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Aspergers: Early Identification and Intervention

Young people with Aspergers are often misdiagnosed and underserved in the U.S. The difficulty in understanding and acknowledging Aspergers by the medical, psychological, and psychiatric community can lead to misdiagnosis and even failure to provide the services needed for these children. Thus, it is critical that parents who suspect their child may have Aspergers or High-Functioning Autism educate themselves about the early signs associated with this disorder and begin the intervention process early.

Moms and dads frequently begin to suspect that there is something wrong before the age of two.  Many kids who are diagnosed at a very young age with Attention Deficit Disorder (ADD) may in fact have Aspergers.

Aspergers is not a disease; rather, it is a developmental neurobiological difference in brain functions and is characterized by the following:
  • stereotyped and restricted patterns of behavior, activities, and interests
  • qualitative impairment in social interaction
  • no significant delay in cognitive development
  • no general delay in language

In addition, intense preoccupation with a narrow subject, one-sided verbosity, restricted prosody, and physical clumsiness are typical of the condition, but are not required for diagnosis. Symptoms of Aspergers are usually recognized during the first three years of childhood; however, it is often not recognized until kids are of school age.

1. Parents may notice a lack of eye contact or social smiles, or they may observe too much eye contact and an appearance of the youngster viewing children as interesting to observe, but not necessarily interact with or seek recognition from. These kids may not have an interest in sharing toys and interests, and tend to be viewed as "lost in their own little world" at times. They may have a greater interest in sensory and physical play with others (e.g., tickling, hugging, piggy back, chasing, video games, fantasy play, repetitive watching of movies, reading books to the exclusion of social interaction, etc.).

2. Aspergers impacts normal development of the brain in the areas of social interaction and communication skills. The disorder makes it hard for children to communicate with others and relate to the social world. In some cases, aggressive and/or self-injurious behavior may be present; however, internal behaviors such as withdrawal, depression, anxiety, eating disorders, and social isolation may be just as prevalent.

Communication may not appear to be delayed, but comprehension and social language requiring give and take may be lacking. Also, an unusual tone or quality, rote or repetitive speech may present. Blurting out, excessively asking the same question over and over, echoing or mimicking, large vocabulary, or difficulty listening to another and understanding another perspective can be apparent. Some children with Aspergers demonstrate extreme abilities in remembering facts, numbers, phone numbers, maps, words, birth dates, or other factual information. They may appear very rigid in their point of view, and unable to accept or understand another's perspective. They may appear to never be able to "let it go," or tend towards appearing argumentative or "splitting hairs." A conversation can lead to tantrums, emotional meltdowns, or withdrawal with seemingly little provocation.

3. Children with Aspergers may exhibit repeated body movements (e.g., hand flapping, rocking), unusual responses to children or attachments to objects and resistance to changes in routines. They may also experience sensitivities in any or all of the five senses.

4. Children with Aspergers tend to rely heavily on rigid internal rules and struggle with the unwritten social rules of social interaction. Failure often accompanies Aspergers kids like a close companion. As a result, they may need much reassurance during stressful periods.

5. Empathy can be defined in numerous ways, and non-verbal communication (e.g., posture, gestures, eye contact, facial expression, tone, etc.), are clues in revealing our emotions, attitude, personality, relationships. This helps guide the interpretation of how another feels leading to an empathetic awareness or understanding of others.  This empathetic understanding can be hindered in a child with Aspergers.

Given that characteristics of Aspergers may include a complete lack of the sense of fear or danger, too little or too much eye contact, which can appear as overly aggressive, threatening, or seductive, combined with a hindrance in the ability to judge another person's feelings or intentions accurately, females with Aspergers may be at increased threat for assault, abuse, violence, or worse. Many girls on the spectrum provide stories of being singled-out or picked on mercilessly due to their odd behaviors or just not fitting in and are literally disabled when it came to surviving the more sophisticated social complexity of adolescent society.

