Complications of the Aspergers Diagnosis: Help for Clinicians

When moms and dads look for assistance for their Aspergers youngster, they encounter diverse opinions (e.g., “he'll outgrow it” … “leave him alone” … “it's no big deal” … “he just wants attention” ...and so on). Many therapists try to work with the Aspergers youngster as if his disorder is like other developmental disorders, but it's very different. Generally, there's a profound misunderstanding by many people regarding the needs of these special children.

For the unskilled, identifying the defining features of Aspergers as outlined below can be challenging, and misdiagnosis tends to occur frequently:

• A lack of emotional empathy
• Clumsy, un-coordinated movements
• Intense absorption in certain subjects
• Limited ability to establish relationships
• Naïve, inappropriate, one-sided social interactions
• Odd postures
• Pedantic, repetitive speech
• Poor non-verbal communication

Diagnosis is further complicated by the fact that an Aspergers youngster or adolescent has many of the same features present in other disorders. These numerous features are often misinterpreted, overlooked, under-emphasized, or overemphasized. Consequently, a youngster may obtain a variety of diagnoses over time or from various therapists. For instance, if the Aspergers child shows a high level of ADHD-like signs and symptoms, this may be the sole diagnosis he gets. However, many ADHD characteristics are also common in Aspergers kids. The same holds true if obsessive or compulsive behaviors are exhibited - the youngster will get tagged with OCD rather than Aspergers.

The following traits are also generally seen in Aspergers children in varying degrees. However, simply because these traits exist does not mean that the youngster ought to be diagnosed in a different way. These traits ought to be noted as significant features of Aspergers:

• Anxiety
• Difficulty with pragmatic language skills
• Hyperlexia (advanced word recognition skills)
• Motor deficits
• Oppositional defiant disorder (ODD)
• Sensory difficulties
• Social skills deficits

Therapists who do not have much knowledge about Aspergers have a problem identifying the defining characteristics. For instance, social skill deficits might be noted by a therapist, but then these deficits are often downplayed since the youngster or adolescent seems to be having appropriate conversations with other people or appears to be interested in others. But with an Aspergers youngster, the conversations aren't usually reciprocal, therefore the youngster should be carefully observed to determine if there is true back-and-forth conversation. Additionally, many Aspergers kids are interested in other people, but the diagnostician must clarify if the objects of their interest are age appropriate (e.g., Do they connect to friends in an age-appropriate manner? Can they maintain relationships over a period of time, or do they end as the novelty wears off?). These are the kinds of observations and queries that must be asked to guarantee a proper diagnosis.

Another illustration of an overlooked area may be the “narrow routines or rituals” which are supposed to be present. This doesn't always show itself as obsessive-compulsive behavior in the usual sense (e.g., repetitive hand-washing or neatness), but instead in the insistence on the need for rules about numerous problems and circumstances. These types of kids might not throw temper tantrums over their need for rules, but may require them as much as the person who has a meltdown whenever a rule is violated. Essentially, there isn't any solitary profile of the standard Aspergers child.

Due to these subtleties and technicalities, the single most significant consideration in diagnosis is that the therapist making the initial diagnosis be familiar with Autistic Spectrum Disorders - in particular, Aspergers. They should have previously diagnosed numerous kids. To make a correct, initial diagnosis demands the following:

1. An evaluation by an occupational therapist acquainted with sensory integration issues may provide additional and useful information.

2. It is essential to incorporate a speech and language assessment, as individuals with Aspergers will display impairments in the pragmatics and semantics of vocabulary, in spite of having sufficient receptive and expressive vocabulary. This can also serve to make moms and dads aware of any abnormal vocabulary patterns the youngster shows that will interfere in later social situations. Once again, these oddities might not be acknowledged if the therapist isn't acquainted with Aspergers.

3. The youngster ought to see a specialist or developmental pediatrician (again, someone familiar with Autistic Spectrum Disorders) for a comprehensive neurological examination to rule out other health conditions and to assess the need for prescription medication. The physician might recommend additional medical testing (e.g., blood, urine, fragile X, hearing).

4. Both parents and the Aspergers child should have sessions with a therapist in which the youngster is very carefully observed to see exactly how he responds in various situations. This is accomplished through play or talk sessions in the therapist's office and by discussions with the parents. The therapist may ask the parents to complete checklists or questionnaires to gain a better understanding of the youngster's behaviors at home and school. If the youngster is in school, the therapist may call the youngster's teacher or ask him to complete additional checklists. The checklists or questionnaires used should be ones that are appropriate for children with Aspergers.

5. Another important factor is to determine the IQ level of the Aspergers youngster. An average or above-average IQ is necessary for a diagnosis of Aspergers.

Help for Clinicians—

Kids can begin to show signs of Aspergers by the age of 3. However, because most kids with ASPERGERS are of average or above average intelligence, the condition may not be noticed until later. When a youngster begins to develop socially and is placed in a school or playgroup setting, symptoms of Aspergers may become more apparent. In some cases, ASPERGERS is not diagnosed until adolescence (especially in girls).

Most experts agree that Aspergers symptoms can vary greatly. In general, each youngster who has the disorder has his or her own unique set of symptoms. Kids with ASPERGERS usually have a combination of the following symptoms:

• Unusual speech patterns with regard to tone, pitch, or accents
• Unusual sensitivity to sound, light, or touch
• Strong aversion to change or spontaneity
• Strong attachment to routine
• Obsessive interest in one topic which they may talk about excessively
• Late development of motor skills or a lack of physical coordination
• Inability to sense other people's needs for personal space
• Inability to read non-verbal social cues and other people's feelings
• Inability to be empathetic
• Extreme difficulty with peer relationships and social situations
• Difficulty understanding their feelings
• Below average handwriting
• Awkward, repetitive gestures, body postures or facial expressions
• Average or above average vocabulary skills
• Above average memory skills

Kids who have Aspergers may show any or all of these symptoms to various degrees. However, all kids with the disorder generally have particular difficulty with social relationships.

Kids who have mild symptoms of Aspergers may simply be labeled as eccentric and not receive appropriate care and attention. It is also common for kids with the disorder to become targets of teasing, ridicule, harassment, or bullying. As a result, kids with Aspergers are at increased risk for developing depression and other mental illnesses.

Moms and dads who suspect their youngster may have Aspergers should talk with his or her pediatrician about their observations and concerns. To rule out other conditions that may be causing the youngster's symptoms, the health care provider will perform a complete physical examination and may perform x-rays and blood tests. If no physical cause for the youngster's symptoms is found, he or she may be referred to a health professional that specializes in developmental disorders in kids.

A thorough diagnosis and evaluation are important for determining the most effective treatments for the youngster. Diagnosis of ASPERGERS can be performed by one or more of the following health care professionals:

• Pediatric neurologist
• Developmental pediatrician
• Child/adolescent psychologist
• Child/adolescent psychiatrist

Diagnosis of the conditions involves taking a complete medical history of the youngster, usually based on the observations and recollections of the parents and other family members. Input from other caregivers or teachers who have had contact with the youngster are also helpful.

The medical history includes information about:

• how the youngster expresses his or her feelings
• the family's medical history
• the infancy period of the youngster
• the pregnancy
• the youngster’s social interactions with peers, siblings, and other family members
• the youngster's development of motor skills, language development, and interests
• the youngster's early (preschool) development

In addition to a medical history, a communication assessment may be performed. This test is used to gather information about the youngster's communication skills, including the following:

• Speech (e.g., clarity, volume, pitch)
• Non-verbal communication (e.g., gestures, glances)
• Non-literal language (e.g., humor, irony)
• Formal language (e.g., vocabulary, sentence structure, comprehension)
• Conversation skills (e.g., turn-taking, sensitivity to cues, ability to follow typical rules of conversation)

In kids who have Aspergers, formal language often is an area of strength, and other forms of communication are usually areas of difficulty.

The Aspergers Comprehensive Handbook

Launching Older Teens and Adult Children With Aspergers

Click ==> Launching Adult Children With Aspergers Guide

Aspergers Teens and Marijuana Use

Question

My 17-year-old son has just recently been diagnosed with Aspergers syndrome. After several really rough years of being bullied and having difficulty with maintaining friendships, we began to see him drifting towards "the wrong crowd" and using marijuana. At first, we assumed it was an experimental thing, but has since caused him to be arrested for possession. He continued to use despite mandatory drug testing.

The scary thing is that I fear that marijuana has become his new "obsession." He admitted to daily use and has told me on more than one occasion that he has no intentions of stopping. He sees it as a harmless, "natural" substance. Now, it has gotten to the point where I have seen discussions on his facebook that indicate he is involved in dealing, not as a big time dealer, but what looks like someone who delivers to "friends." He flat out denies he is involved in dealing despite my husband and I having read these messages. He even came home recently with a black eye and I fear he was beaten due to a bad deal. We are scared out of our minds and not sure where to go from here.

He wants to go to college, has good grades, but just cannot see the dangerous road he is on, despite many people telling him and the trouble it has already brought to him. We have him in counseling (for the past month or so) and it is clear that he is self-medicating.

