Most Aspergers (high functioning autistic) children and teens have at least one comorbid (i.e., co-existing) condition in addition to their autism diagnosis as listed below:
1. Co-occurring mental disorders— Kids with Aspergers can develop mental disorders (e.g., anxiety disorders, attention deficit hyperactivity disorder (ADHD), depression, etc.). Research shows that children and teens with Aspergers are at higher risk for some mental disorders than those without Aspergers. Managing these co-occurring conditions with medications or behavioral therapy, which teaches kids how to control their behavior, can reduce symptoms that appear to worsen a youngster's Aspergers symptoms. Controlling these conditions will allow kids with Aspergers to focus more on managing their disorder.
2. Fragile X syndrome— Fragile X syndrome is a genetic disorder and is the most common form of inherited intellectual disability, causing symptoms similar to Aspergers. The name refers to one part of the X chromosome that has a defective piece that appears pinched and fragile when viewed with a microscope. Fragile X syndrome results from a change, called a mutation, on a single gene. This mutation, in effect, turns off the gene. Some children may have only a small mutation and not show any symptoms, while others have a larger mutation and more severe symptoms. Around 1 in 3 kids who have Fragile X syndrome also meet the diagnostic criteria for Aspergers, and about 1 in 25 kids diagnosed with Aspergers have the mutation that causes Fragile X syndrome. Because this disorder is inherited, kids with Aspergers should be checked for Fragile X, especially if the moms and dads want to have more kids. Other family members who are planning to have kids may also want to be checked for Fragile X syndrome.
3. Gastrointestinal problems— Some moms and dads of Aspergers kids report that their youngster has frequent gastrointestinal (GI) or digestion problems (e.g., stomach pain, diarrhea, constipation, acid reflux, vomiting, bloating, etc.). Food allergies may also cause problems for kids with Aspergers. It's unclear whether these kids are more likely to have GI problems than neurotypical kids. If your youngster has GI problems, a doctor who specializes in GI problems, called a gastroenterologist, can help find the cause and suggest appropriate treatment. Some studies have reported that kids with Aspergers seem to have more GI symptoms, but these findings may not apply to all Aspergers kids. For example, a recent study found that kids with Aspergers in Minnesota were more likely to have physical and behavioral difficulties related to diet (e.g., lactose intolerance or insisting on certain foods), as well as constipation, than kids without Aspergers. The researchers suggested that kids with Aspergers may not have underlying GI problems, but that their behavior may create GI symptoms (e.g., a youngster who insists on eating only certain foods may not get enough fiber or fluids in his or her diet, which leads to constipation). Some moms and dads may try to put their youngster on a special diet to try to control Aspergers or GI symptoms. While some kids may benefit from limiting certain foods, there is no strong evidence that these special diets reduce Aspergers symptoms. If you want to try a special diet, first talk with a doctor or a nutrition expert to make sure your youngster's nutritional needs are being met.
4. Intellectual disability— Many kids with Aspergers have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak. For example, a youngster with Aspergers may do well on tasks related to sight (e.g., putting a puzzle together) but may not do as well on language-based problem-solving tasks. Kids with Aspergers often have average or above-average language skills and do not show delays in cognitive ability or speech.
5. Seizures— One in four kids with Aspergers has seizures, often starting either in early childhood or during the teen years. Seizures, caused by abnormal electrical activity in the brain, can result in: (a) staring spells, (b) convulsions (i.e., uncontrollable shaking of the whole body) or unusual movements, and (c) a short-term loss of consciousness or a blackout. Sometimes lack of sleep or a high fever can trigger a seizure. An electroencephalogram (EEG), a nonsurgical test that records electrical activity in the brain, can help confirm whether a youngster is having seizures. However, some kids with Aspergers have abnormal EEGs even if they are not having seizures. Seizures can be treated with medicines called anticonvulsants. Some seizure medicines affect behavior; changes in behavior should be closely watched in kids with Aspergers. In most cases, a doctor will use the lowest dose of medicine that works for the youngster. Anticonvulsants usually reduce the number of seizures but may not prevent all of them.
6. Sensory problems— Many kids with an autism spectrum disorder either over-react or under-react to certain sights, sounds, smells, textures, and tastes. For example, some may: (a) have no reaction to intense cold or pain, (b) experience pain from certain sounds – and sometimes cover their ears and scream (e.g., vacuum cleaner, a ringing telephone, a sudden storm, etc.), and (c) dislike or show discomfort from a light touch or the feel of clothes on their skin. Researchers are trying to determine if these unusual reactions are related to differences in integrating multiple types of information from the senses.
7. Sleep problems— Kids with Aspergers tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behavior. In addition, moms and dads of Aspergers kids with sleep problems tend to report greater family stress and poorer overall health among themselves. Fortunately, sleep problems can often be treated with changes in behavior (e.g., following a sleep schedule, creating a bedtime routine, etc.). Some kids may sleep better using medications such as melatonin, which is a hormone that helps regulate the body's sleep-wake cycle. Like any medication, melatonin can have unwanted side effects. Talk to your youngster's doctor about possible risks and benefits before giving your youngster melatonin. Treating sleep problems in kids with Aspergers may improve the youngster's overall behavior and functioning, as well as relieve family stress.
8. Tuberous sclerosis— Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumors to grow in the brain and other vital organs. Tuberous sclerosis occurs in 1 to 4 percent of children with Aspergers. A genetic mutation causes the disorder, which has also been linked to mental retardation, epilepsy, and many other physical and mental health problems. There is no cure for tuberous sclerosis, but many symptoms can be treated.