and teasing

Examples: Use AS youngster's strengths in exchange for liabilities to foster acceptance:

• Encourage participation in conversations
• Insensitive or inappropriate comments from AS are usually innocent
• Model two-way interactions
• Rehearse proper response repertoires
• Teach and support proper reaction to social cues
• Teach WHAT to say, WHEN, and HOW to say it
• Teach/model correct emotional responding
• Teaching WHY & WHAT response is appropriate is necessary

COMMUNICATION AND GESTURES—

Six steps for understanding challenging communications:

(1) Try to figure out what your youngster is communicating with the challenging behavior.

• “I can't remember what I'm supposed to do”
• “I'm mad…scared…confused”
• “This is too difficult for me”

(2) Consider how you can adapt the situation.

• Youngster expressing confusion? -> consider how to make the situation easier to understand. Make it more concrete, routine, or predictable
• Youngster overwhelmed or overstimulated? Try reducing amount of time in situation, or avoiding it in future.

(3) If the message must be communicated, come up with alternate way in which your youngster can communicate his or her needs or wishes more appropriately.

• Help your youngster develop appropriate ways of conveying requests/needs. If screaming when confused by a task, teach youngster to raise hand, ring a bell, or say: “I need help with this…this is too hard”

(4) Practice the “new way” of communicating.

• model more appropriate phrase or nonverbal signals
• have youngster practice the “new phrase” or behavior
• during the situation, remind (prompt) youngster to use new phrase or behavior

(5) Reward your youngster for using the strategy by showing that it gets his or her needs met.

• if asks to leave situation, provide her with immediate break
• if needs attention, stop what you're doing and provide some time/interest
• if your youngster requests help assist her immediately

(6) Be sure that the challenging behavior is no longer effective in getting your youngster's needs met.

• ignore problem behaviors
• provide prompt for the “new, appropriate one
• if youngster screams to avoid situation, prompt her to use an appropriate phrase. Do NOT allow her to leave the situation while she is screaming.

My Aspergers Child: Preventing Meltdowns and Tantrums