6. Kids with Aspergers have difficulty understanding subtle cues. Misunderstandings, literal interpretation, and/or sensory over stimulation can lead to overreactions, irritability, low frustration tolerance, tantrums, aggressiveness, appearing to have an explosive temperament, self stimulation, anxiety, depression, or self injury. Kids with Aspergers develop a tendency of distrust towards others due to social failures and negative social experiences over time, which can lead to self-isolation and social phobia. This behavioral reaction can be viewed as "rude" by others, and often children on the spectrum struggle to understand why they are not liked or frequently feel rejected.

7. Kids with Aspergers may become extremely upset if their routine or ritual is changed in any way, and can become agitated if someone touches their things, moves furniture or toys around, or even takes a different driving route to or from school. They may be very rigid and insist on doing things the same way every time, or demonstrate an extreme aversion or experience tantrums during transitions. Stereotypical movements (e.g., spinning, flapping, lining things up, toe walking, body rocking, grimaces, twirling, pacing, racing around, noisemaking, leg bouncing, clearing of the throat, chair rocking) may be more significant or frequent during periods of change or transitions.  An extreme perfectionism or "having to finish" what they have started to the point of meltdowns may be evident especially during unexpected or unwanted transitions.

8. Kids with Aspergers may display a very narrow or an unusual range of interests, with elaborate or unusual play-based behaviors. They may act-out elaborate rituals, which appear to be creative play, but are actually scripted activities without the variation or creativity of imaginary play. They may demonstrate fixations on things (e.g., Pokémon, television shows, computer games, numbers, trains, cars, etc.), and tend toward lining things up, organizing by color, or even repeating lines verbatim.

9. Kids with Aspergers may exhibit and excessive desire or intense aversion to sensory input. They may appear hyperactive, and pursue movement to an excessive degree, or they can appear unresponsive or ‘flat’ if overwhelmed hypersensitive to sensory input and movement.  Some may have an unusual or extreme response to sounds and cover their ears in response to vacuum cleaners, hair dryers, crying babies, sirens or other loud or unexpected noise. Some may be extremely affected by smells, tastes, textures, heat, or commotions. They may have problems falling asleep, or staying asleep. Kids who are overly reactive to crowds and commotion may appear uncomfortable or avoidant of cafeterias, malls, gymnasiums, parties, family gatherings, or even theaters. In reaction, they may feel hot, get a stomach or headache or tantrum, or resist going to such places. 

10. Kids with Aspergers may interact very well with grown-ups, but struggle with appropriately initiating peer interaction or maintaining interest.  Sometimes, kids with Aspergers do not notice if a playmate loses interest, or even wanders away. The unwritten social rules seem to be confusing, and interpreting social comments, facial expressions, tone of voice, or body language can be similar to trying to interpret a foreign language. A general lack of fear may be evident, and kids with Aspergers may talk openly with strangers, hug strangers, invade other's personal space, bump into peers in lines, touch or climb on others inappropriately, or have excessive or a complete lack of separation anxiety from moms and dads.

11. Motor clumsiness or fine motor difficulties may be present, and intuitive physics may be higher than intuitive psycho-social abilities. An Aspergers youngster may be able to dismantle and recreate elaborate Lego designs, set a clock, reprogram a VCR, match shapes, or display, artistic or musical talents.

12. Social isolation, a limitation in reciprocation or give and take interactions, tending to be self-absorbed or aloof, a lack of social discrimination, and/or difficulties with social skills are also common in Aspergers children and teens. Social isolation may look like the youngster is withdrawn, avoiding contact or interaction with children, family, or peers, and a preference towards playing alone or with "things" rather than playmates. Kids with Aspergers may appear to play next to – but not with – others, and establishing friendships with “give and take” interactions may be lacking.

For a professional to meet only briefly in a single setting is not enough to paint a complete portrait of an Aspergers child's needs and abilities.  Often, a child with Aspergers can appear to have the behaviors of a mentally handicapped, behaviorally disordered, or hearing impaired person. The behaviors noted are sometimes dismissed as immaturity, odd, or shy.

Early identification and intervention are considered key to positive outcomes for kids on the spectrum. In order to reach all Aspergers children, school psychologists, mental health professionals, physicians, and moms and dads should work together to become better informed regarding research, assessment tools, and diagnostic criteria, as well as the best proactive interventions to increase social skills, personal communication, behavior, and peer interaction for Aspergers children. 