Do you have any advice? I don't think a traditional drug treatment program would work with his very rigid way of thinking and I'm afraid this could make matters worse. Thank you - your newsletters have brought a lot of great advice and validation during the process of learning about Aspergers.

Answer

Adolescence is a time that is more emotional for everyone. Yet the hormonal changes coupled with the problems associated with Aspergers can result in the Aspergers teenager becoming emotionally overwhelmed. Childish temper tantrums can reappear. The Aspie teen may act-up by physically attacking a teacher or peer. He may even experience a "meltdown" at home after another day filled with harassment, bullying, pressure to conform, and rejection. Suicide and drug addiction become real concerns, as the Aspergers teenager now has access to cars, drugs and alcohol.

Marijuana is the most widely used illicit drug among America's youth today, and children are smoking it at a younger age than ever before. Moreover, the strength of the drug has increased in the past two decades, and other chemicals are often added to increase its effects. Here are the facts on marijuana:

• A significant body of research has identified the consequences of marijuana use, including changes to the brain, problems with learning, effects on mental health, and lung and respiratory damage. Marijuana leads to changes in the brain similar to those caused by cocaine, heroin and alcohol.

• Adolescents age 12 to 17 who use marijuana weekly are nine times more likely than non-users to experiment with other illegal drugs or alcohol, five times more likely to steal and nearly four times more likely to engage in violence.

• Despite popular belief, scientific research has shown that marijuana use can indeed lead to dependency and addiction.

• For teens, marijuana can lead to increased anxiety, panic attacks, depression and other mental health problems.

• Marijuana affects alertness, concentration, perception, coordination and reaction time.

• Marijuana affects many of the skills required for safe driving and other tasks, and these effects can last up to four hours.

• Marijuana is more potent than ever and can lead to a host of significant physical, social, learning and behavioral problems at crucial times in the lives of teens. 60% of teens currently in drug treatment have a primary marijuana diagnosis. Today's marijuana is more potent and its effects can be more intense.

• Marijuana is the most commonly used illicit drug in the United States. Every day in 1999, more than 3,800 youth ages 12-17 tried marijuana for the first time. That's more than tobacco. The number of eighth graders who have used marijuana doubled between 1991 and 2001, from one in ten to one in five. Young marijuana users often introduce other youth to the drug.

• Regular marijuana users often develop breathing problems, including chronic coughing and wheezing.

• Research has also shown a link between frequent marijuana use and increased violent behavior.

Moms and dads are the most powerful influence on their kids when it comes to drugs. Two-thirds of youth ages 13-17 say losing their parents' respect is one of the main reasons they don't smoke marijuana or use other drugs. Moms and dads who perceive little risk associated with marijuana use have kids with similar beliefs. Often times, parents neglect to refer to marijuana use when talking to their kids about drugs. They are more concerned about so-called "hard" drugs and the dramatic increase in use of club drugs. Many moms and dads do not fully appreciate the specific dangers of marijuana today. In some cases, they draw on their own experiences with drug, 30 years ago when it wasn't nearly as potent.

What can parents do?

Clear communication by moms and dads about the negative physical, emotional, and functional effects of drugs, as well as about their expectations regarding drug use have been found to significantly decrease drug abuse in Aspergers teenagers.

Adequate parental supervision has also been found to be a deterrent to drug use in Aspergers teens. Specifically, parents knowing how, where, and with whom teens socialize, as well as limiting their child's access to substances that can be abused have been associated with less teen drug use.

Limiting the amount of alcohol, cleaning solutions (inhalants), prescription, and over-the-counter medications that are kept in the home to amounts that can be closely monitored and accounted for has also been found to decrease substance abuse by teens.

Family-focused abuse-prevention programs have produced reductions in teen drug abuse. Among ethnic minorities in the United States, those who strongly identify with their communities and cultures have been found to be less likely to experience risk factors for using drugs compared to their peers who are less connected to their communities and cultures. Thus, incorporation of a ‘cultural componen’t to drug abuse prevention programs may enhance the effectiveness of those programs. In addition, teenagers 15 to 16 years old who use religion to cope with stress tend to use drugs significantly less often than their friends who do not use religion to cope.

Drug use has been found to occur most often between the hours of 3 and 6 p.m. – immediately after school and prior to parents coming home from work. The teenager’s participation in extracurricular activities has been revealed as an important technique in preventing drug abuse in this age group.

My Aspergers Teen: Discipline for Defiant Aspergers Teens

What do we do or say to those that think Aspergers is something to fear?

Question

My 5 1/2 year old son was diagnosed with aspergers by a neurologist over this summer. My in-laws were so upset that we had him tested. They insist that we "labeled" him and have now made his life hard. We feel that now he is getting the help that he needs and the label is not a "bad" thing. What do we do or say to those that think aspergers is something to fear?

Answer

The importance of getting a diagnosis for a child who truly has Aspergers cannot be emphasized enough. If the issues that cause a child to behave strangely are unknown, parents can never get the child the help he needs and is entitled to. And someone with Aspergers does need help!

Aspergers children and adults see the world from a different point of view. They think “normal” people speak in riddles. Their thoughts go something like this:

• “How come they are not interested in details like me?”
• “Why are relationships so complicated?”
• “Why don’t people say what they mean?”
• “Why use non-verbal signs like body language instead of just telling something like it is!”

Aspergers children and adults think their world is more logical then ours. However, the majority of people do not have Aspergers – so, how the majority “thinks” is considered normal. An Aspergers child has to adjust to our “strange” way of relating to each other and our ways of communication. It’s very hard for an “Aspie” to adjust to something so far off from logic.

Parents and teachers need to understand and relate to the Aspie's different way of thinking. In order to be able to do that, a diagnosis has to be made. If you don’t know what is wrong, how can you help or reach out?

The Aspergers Comprehensive Handbook

How should I treat my friend who has Aspergers?

Aspergers is the name given to a group of problems that some people have when they are trying to communicate with others. They have difficulty understanding others. Kids with Aspergers can hear what others say to them – and they know what the words mean – but they don't pick up the 'non-verbal' part of communication. As a result, they often don't get the full message.

You might get angry with someone, and say ‘go away’. Most children know that means 'leave me alone', but a child with Aspergers might believe that you want him to go very far away.

Aspergers is sometimes called an 'Autism Spectrum Disorder' because it is a little like autism. A child with Autism cannot communicate well with others and really does not understand that people talk about feelings and have emotions. Children with Aspergers can talk, but they get confused a lot in social interactions.

Here’s what that may look like in real life:

• Because children with Aspergers (Aspies) don't understand the feelings of others, they may do things which upset other people (e.g., using things that do not belong to them without asking permission).

• Children who have Aspergers may have problems understanding that they have to listen as well as talk.

• Some may do inappropriate things to try to make friends, and this can get them into trouble.

• Sometimes Aspies get very upset and aggressive.

• Their behavior can seem a bit different or unusual, or it can be really difficult.

• Aspies are often really interested in things, like computers, stars, making things – but they have trouble having a conversation with someone.

• Aspies can be obsessive about something they are interested in, and don't understand that others are not as interested.

• Aspies can be targeted by bullies because they can easily be upset.

• Aspies like things to happen the same way all of the time, so they may get upset when lesson times are changed, or they have to move to a new desk in the classroom.

• Aspies may be surprised when people do something they haven't expected (e.g., if someone laughed because of something amusing, they might not know it was funny).

• Aspies may be upset by some noises or smells or by what some things feel like or look like (e.g., they might hate the feel of shoes on their feet, or how sand feels, or refuse to wear anything that is red).

• Aspies may choose to play alone and stay away from other children, or talk to adults.

• Aspies may find it hard to understand the feelings behind a facial expression. They may think that if someone smiles at them in a friendly way, that person wants to be their best friend. They can then be very disappointed when the person wants to play with someone else.

• Aspies may have problems making friends. They often want to have friends, and they can feel very lonely, but they don't know how to be a friend.

• Aspies may like to be playing with a computer rather than with other children, as they don't have to communicate socially with the computer.

• Aspies may take a long time to understand the ‘rules' about not interrupting when someone is talking, or how to take turns, or how to share.

• Aspies may think that other children have done something deliberately to hurt them when they have accidentally bumped into them. They can even believe that a chair tried to bump into them!

• Aspies might be called 'eccentric', which means a bit odd and different to other people.

If your friend or someone in your class has Aspergers, here’s how you can help:

• Be friendly
• Don’t bully him or play tricks on him
• Help him to learn that he must be kind to other people
• Help him to practice skills like talking to the class
• Help him to understand the rules by being firm and saying things like, "It's my turn now, then it will be yours"
• Help him when he has trouble understanding
• Ignore 'bad' behavior
• Include him in your group, but don’t get upset if he doesn't want to join in
• Let him know that you like him
• Praise him when he does well
• Stand up for him if others are being unkind
• Understand that he is not trying to be difficult
• Understand that unfamiliar things and unfamiliar noises can be upsetting for him

The Aspergers Comprehensive Handbook

Aspergers and Loneliness

It is hard to know if kids with Aspergers are as lonely as their moms and dads believe they are. Therapists do know that playing with a friend, making a friend and being with a friend are "overwhelming skills" for Aspergers children. Kids without Aspergers make no sense to Aspies because Aspies are totally preoccupied with their own agendas.

Teaching Aspergers children social skills is a big task for moms and dads and educators. It is not like teaching the child how to ride a bicycle or tie a shoe, but rather trying to teach something no one formally taught you. How do you teach someone how to read a room, especially someone who has no understanding of other individual's emotions and body language? Kids with Aspergers have no idea about how to reason socially and come up with proper courses of action in social situations (e.g., one guy with Aspergers got lost in the school corridors on his way to gym. He had forgotten the route, but he did not think to simply follow his classmates to the gym).

Yet therapists emphasize the need to teach Aspergers children social skills because they desperately need them to get along in life. The Aspie’s lack of social understanding virtually colors every other experience in his/her life. Yet the question of whether kids with Aspergers are truly lonely and want friends is a different discussion. Like all kids, some are extroverted and others are more withdrawn. Like all kids, they probably vary in their need for social interactions.

When researchers ask kids with Aspergers about friendship, they are usually very negative. They think of friendship with other kids as too much work and often prefer grown-ups. For example, when a teacher was forcing a six-year-old to participate in a playgroup with other kids, he said, "I hate kids. I don't play with kids. I'm not a kid. I was born a grown-up." Michael, a fourteen-year-old with Aspergers advises other Aspergers children, "If you like being on your own, then be happy with your own company and don't let anyone convince you its wrong." His advice to ‘pushy moms and dads’ is "Never force your youngster to socialize. Most Aspergers children and autistic individuals are happy to just be by themselves."

However, these kids might be happier by themselves because social activity has caused them so much pain in the past. In one study, gifted kids with Aspergers could not describe friendship in positive terms such as "a friend is someone who is nice to you." They had only negative associations such as "a friend is someone who does not hit you." These kids told interviewers only about how mean other children had been to them and seemed to lack any idea of what reciprocal friendship really means.

Yet as Aspergers children go through the teen years, most realize that they are missing out by not fitting in. It is at this point in their lives that they crave friendships with peers, yet this unfulfilled desire on top of high school pressure to conform, constant rejection and harassment can often cause depression in Aspie teenagers. They grow more isolated even as they crave more interaction with other teenagers. Young Aspie kids often believe everyone in their class is the same and everyone is a potential friend. Aspie teenagers know better.

Research shows that the more time a person with Aspergers spends socializing, the happier she is. Aspergers children can and do form friendships. When they do, research shows that even one friendship will speed up their entire social development.

People married to someone with Aspergers often talk about their own feelings of loneliness. They tell counselors that marriage to a person with Aspergers feels like living alone. An Aspie husband/wife often does not attend to details like anniversaries, may not connect with the couple's kids on an emotional basis, and may not benefit from marriage counseling. A parent of a youngster with Aspergers may feel rejection when their youngster refuses to cuddle or express affection. The youngster's needs are unrelenting and yet the moms and dads' rewards are sometimes rare. Brothers and sisters hide their lonely feelings about living in a family where their Aspie sibling monopolizes their moms and dads' precious time and they miss the normal give and take of sibling relationships. Many siblings believe that the Aspie's “disability” is an advantage …a passport to special attention, recognition and privilege.

Helping kids with Aspergers develop social skills will no doubt become easier in the future. Every day educators are developing better techniques. Researchers are closing in on the genetic and environmental causes of Aspergers and may someday develop a cure. There is promising new research being conducted in a study on "Friendship and Loneliness in Individuals with Aspergers." Perhaps someday the answers will be clearer for individuals with Aspergers and those who love them.

Aspergers Teens and Social Isolation—

In the teenage world where everyone feels insecure, teens that appear different are ostracized. Aspergers teens often have odd mannerisms. For example, they may talk in a loud un-modulated voice, avoid eye contact, interrupt others, violate others’ physical space, and steer the conversation to their favorite “weird” topic. Aspie teens may appear willful, selfish and aloof, mostly because they are unable to share thoughts and feelings with others. Isolated and alone, many Aspergers adolescents are too anxious to initiate social contact.

Many Aspie teens are stiff and rule-oriented and act like little grown-ups – a deadly trait in any adolescent popularity contest. Friendship and all its nuances of reciprocity can be exhausting for a person with Aspergers, even though he wants it more than anything else.

The Aspergers Comprehensive Handbook

All About Aspergers

Aspergers is a developmental disorder on the Autism spectrum. It affects verbal and non-verbal communication (body language) social interaction, a dislike of change, an aversion to noise, inflexibility of thought and, quite often, an obsession with a certain interest.

Kids with Aspergers (Aspies) usually have excellent memories, especially in the area of facts, figures, dates, times and statistics. Math and science are subjects of interest and kids usually excel in these areas.

There is a large range of severity of symptoms with Aspergers. Kids who have very mild symptoms often go undiagnosed for years. It is not unusual for kids with medium severity to go undiagnosed until they start school, at which time the disorder is seen in behavior problems and lack of social skills. Although females do sometimes suffer from the disorder, it is far more prevalent in males.

Aspergers Traits—

Kids who have Aspergers have trouble interacting with their peers, but can carry on an intelligent and often animated conversation with adult. They use language differently than non-Aspergers sufferers and are often labeled odd and eccentric. Kids with Aspergers take verbal and written communication literally. They are happier when schedules are consistent and when they are in a rigidly structured environment. If bored, they may touch, talk out, or make noises to occupy themselves; most often they will concentrate on the activity or hobby of their preferred choice.

Kids who have Aspergers have traits that make them appear to be perfectionists. They love being the first and the best at things and find imperfection, losing and criticism very frustrating. Their ability to communicate their feelings often results in inappropriate behavior. Aspies experience emotions that are overwhelming, which causes them to have a high anxiety level. They need to be around people who are patient, understanding, loving and supportive. Tender loving care (TLC) is needed to help them reach their goals. These kids flourish in this type of environment.

Problems—

Problems coping will become less as the youngster matures, but as with all kids, new ones will appear. Adolescents find the lack of friendship perplexing. They continually try to their best to cultivate new friendships only to find they don’t last. Moms and dads need to teach Aspies social skills that come naturally to non-Aspies. If social skills are taught from a young age, it makes life easier for Aspergers adolescents.

Many skills can be taught to Aspies. However, keep in mind that each youngster is an individual with his own personality and characteristics. Difficulty levels, as well as levels of achievement will vary.

Aspergers vs. Autism—

Aspergers is more common that Autism, though it is quite rare. Few people including health care professionals have ever heard of it. Fewer still have had any experience dealing with it and even fewer understand it. Most health care professionals have some knowledge of Autism, though most refer kids who suffer from it to specialists in the Autism field of expertise.

Aspies have been described as having a dash of Autism. Expert’s opinions differ greatly on whether Aspergers should remain on the Autism spectrum, or if it should be in a classification of its own. Autism has been defined as a withdrawal from reality. Though this is not what Autism is, thousands of people, including some health care professionals, still view it as such.

The severity of Autism is much greater than that of Aspergers. Many times kids with Autism cannot speak and only make sound. Classic Autism brings many learning problems with it. The language of those with Aspergers is most often clear, intelligent and usual. Their cognitive ability is almost always at least average and more often above average.

At the present time, the similarities and characteristics of Autism and Aspergers are enough to put them on the same spectrum of developmental disorders. It is important that any diagnosis be perfectly clear, though this can change as the youngster matures. Traits of kids on the high end of the Autistic spectrum appear less severe as the youngster matures and learns to cope with his disorder and difficulties.

Areas Affected by Aspergers—

• Communication
• Narrow interests
• Repetitive routines and inflexibility
• Social interaction

Communication—

Aspies will experience both verbal and non-verbal communication problems. Though they often have very advanced verbal skills, spoken language is difficult for them to understand. Keep conversation simple and precise. Metaphors have to be explained to be understood, as do similes. Aspies tend to take your words literally and make interpretations concrete. Some Aspies may experience delayed speech, but most do not. They tend to use phrases they have heard and committed to memory, although they frequently use them out of context. Moms and dads of kids with Aspergers may need to translate phrases in order to decipher exact meanings.

Aspies can, at times, speak in an odd way. They may be loud, speak very formally, or even in a monotonous tone. They may talk incessantly about an area of interest without realizing that the listener is experiencing intense boredom. Often they have trouble finding the right words to express what they are trying to say. They have the same problem expressing their feelings and may appear to speak “at you” instead of “to you.”

The Aspergers youngster does not make direct eye contact, nor do they understand body language and facial expressions, though these things can be taught successfully. These kids tend to have odd facial expressions and find the reading of facial expression and body language in others to be beyond their comprehension abilities. This tends to initiate further problems, including frustration and anxiety.

Teaching Body Language—

The easiest and simplest way to teach body language and facial expressions is through a fun game. Make a face and ask the youngster to guess its meaning. Continue playing this game for a few minutes each day until the youngster learns what you are communicating. Some examples are sad, happy, surprise and frowns. Once the youngster has mastered facial expressions, play the same game to teach body language. Knowledge of basic facial expressions and body language gives the Aspergers youngster a definite advantage when interacting with others.

Reading—

It is not unusual for kids with Aspergers to acquire outstanding reading skills at a very young age. The trick here is to assure the youngster understands what he is reading. Take time to read to and with your youngster and allow her to read to you in return. Talk about the meaning of the story and explain to the youngster how to get the most out of a good book.

Narrow Interests—

A definite symptom of Aspergers is the youngster’s obsession with certain topics. Examples are trains, cars, trucks, airplanes and all other modes of transportation. Dinosaurs, science, computer and maps also are subjects of high interest. Kids with Aspergers want to know how things work and how they are made. They tend to become preoccupied and obsessed in all things intellectual. These things will change as the youngster matures, but the intensity level is always extreme.

Social Interaction—

All Aspies have poor social skills. They do not read social cues, so cannot give a proper social response. They have no desire to share their experiences with others. These problems tend not to be as severe around moms and dads or grown-ups, but cause very definite problems when the youngster is interacting with peers. This causes difficulties when trying to make friends their own age and results in high anxiety, frustration and behavioral problems.

Kids with Aspergers often find themselves alone. Many are happy as loners; others are not. They are noticeably different when interacting with their peers in an unstructured environment such as a park or school playground. They are very naïve, which causes them to be bullied and teases unless protected by an assistant, buddy or sibling. They focus on small areas of detail and almost always fail to see the overall picture of situations. This lack of skill can be likened to a tapestry. Where non-Aspies see the entire tapestry, Aspies tend to focus on each individual thread. This causes them to overlook certain aspects of situations, which can cause more frustration and anxiety.

Repetitive Routines—

Aspies tend to limit themselves and those around them to rigidly structured routines. They want things done in a certain way and often, though not always, pick certain foods that they like to eat and insist on one of them at every meal time. As they mature, these routines change and the youngster is more likely to listen to reason.

Because of their inflexibility kids with Aspergers often limit their own creativity and imagination. The same things are done in the same way every time. They often memorize details and have a great rote memory, but learn without understanding. Aspies need everything to be explained simply and in great detail. For instance, instead of telling the Aspergers youngster to set the table, you need to be much more specific. Tell her to put knives, forks, spoons, plates, cups and glasses on the table. This allows her to know exactly what is expected of her.

Never assume that an Aspergers youngster understands instructions just because he can repeat them back to you. Be certain to follow through and ascertain that the youngster knows exactly what you want her to do. This makes it much easier for all involved and keeps the youngster’s frustration and anxiety to a minimum.

Education—

If an Aspergers youngster is to attend a public school, it is important that he have lots of support available. The best way to assure this is by supplying the school with a Statement of Special Education. This will give school officials advice on the needs of the Aspergers youngster. This advice should be supplied by the moms and dads and a health care professional who specializes in Aspergers. Obtaining a Statement of Special Education is a stressful and confusing process that can take more than six months. Contact anyone who may be able to help you with this process. It is important that the Aspergers youngster have this support in place before attending school, or as soon as possible after he is diagnosed.

The school that the Aspergers youngster attends must be willing to learn about Aspergers and the difficulties that both the youngster and educators will face. Aspies need a very structured environment if they are expected to excel. The more structured the school environment, the less behavioral problems will become evident. Check with several schools to find out what support is available.

A teacher with a specific knowledge of the Autism spectrum should be assigned to give support to the Aspergers youngster, the educators and the school. Each youngster who has Aspergers should also be assigned a Special Support Assistant (SSA,) or, in Canada, an Educational Assistant (EA.) Other specific professions support, such as language and speech therapists should be assigned if applicable to ensure the youngster develops proper language and speech skills.

If you plan on home schooling your youngster, speak to your Aspergers health professional. A diary should be kept for communication, achievements and problems. Home schooling is not always the answer for kids with Aspergers, as they do need a lot of social interaction with kids their own age in order to develop communication skills. Only your Aspergers health care professional can tell you if home schooling your youngster is the right for her. After all, the youngster’s well-being is the top priority.

Life Issues—

Aspies often have high stress levels. Things overwhelm them easily and they don’t have the skills they need to control their emotions. Music may be nothing more to than noise to the Aspergers youngster and can cause emotions to reach out of control levels. Overwhelming situations can result in meltdowns immediately or hours or even days later.

Meltdowns—

Meltdowns can result in the Aspergers youngster going out of control. He may cry, scream, cry and scream, kick, throw things, pound on walls, or engage in other inappropriate behavior. It’s very difficult to determine when, where or why a meltdown will occur. When you ask the youngster what the problem is, they may give an off the wall reply, such as “I have no green toys,” when he has hundreds of green toys in his room.

Never punish an Aspergers youngster for having a meltdown, which appears to be nothing more than an intense temper tantrum. Allow her a quiet time and once he is again in control, try to find out what the real problem is. It could be something that happened immediately before the meltdown, yesterday, or even last week. It’s very difficult to determine why a meltdown occurs unless the youngster learns to communicate his feelings.

Meltdowns often occur after a rough day at school, a disagreement with a sibling, a lost game, a sporting event or other activity. Be patient and supportive. Don’t shout. Let the youngster know that you support her and love her. It is not unusual for Aspies to meltdown upon arriving home from school. A school day is very structured and they try to be on their best behavior, so venting when they get home is quite natural.

Aspies and the Holidays—

Aspies are easily over stimulated. Their emotions overwhelm them and it is up to the people around them to make life easier for them.

The holidays are especially difficult for kids who have Aspergers. Remember, they are not social people. Crowds and noise overwhelm them. They do not cope well with the hustle and bustle of holidays, especially Christmas. This brings a lot of stress into the life of the Aspergers youngster.

Some Aspies may not want to join in when the family opens presents. She may be checking out the lights on the Christmas tree, trying to figure out how they work, or she may sit in a corner participating in one of her obsessive hobbies. Let her be. If you pressure her to join in, she will become overwhelmed and go into a meltdown. This will only result in upheaval and chaos for the entire family. Allow the Aspergers youngster to check out the lights and open her presents in her own time.

Aspergers Stress Factors—

• Being pressured in anyway, such as to be on his best behavior, or to join in the festivities can cause overwhelming emotions in the Aspergers youngster.
• Having too many people around. Crowds and the buzz of conversation can overwhelm the Aspergers youngster.
• Noise. This includes the crinkle of wrapping paper, Christmas carols, singing and dancing Christmas decorations, or anything that causes sound on an ongoing basis.
• Too many visitors at the same time. Remember, the Aspergers youngster does not like to be surrounded by people and noise.

Coping—

• Allow only one person to open presents at a time. This will alleviate the crinkle of wrapping paper and nose from the excited voices of siblings.
• Encourage the Aspergers youngster to enjoy herself and have fun. If this means she retreats to a quiet area where she can be alone, let her be. This is his way of coping and of enjoying the holiday. Never pressure an Aspergers youngster to play with other kids.
• Have a quiet breakfast on Christmas morning.
• Keep meals quiet. Do not allow toys at the table. Ask each youngster to talk about their favorite toy, including the Aspergers youngster.
• Keep noise minimal. Do not play music for extended periods of time or it will become nothing but noise to the Aspergers youngster.
• Keep visitors minimal. Family members and friends should keep visits short and they should visit at separate times. Be sure everyone knows when they are expected and how long they are expected to stay.

Strategies for Coping—

• Ask the youngster to look directly into your eyes when you talk to her. Praise her when she is successful.
• Aspies are often immature. Never tell them to act their age. They have no concept of age-related behavior.
• Be sure the youngster knows what is expected of her. Use simple language that she can understand.
• Give the Aspergers youngster lots of support, praise and TLC. Let them know that you love them and are there for them, always.
• Identify ways to cope with behavior problems. Hugging will help some Aspies, while others don’t like to be touched. Get to know your youngster.
• Keep instructions simple and on a level that the youngster can understand.
• Learn to identify stress triggers and avoid them when possible.
• Limit choices to keep the youngster from being overwhelmed.
• Sing or whisper words to young kids in order to get their attention and to help them keep focused.
• Teach the youngster stress busting techniques such as deep breathing or counting to ten. Many Aspies find a stress ball beneficial.
• Try to incorporate flexibility into the youngster’s routine at an early age. This allows her to realize and accept that things do change.
• Use social stories to prepare Aspies for new social experiences, the new school year, a move, and any other changes that will take place in their life.
• Warn the youngster well in advance of any changes to be made in his environment, such as moving the furniture or rearranging his room. The youngster’s school must be made aware that moving his desk can cause behavioral problems.

Remember, Aspies are unique. They have their own quirks, distinct personalities, abilities, likes and dislikes. The only difference between them and any other youngster is that they look at the world in a different way. They just need some extra love, support and patience from family members.

My Aspergers Child: Preventing Meltdowns

Helping Aspergers Children with Homework

Question

How much assistance should moms and dads offer when it comes to helping their Aspergers child with his/her homework?

Answer

School can be a complex situation for kids with Aspergers. Homework can be a real struggle, especially after spending an entire day forced to sit in the classroom. Truthfully, moms and dads of kids without Aspergers also struggle with how to handle the homework problem. Should you push, hover, beg, and plead – or should you gently remind your youngster about his assignments and then let her face the consequences? The answer lies somewhere in the middle.

There are several reasons why homework can be such an issue for Aspergers kids. Homework interferes with free time, which is better spent on that special interest. Homework is hard because of the distractions of home.

The main problems that interfere with homework are:

• Anxiety caused by frustration. Teach your youngster relaxation techniques he can use during class (e.g., deep breathing) and homework times to reduce frustration. Anti-anxiety medications can help in moderate to severe cases.
• Cognitive reasoning. Cognitive therapy is very helpful in this area.
• Communication difficulties (pragmatics or comprehension). Speech/language therapy can help your youngster with communication skills. These therapies can be performed in the home with the help of published resources.
• Lack of organizational skills. Use written list, daily schedules, and a visual timer to help your youngster gain organizational skills. Time management is often an area of concern and should be developed, as well.

Here are some thoughts that may help you deal with homework-related issues:

• Have you established a homework routine? Kids with Aspergers work much better with a set routine.
• Is she easily distracted by noise or activity? Set up a homework zone that suits her sensory needs.
• What frustrates or upsets her? Avoid these triggers before and during homework time.
• What is her best time of day? Does she work better right after school or after a play break and snack?

You can have success with your Aspergers youngster. Homework does not have to be a problem. Remember, work with your youngster’s strengths – and be consistent.

My Aspergers Child: Preventing Meltdowns

Surviving Thanksgiving: Tips for Parents with Aspergers Children

Thanksgiving is especially difficult for kids who have Aspergers. They are easily over-stimulated, and their emotions overwhelm them. So it is up to the family members around them to make life a bit easier for these kids. Remember, they are not social people. Crowds and noise overwhelm them. They do not cope well with the hustle and bustle of family get-togethers.

Some Aspergers kids may not want to join in when the family sits down to eat. They may be checking out the “goings-on” in the kitchen, trying to figure out how people cook, or they may sit in a corner participating in one of their obsessive hobbies. Let them be! If you pressure them to join in, they may become overwhelmed and go into a meltdown.

Surviving Thanksgiving: Tips for Parents with Aspergers Children—

Following these simple guidelines should lead to a much more positive experience for everyone, and will provide your Aspergers youngster with the love, support and confidence to participate fully in this wonderful occasion:

• Explain any changes to your Aspie’s routine; prepare him for any changes by calmly telling him the day before what will be happening. Visual supports always work well, so use photos or drawings to explain what will be happening.

• Explain to your Aspie that he will need to be given permission to leave the table. Rehearse this together with some simple role-play (this is very important because it gives your youngster an exit strategy and also allows him to get through the dinner without going into meltdown). If you see that he is becoming upset, you can activate the exit cue so he can get out before the situation deteriorates).

• Explain to your youngster what is expected of him (e.g., “Say ‘hello how are you’ to guests and sit at the table with us when we eat”).

• Keep any physical changes to your home to the minimum. Decorate, but don't make a big deal about it all.

• Reduce the time talking about Thanksgiving. Remember, your Aspie cannot easily control his emotions, so to talk a lot about this occasion may lead to stress and anxiety. Enlist the help of others in your home in keeping conversations about Thanksgiving to a minimum when the Aspie is within ear-shot.

Tips for Adult Aspies—

Here are some tips that adults with Aspergers may find helpful in surviving Thanksgiving:

• Seek help from a counselor if you need to. Holiday therapy can be a temporary bridge to January 2nd.

• Schedule realistically. Over-scheduling during Thanksgiving can lead to burnout when being around people is gratifying, but stressful (or just plain difficult). While it's great to push yourself to socialize, Thanksgiving is a time to be reasonable – don't expect yourself to attend 3 “get-togethers” in one day.

• Plan for taking breaks during visits; announce a time-out and remove yourself from the group (e.g., take a walk outside, take a nap with a book, take some quiet time for deep breathing, offer to run an errand in the car, play a video game alone, etc.).

• Beware of the lure of substance use. Many of us rely on an alcoholic drink or two to help ease “party anxiety”. While there may not be too much harm in this, there tends to be a surge in substance abuse during Thanksgiving, which can lead to hangovers, a shaken sense of self, embarrassment, or worse. Remember that as long as you're using substances to deal with holiday stress, you're not truly growing in your ability to handle difficult social situations.

• Be extra kind to yourself. We spend so much time during Thanksgiving thinking about giving to others (or avoiding it), but how much do we think about truly giving to ourselves? This is the time to use kind words and actions to take care of yourself (e.g., buy or check out a new book, go to the movies, eat a favorite meal, spend quiet time petting the cat, etc.).

The Aspergers Comprehensive Handbook

Living with an Aspergers Partner/Spouse

Click ==> Living with an Aspergers Partner: Relationship Skills for Couples Affected by Aspergers

How To Help Siblings Deal With An Aspergers Brother/Sister

The special needs of the siblings without Aspergers can be classified into four categories. These children need:

1. help dealing with peer and community reactions
2. information
3. to have expectations clarified
4. to have their feelings validated

Having a child with any type of developmental disability can be very stressful for the parents and the siblings of that child. Siblings without Aspergers may be drawn into care-taking roles (e.g., teachers, co-parents). Many children find these roles difficult to fulfill because it takes away much of their own childhood and sets aside their own needs.

For most siblings without Aspergers, having an Aspergers brother or sister becomes a central experience in their lives. They may see their Aspergers sibling as having the spotlight (not an easy situation for any kid). Thus, it is very important for parents to be aware of how the Aspergers child – and the sibling without Aspergers – may need to be nurtured in special ways.

Often times, brothers and sisters are thrown together for better or for worse. When a sibling has Aspergers, it can complicate that relationship because one child lacks social skills and the other child simply cannot figure out why his brother or sister acts the way he/she does.

Here are some important factors to bear in mind as you attempt to assists your NT or “neurotypical” child (i.e., the child without Aspergers) in dealing with his/her Aspergers sibling:

1. A child may need help in understanding what it feels like to be sensitive to touch or sound. A demonstration of metal scratching a chalk board could be used to show how sound can be unpleasant to their Aspergers brother/sister.

2. Children may become anxious about an Aspergers sibling’s future, and to some extent may begin to wonder what their own responsibility should be. Sometimes having an Aspergers brother or sister can interfere with establishing a sense of autonomy. The non-Aspergers child can feel guilty as she moves forward toward relationships, higher education or jobs, while the Aspergers brother/sister may be developing more slowly or struggling. The non-Aspergers child may feel like she is abandoning her parents as well. Reassure her that things are being taken care of, and that it is important that she keep moving forward in her own individual life.

3. Children may become competitive with - or critical of - their parents around how to best manage the behavior of their Aspergers sibling. Admit that you, the parent, do not have all of the answers. This admission provides an opportunity for a more realistic picture of parents as people coping, rather than as ‘superheroes’ whose achievements the child can never equal.

4. Don’t put the sibling in a parenting-role with the Aspergers child. Let her know that she can help or teach, but it is important for her to have different ways to interact that are also fun.

5. Don't accept bad behavior from your Aspergers youngster, and don't expect perfection from your other kids.

6. Fully educate yourself about your Aspergers youngster, and then inform his siblings on an age-appropriate basis. Know that Aspergers kids find it very difficult to pick up on social cues and often have intense, narrow interests.

7. Get some counseling from a mental health care professional. There is nothing wrong with allowing your children without Aspergers to receive extra assistance to help them cope with their Aspergers sibling. In psychotherapy, they can learn specific tools, build self confidence, and have a safe environment to share their thoughts and feelings.

8. Give children without Aspergers a balanced presentation of both the special strengths and talents as well as the challenges of the child with Aspergers.

9. Help your Aspergers child understand how his siblings think and feel, and why they behave the way they do.

10. In some cases, non-Aspergers siblings feel the need to be high-achievers in order to make up for the stress caused by their Aspergers brother/sister. Keep an eye out for this “perfectionism” and reassure the child without Aspergers that she can simply be herself (e.g., “It’s OK to do your best – but perfection is never a requirement”).

11. It is often tempting to coddle the Aspergers child and expect the other children to do so as well. Do not make this mistake.

12. Know that the Aspergers diagnosis should be disclosed to the child with Aspergers before it is explained to siblings. Once the child with Aspergers appears to be comfortable discussing the diagnosis with other family members, you can share the label with his brothers and sisters. Until then, use descriptive language, but no label.

13. Know that the child with Aspergers will benefit and learn social skills from their siblings. They should be entitled to a reasonable amount of sibling rivalry. You don't want to deny the Aspergers child the typical childhood, which includes fighting over games and movies.

14. Let siblings know what the Aspergers child needs to the extent that they can understand, and provide as normal of an environment as possible.

15. Let your children without Aspergers know that it is all right to feel angry, embarrassed, jealous, neglected, worried, or any other feeling they might have about their Aspergers sibling. Emotions are not “bad”; siblings often have these feelings, and they are not “wrong” for having them.

16. Non-Aspergers children sometimes feel guilty that they have friends and their Aspergers sibling does not, and they may find themselves in a position of having conflicting loyalties between friends and family. If a sibling becomes protective when her Aspergers brother is teased, reassure her that she is not the only protector – it is the parent’s and teacher’s job as well.

17. Non-Aspergers kids benefit from opportunities to express their emotions about their Aspergers sibling’s special needs and behaviors. Useful activities might include reading books about Aspergers, making a book about Aspergers, or using puppets/dolls/stuffed animals to facilitate the expression of emotions.

18. Parents often find it is necessary to explain why their rules and expectations may be different for the child with Aspergers (e.g., the Aspergers child may be allowed to spend more time on the computer or less time doing homework). This may appear unfair to the other children, but it needs to be explained at a level they can understand (e.g., “Your brother needs special teachers at school to help him with homework…” or “The computer helps your brother calm down when he feels over-stimulated…”).

19. Realize just as you may grieve the loss of a “normal” child, the Aspergers child’s siblings may also be grieving, because they don't have the kind of sibling-relationship that other families enjoy. Let them talk about their feelings.

20. Seek support groups. Moms and dads in these support groups have other children too, and they can be a valuable resource for the siblings of your Aspergers youngster.

21. Set aside quality time alone with each youngster. One way to accomplish this is to take one child at a time on an errand or personal appointment when you can.

22. Some children may benefit from sibling support-groups. This can be particularly useful when the sibling does not know other siblings of Aspergers children. In a support group, the brother/sister has an opportunity to find out that he/she is not alone. Sibling support groups promote an atmosphere in which siblings are more likely to express negative feelings; they may feel safer to do so because they are in the presence of others going through similar experiences, and because they don’t have to worry about hurting or angering their parents. Siblings can also use the support group to brainstorm ideas about how to handle touchy situations with their “Aspie” brother/sister.

23. Sometimes kids believe that Aspergers is contagious. Reassure siblings that they cannot “catch” a case of Aspergers even though they are around their Aspergers sibling frequently – it’s not like a cold or the flu!

24. Sometimes kids blame themselves and engage in “magical thinking” where they believe that their actions or angry thoughts “caused” their sibling to have Aspergers. Thus, reassure siblings that having Aspergers is not anyone’s fault – it is simply something some people are born with.

25. The children without Aspergers need to be encouraged to pursue their own interests. This helps them focus outside the stress that having an Aspergers sibling may have on the family and helps them see themselves as more than so-and-so’s brother/sister.

26. The sibling without Aspergers may find herself in a situation where she has to explain to others the unusual behavior of the Aspergers sibling. After helping children to better understand Aspergers, they can be helped to learn to explain what Aspergers is to others. Moms and dads can help by providing opportunities for kids to rehearse or practice explaining (e.g., through puppets or role-play).

27. Understand that Aspergers is an "invisible" disorder. Siblings may be embarrassed in front of their peers when their sibling (who looks no different than any other child) can't stop blinking his eyes or making faces (tics). Siblings may think of their Aspergers brother/sister as simply naughty or rude – particularly if they are quite young and unable to fully understand the Aspergers-related issues.

28. When explaining an Aspergers child’s behavior to the other children, be sure to provide factual information and concrete explanations (e.g., “He plays the same thing over and over because he doesn’t think that it’s fun to try new things…” or “She’s flapping her hands because it helps her calm down…”).

29. When siblings witness cruel behavior towards their Aspergers sibling – or are the target themselves – it is imperative from the beginning that adults get involved. Siblings should be encouraged to share this information with trusted adults as soon as it occurs. Moms and dads can use this opportunity to discuss with all the kids in the family how to choose friends. Both the sibling and the Aspergers child will need to develop strategies with school staff for dealing with teasing/bullying.

30. "Family meetings" where parents and all the kids get together to discuss the week's events can (a) provide good insight to family members and (b) provide opportunities to problem-solve past issues and trouble-shoot potential future issues.

The Aspergers Comprehensive Handbook


Comment:
I have a brother who was born in 1967 who I believe has Asperger’s. My brother began undergoing testing to determine what his problems were and how he could be helped when he was three. He worked with a speech pathologist, went to a local clinic for special needs kids and repeated kindergarten. My mother said his doctors could not find a suitable label for his disability so we just called it a learning disability.


My mother got a master’s degree in Special Education in the 1980’s and my parents worked tirelessly on trying to improve my brother’s understanding of non-verbal language and his balance and coordination throughout the 70’s and 80’s. My parents advocated at the local, state and national levels, but when they weren’t around, I was my older brother’s policeman at school, church and in other social settings. We both had to cope with extensive bullying.


My brother became a talker when he lived in Indianapolis and made good friends there, but moved away to try a PhD. He is still subject to embarrassing and explosive bursts of temper and awkward and painful falls. He knows everything about city planning and has a bachelor’s and two master’s degrees, but never had a serious girlfriend and cannot relate to his peers who are married and raising children. He successfully lived hours away from my parents for 12 or more years although he hated his government job.


He has been living at home again with our parents for the last five years after having a disastrous experience trying to do a PhD in Ohio. He has a history of anxiety and depression and has had incidents of road rage with and without me in the car. At times, he has struggled with suicidal feelings also. He has barely worked full-time in the last five years and has had considerable difficulty re-launching his career after completing his second master’s. He hasn’t had a date in a decade. He applies for jobs all the time, occasionally gets interviews, but is not hired. I know part of it is the economy, but I’m concerned that he needs guidance he is not getting. I don't think his problem is a lack of motivation right now although he has struggled with that in the past.


My parents are in their 70’s now and we live in Oklahoma while the rest of our relatives live in Indiana, so there isn’t much extended family support. Neither my brother nor I are married with children. I want my brother to at least have a work life he can be proud of that will pay his bills and I deeply desire for him to not feel so socially isolated. I’m scared that he will be more than I can handle when my parents pass away. Because he has so much formal education and once worked in a career position and even helped a mayor in Tulsa get elected, I don’t know if the techniques in your book will be helpful to him or if he will even be open to them. My parents over-parented him and I think he is showing the fallout from that.


Do you even think I am on the right track? He says he doesn’t worry much about his learning disability, but I am concerned that out of ignorance and good intentions, my parents gave him extremely unrealistic expectations for his life that are dangerous for him now. My mother acknowledged that he may have Asperger’s. His physical coordination never improved despite years of coaching him on it. His social awareness improved along with his communication skills, yet he has few friends and rarely feels understood. He was exempted from registering for the military at age 18 by his clinical psychologist and pediatrician and was allowed to take college entrance tests un-timed. He is still extremely slow to complete tasks and has crippling perfectionism that keeps him from taking risks.


Should I press for him to be evaluated by a clinician for Asperger’s? Should I attend a support group for siblings of those with Aspergers? Are there any services or groups that might help him since he is an adult and is, in fact, approaching middle age? He has already received years of counseling with different people. Or would a definitive Asperger’s diagnosis really be helpful to him? I have often thought that it might help for him to matter-of-factly state in job interviews and in social situations that he has Asperger’s because generally, people just think he is weird, underestimate his intelligence and then avoid him or exclude him.

About MyAspergersChild.com

Welcome to MyAspergersChild.com!  We have joined with Online Parent Support, LLC to create a single resource for children, parents, teachers, mental health professionals, and others who deal with the challenges of Asperger's Syndrome and Autistic Spectrum Disorders.

This site provides articles, conference information, educational resources, links to local/national/international support groups, lists of camps/schools, moderated support message boards, recommended reading, sources of professional help, and online parent-coaching.

We strongly believe that everyone faced with challenges associated with Asperger's Syndrome and Autistic Spectrum Disorders should have the right to - and deserve - support and understanding, inclusion, and appropriate education so they and their families can experience the greatest quality of life possible.

Living With An Aspergers Partner/Spouse

Folks with Aspergers often live in their own little world. Intimate relationships with someone identified as having Aspergers is difficult simply because they have a problem with communication and empathy (abilities healthy relationships rely on). Getting into a romantic relationship with an ‘Aspie’ will require you to change your expectation of "normal" behaviors. In exchange, however, you might find yourself part of a lasting and satisfying relationship.

Here are some tips for those who may be in a romantic relationship with an ‘Aspie’:

1. Accept the fact your Aspergers partner views you as an NT or "Neurotypical" (i.e., someone without Aspergers). ‘Aspies’ created this term. They use it to specify men and women without any of the ASD diagnoses. Social-skill training for Aspergers individuals consists of learning how to communicate in the “Neurotypical” style. NTs should try to come to terms with this particular view of their behavior at the start of the relationship.

2. Aspergers individuals do not react to the normal give and take of organic conversation. Though often talkative and articulate, they might speak all night on topics that only interest them. As a word of caution here: do not to try to engage in the monologue or change the topic. When they are done speaking (which they will be eventually), you can then bring up the next subject.

3. Aspergers individuals have a problem with expressing physical affection. They're oversensitive to stimuli (e.g., touch). He might not be comfortable holding your hand, getting unpredicted hugs, or kissing in the beginning. You might not understand this since you may have witnessed him showing affection to close family members. His lack of physical affection doesn't mean he does not care for you. Aspergers individuals don't react well to change and require a great deal of time to adjust to new surroundings and people.

4. Aspergers individuals have a problem with interpreting nonverbal communication (e.g., facial expressions, tone of voice). If you get annoyed with them for some reason (e.g., they don’t seem to listen, they appear to be blind to how you’re feeling), it’s best to talk to them as calmly and rationally as you can. He probably will not "understand" your feelings. Ignore his “mindblindness” – or it'll only irritate you much more.

5. Aspergers individuals take vocabulary at face value. Sarcasm, humor and innuendo befuddle them. When communicating with him, keep the vocabulary clear and direct and steer clear of figurative language. They do not lie, so stay truthful with them.

6. Aspergers individuals understand the “basics” of a romantic relationship. He might not behave as an average sweetheart; however, this does not alter his role in your life – or your place in his. When attempting to indicate your desires to him, be positive and concrete. State the obvious. Dropping hints and coy behavior will get you nowhere fast.

7. Be patient while you help your Aspergers partner develop some necessary social skills. He'll most likely listen to you more than anyone else.

8. Do not take offense if he does not remember to reciprocate feelings, greetings, verbal expressions, or if he doesn’t respond when you ask a question. Aspergers individuals have a problem with social hints so, if anything, carefully remind him you need an answer.

9. Intellectual curiosity to the point of infatuation identifies Aspergers. Respect that they value their space, time and interests. Understand you may be one of these pursuits that they focus on. If after a period of time their curiosity about you weakens, realize that it does not reflect their intimate emotions towards you.

10. Try to make use of technology to your benefit. Text-messaging and internet-based communication will be a better way for you to communicate with ‘Aspies’ since it cuts-down on the amount of social and non-verbal hints you may expect them to interpret in a telephone or face to face dialogue.

For more information on how to relate to an Aspergers partner or spouse, download the eBook below:

Living with an Aspergers Partner


Comment


Dear Mark


Many thanks for your book, it has helped me a great deal from much despair in dealing with who I am certain is/was an Asbergers boyfriend. He is a lovely guy in so many ways and I love him SO much but the pressures over 2 1/2 years of my having to take responsibility in so many areas (social, financial, organizational) and not receiving much empathy, comfort or support PLUS being completely misunderstood by him when I have criticized this or asked for clarification, led to acrimony, temper tantrums and sometimes violent impulses on both our parts. To the point where we had to part to get some breathing space and to try and reassess the situation. It is 6 months now since we have lived apart.


It is only in the last week or so that I have been convinced he is an Aspergers , I was alerted by a comment someone made who recently met him. I am now trying to encourage him to get a proper diagnosis and being patient and understanding with his resistance to the idea of Asbergers. (He claims to have had an autism test which tested negative) I think he will in time come to listen to me. He is seeking psychotherapeutic support, waiting to be referred to one by his GP (This is for stress and for unresolved trauma when he had the stupid job of nightclub doorman and he constantly got beaten up) plus he is interested in emdr therapy.


The thing is I still adore him and I cant move on. I helped him, two years ago come off anti psychotic drugs and anti depressants which were really making things worse for him, making him slow, obese and he looked like death on them. Physically and mentally he improved so much off the drugs and started doing yoga and other relaxation techniques. He looks great for it now and his art work is attracting professional attention and important exhibitions. BUT I was so puzzled as to why other things didn’t improve. 10 years previously he was diagnosed as a psychotic depressive, which he is absolutely not. He never suffers from psychosis or paranoia (except what is logical from not reading social cues). His depression Im guessing was from the problems that the world has thrown at him that he could not negotiate given his obvious limitations.


He easily mentally overloads at work and constantly gets interrupted by distracting thoughts (he is a part time care assistant for the elderly) He is nagged there for not being receptive to simple commands and not being organized enough. His speech is monotone and he mumbles so that sometimes its hard to follow what he is saying. This guy has very high educational achievements but cannot get employed to his educational ability. He can talk obsessively about a subject and then be very shy.


Now I understand what is wrong, my sadness and depression have lifted somewhat and I feel as if I want to try again and need some advice. The problem is that he got so hurt and fed up from my constant nagging when we lived together and then after we split my asking to go over our past and explore our feelings and my subsequent upset when he couldn’t voice his feelings, that he is understandably wary of me now. He is weirdly contradictory about whether nor not he wants to try again and in fact if I press him he yells at me that I do not understand the pressures that he is under (which before I didn’t)


What is confusing is I know he still loves me. He is loving and happy when he sees me (kisses and hugs me) and still accepts my help and speaks/texts to me every day. when I say, ‘look if you don’t want this relationship then why come over, kiss me, hug me tenderly and accept meals, favours etc? Is it just you want me to help you in your life? Please go away and stop doing it as my hopes get raised. You are messing my head around’. He doesn’t seem to take that on board, gets upset and runs away for a bit and then comes back.


So, Mark, I am all confused and feel obsessive about this. And it is affecting me badly in my work and life. I spend too much time feeling sad. I don’t know if I am being rejected or not. I love this guy so much Im willing to take on board the amount of support he needs (yet don’t think I can actually live with him) but I feel really gutted that he keeps telling me to ‘see other men’, when Im still so involved emotionally with him and he seems to encourage it by his actions, his looks, his presence etc.


Its his telling me to see other men that confuses me most - as if I do, I cant invest so much of my time and energy in him and really I should get him right out of my life till I can heal. Perhaps he doesn’t get that.


My friends all say, ‘don’t see him, you are punching below your weight, he is a child and will never give you what you want’. But they don’t know the loveliness and tenderness of when things are good with us.


Yours in confusion Cordelia


(Im in my late 40s and he is 35 there are no kids involved and wont be!)




Comment


I would say to him "can we just be friends" ...and go from there. Unfortunately, it make take a year or two before he trusts in the relationship again.


Just be friends for now, and if it's meant to be, the relationship will be restored back to its original level of intimacy in due time.


You know how to handle the Aspergers-related difficulties differently now. Thus, the relationship can be a "new and improved" version of the original one.


Mark

Low Muscle Tone and Motor Clumsiness in Aspergers Children

In this post, we will address low muscle-tone (Hypotonia), motor clumsiness, and some strategies to improve particular skills…

Hypotonia is a state of low muscle-tone (i.e., the amount of tension or resistance to movement in a muscle), frequently including decreased muscle strength. Hypotonia isn't a particular medical condition, but a potential outward manifestation of several different diseases and disorders that affect motor nerve control by the brain or muscle strength.

Identifying hypotonia is usually relatively simple, but figuring out the actual cause can be challenging. The long-term results of hypotonia on a kid's development rely primarily on the seriousness of the muscle weakness as well as the cause. Some problems have a particular remedy; however, the primary remedy for most hypotonia of neurologic cause is physical therapy and/or occupational therapy to assist the individual in compensating for the neuromuscular impairment.

The affected muscles may be trained, but not via regular weight training. Proper training to address hypotonia comes from some very specific therapy and may not be 100% effective. In young kids, the difficulties of low muscle tone may decrease in severity as they age (up to about age 10); nevertheless, children with Aspergers will probably continue to adjust and compensate for the remainder of their lives.

Low muscle tone is usually referred to as "floppiness". This is because the muscles are meant to help support the skeletal system and are designed to prevent certain kinds of motion. Because the muscles are not especially tight, individuals with low muscle tone frequently experience "hypermobility" (i.e., the ability to move limbs into awkward positions). Children with Aspergers often find that they're able to very easily carry out feats that require flexibility, but not strength or balance (e.g., splits, back-bending, shoulder rotation, etc.). They might display uncommon flexibility in other joints (e.g., fingers).

This kind of flexibility comes with a price. Aspergers children are generally very uncoordinated and awkward. In running, this plays a role in the so-called "unusual gait". A myth is that muscle tone just impacts the large muscles, but this is not the case. Muscle tone impacts all activities requiring muscles including speech, pencil grip and writing.

Fine motor skills are hard to learn if you have Aspergers. These fine skills are essential for drawing or coloring, grasping objects, riding a bike without training wheels, zipping-up jeans, and tying shoelaces. However, when muscle tone is low, these skills are much harder to perform properly.

When an Aspergers child isn't proficient at something (e.g., riding a bike), but all his friends can do it, this deficiency can create a sense of isolation in the Aspergers child. Imagine watching all the other children in your neighborhood doing various activities very easily while you don’t appear to have the same abilities. Consequently, Aspergers children can start thinking they're ‘dumb’ or ‘stupid’. This is definitely not the case. Intelligence has nothing to do with it!

Aspergers children often slump a great deal when seated or standing for long stretches. Occasionally, they'll stand with their legs crossed in what seems to be an uncomfortable manner. Even though this appears uncomfortable, this is really an extremely comfortable position for Aspergers kids. Additionally, they frequently sit with their head and shoulders rolled forward and will often lean on walls, furniture, door frames and desks. Moms and dads of Aspergers kids will probably be very familiar with being "leaned on".

Low muscle tone doesn't prevent Aspergers kids from enjoying themselves. They are able to run and have fun with other kids without feeling any harmful effects. The issue is that they are a little slower and they tire easier. Consequently team sports (e.g., soccer, basketball, football) are often not suitable to these children.

While the slumping and leaning habits are not necessarily good posture, they are not particularly harmful to the Aspergers child unless of course the position is adopted for very long intervals without proper breaks.

It is important to remember that “low muscle tone” isn't a diagnosis. Usually, kids are believed to have low muscle tone because they have poor postural stability and poor performance on movement tasks. The presumption is made that these issues result from low muscle tone - but this isn't always the case. Aspergers children might have problems with understanding movement skills and obtaining basic strength needed for action for a combination of reasons: joint hypermobility, a fearful temperament, difficulties with the thinking skills needed for learning, such as predicting what happens next and the ability to learn from watching other people and from their own experience.

Therefore the real question is not what you can do for an Aspergers child with low muscle tone, but instead what you can do to improve overall performance on age-appropriate movement tasks? And that depends on the underlying reasons for the child’s problems, which may or may not have anything to do with low muscle tone.

Children with Aspergers can have a comprehensive assessment by a physiotherapist and/or occupational therapist to determine the nature and degree of the problem. Listed here are a few of the areas where motor clumsiness is evident, and some ways of improve specific skills:

Locomotion-

When the Aspergers child walks or runs, the movements may seem ungainly or "puppet" like, and many kids walk with no associated arm swing. There might be deficiencies in upper and lower limb control. This particular feature can be very noticeable and other kids may mock the Aspergers child, resulting in his/her desire not to take part in running sports and physical education in school.

A physiotherapist or occupational therapist can develop a remedial plan to ensure the child’s movements are coordinated. Therapy might include the use of a large wall mirror, video recording, modeling, and imitating more "fluid" movements using music and dance. An intriguing fact is that the ability to swim seems least affected, and this exercise can be encouraged to allow Aspergers kids to experience genuine proficiency with movement.

Basic skills-

Catching and throwing precision seems to be especially affected in Aspergers children. When catching a ball with two hands, the arm movements of the child are often badly coordinated and affected by problems with timing (i.e., the hands close in the correct position, but a fraction of a second too late). One study noted that Aspergers children would frequently not look in the direction of the target prior to throwing. Clinical observation additionally indicates that Aspergers children have poor coordination in their ability to kick a ball.

One consequence of not being proficient at ball games is the exclusion of the Aspergers child from some of the most well-liked games on the playground (i.e., kick ball). Aspergers children might avoid such games simply because they understand they lack proficiency, or are intentionally excluded since they're a liability to the team. As a result, they're much less able to improve ball skills with practice.

From an early age, mothers and fathers should help their Aspergers child practice ball skills in order to guarantee that he/she has fundamental proficiency to be included in the games. A number of kids might be enrolled in a junior soccer or basketball team to enhance coordination and to learn to play specific games. It's also vital that you have your child’s eyesight examined to determine whether wearing glasses enhances hand-eye coordination.

Balance-

In Aspergers children, there can be an issue with balance, as tested by analyzing the ability to stand on one leg with eyes closed. A number of Aspergers youngsters are not able to balance when placing one foot in front of the other (i.e., tandem walking, which is the task of walking a straight line as though it were a tightrope). This may affect the child's ability to use some adventure playground equipment and activities in the gym. The child may need practice and encouragement with activities that require balancing.

Manual Dexterity-

This area of movement skills involves the ability to use both of your hands (e.g., learning to dress, tie shoelaces, eat with utensils, etc.). This might also extend to the coordination of feet and legs (e.g., learning to ride a bike). If the Aspergers child has problems with manual dexterity, a good technique to help is "hands on hands" training (i.e., a parent or teacher physically patterns the child's hands or limbs through the required movements, gradually fading out physical support).

Handwriting-

A teacher may invest a lot of time interpreting and correcting the Aspergers youngster’s illegible chicken scratches. This child may also be aware of the poor quality of his handwriting and may be hesitant to take part in activities which involve extensive writing. Regrettably, for many kids, high school instructors and potential employers consider the neatness of handwriting a way of measuring intelligence and character. As a result, the individual with Aspergers may get embarrassed or upset at their own inability to write neatly and consistently. The child might need an assessment by an occupational therapist and remedial exercises, but today's technology might help reduce this issue.

Kids with Aspergers are often very competent at using computers and keyboards, and the youngster might prefer typing over writing homework and exams. In this case, the presentation of their work is then similar to the other kids. A parent or guardian or instructor could also act as the youngsters scribe to guarantee the legibility of his/her written answers or homework. The ability to write longhand may become a lot less important in the future (to the great relief of thousands of children with Aspergers).

Rapid movements-

Research conducted recently noted that, while engaged in activities that require motor coordination (e.g., cutting out shapes with a pair of scissors), a significant percentage of kids with Aspergers were known to hurry through the task. They seemed to be impulsive, unable to take a slow and calculated approach. With such haste, errors occur. This is often infuriating for the Aspergers child and the teacher. The child may require guidance and reassurance to work at a suitable pace, having time to correct mistakes. Occasionally the youngster can be asked to slow down by having to count between actions and using a metronome to indicate a suitable pace.

Lax joints/Immature grasp-

One of the features analyzed during a diagnostic evaluation of Aspergers children is the existence of lax joints. We don't know if this is a structural problem or due to low muscle tone, but the autobiography of David Miedzianik (1986) explains how:

At infant school I can seem to remember playing a lot of games and them teaching us to write. They used to tell me off a lot for holding my pen wrong at infant and primary school. I still don't hold my pen very good to this day, so my handwriting has never been good. I think a lot of the reason why I hold my pen badly is that the joints of my finger tips are double jointed and I can bend my fingers right back. (p. 4)

The Aspergers youngster could be referred to an occupational therapist or physiotherapist for evaluation and remedial activities whenever difficulties occur from lax joints or immature grasp. This ought to be a priority with an Aspergers youngster, because a lot of school work demands the use of a pen or pencil.

Exercises for babies and young children with hypotonia to develop fine motor skills—

• Create tape recordings of your child's own sounds, the sounds of your family, and appropriate music. Play these tapes often, and dance your child around rhythmically in your arms during music or sounds. Again, this helps your child to become aware of her own body.

• Draw feet up to the baby's mouth, circling the mouth with each big toe. Repeat with hands and fingertips in order to increase awareness of extremities and oral motor control.

• Expose the baby to as many different pleasant stimuli as you can think of. This includes mobiles, wind chimes, patterned cloth for crib sheets and bumpers, and musical or noise toys in bright, primary colors. Primary colors are bright red, blue and yellow. Babies see high-contrast things the best, and love these colors. An effective tactic that some parents have used is to cut out suitable pictures from magazines and placing on baby's walls, which allows the frequent change-out of pictures needed to give stimulation without breaking the bank.

• Give a newborn a lot of smiles, hugs and cuddles. This both increases emotional bonding and stimulates baby's senses.

• Help the child with hypotonia to do occasional rounds of heel walking, where all of his weight is balanced on his heel and his toes stick in the air.

• Hold bright or desirable small objects out, encourage reaching for it and praise any attempt or success to do so.

• Lightly brush from the heel to the toe on each foot and from the base up to the fingertips on each hand with light massage strokes or a soft, 1 inch paintbrush.

• Make a safe place for your child in every room of your house, and bring baby along as you go about your normal routine. The frequent changes in environment and constant contact with you will help stimulate your child's mind and awareness.

• Place child-safe mirrors on crib walls or down near the floor where your baby can see himself often. This helps increase your child's self-image and self-reflection.

• Place toys or objects at the midline of the body and encourage drawing the limbs in to pick these objects up successfully.

• Play patty cake and patty foot to bring hands and feet into the center of the body.

• Resist any thrust of your baby's legs while you're holding him, and hold him often in a standing position while supporting him well in the torso.

• Rub the hands and feet together, first left hand to left foot, then right hand to right food, then across the body.

• Talk to the baby often. Tell your child what you're doing, especially when bathing, grooming, dressing or changing her. Verbally repeat each step in the process often. Play mimic games with your baby, repeating the sounds he will naturally make. Encourage your baby to make sounds by making faces, singing, and talking nonsense syllables.

• Use a backpack with books or toys in it for weight training.

• Use deep pressure massage on the hands and feet, focusing on the pad of the big toe and each of the fingertips.

• Use small beanbags for weights and movement training.

The Aspergers Comprehensive Handbook