17 comments:

Anonymous said...

My snow as finally diagnosed at 8. Honestly, he was very talkative and seemed fine in his earlier years. He had some sensory issues and hated to be left with a babysitter, had some issues with attractions at Disneyland and sound issues with fireworks, but I really didn't think much about it. At five the school diagnosed him with autism but I just didn't see it and thought they were wrong. Now at 8, he has been diagnosed and his symptoms are much worse. He throws tantrums when he doesn't get his way, has a lot of sensory issues, and few friends. Hoping for a lot of intervention from school this year.

Tara said...

This article describes my son perfectly! We live in the UK and his first 2 yrs in school were awful. Despite teachers reassuring us there was nothing wrong and he was just poorly disciplined (!) we pursued assessments within the NHS. Two yrs later, at age 7 he was diagnosed with ADHD. It didn't fit. but at least as parents we could stop beating ourselves up. We changed schools having discovered that he had been bullied beyond belief by a teacher. With the support of his new school he has absolutely blossomed and was diagnosed with aspergers at age 9. We have been told its through our determination that he has been diagnosed so early. In my opinion, if he was diagnosed when things were clearly going wrong at age 5-6 it would have spared a little boy having his confidence shattered at such a young age.

Anonymous said...

What are Your thoughts on ABA therapy for kids with Aspergers.
My son is 14 and the school refuses to say my son has Aspergers
but have gotten a diagnosis from a psychiatrist. I am concerned going
into highschool they are putting my son in behavior intervention program
that seems to be a discpline program and self contained when he is shutting down
and experiencing extreme depression and anxiety, I do not know much about
ABA and am wondering what you think of this therapy.

Anonymous said...

My son was diagnosed with Aspergers when he was five he is now 6. As he was growing up since birth when he had check ups the Dr. would ask if he was ever diagnosed with Autism, which the answer was always no til earlier this year. My problem is family telling me he dont have Aspergers, and dont let anyone label him. How do I nicely tell them to stay out of it if they are not going to be supportive. I even have an in-law who says he dont have anything he just wants attention ( shes not even around my kids). Im just tired of everyone's opinion esp. since they aint a dr.

Anonymous said...

Even when young people are diagnosed they are often underserved as the services they need are either unavailable or cost prohibitive to most families. This is the sad reality,even when parents educated themselves

Anonymous said...

I have the same problems. Everyone says there is nothing wrong with my son he was either misdiagnosed or he's just being a boy. I listen politely, nod my head where appropriate and move along. We have very little to do with any family members because they all think I should just discipline him more. I feel very isolated and alone a lot. I get most of my "support" from groups/pages like this.

Anonymous said...

we haven't got a diagnosis yet, hopefully in a few weeks....although the school told me that it won't matter to them, it would only give us peace of mind.......our daugter is 10 and gets 45 min a month in social skills from the school. We take her elsewhere for more social skills an hour a week...out of our pocket

Anonymous said...

Thank You for your page it helps me so much. All thr schools my son has been in put him in special math and reading reduce his homework but they would not test him. Today I found out that he has Persvasive Developmeny

Anonymous said...

Developmental Disorder. To my understanding it is between Aspergers and Autism. We still have to do more testing. Your page has helped alot thank you.

Anonymous said...

For two years school told me my son was autistic and I simply didn't see it because he was so talkative...at least that is what I thought (I didn't realize he had some issues at school). I knew that he had some sensory issues..getting onto airplanes was awful for a while, going to see doctors is still tough, he has trouble with not getting his way, he covers his ears during fireworks, etc. I really didn't think of the whole Asperger's thing until I started doing research. He is very aspergers and we are finally getting some help through school and outside sources. We are also learning how to deal with his various issues and how to help him. He will be in third grade this year. Your page has been very helpful.

Anonymous said...

I am a grandmother to a 12-year-old Aspie. My recommendation is that you don't depend on a school system to acknowledge your child's special needs. They are required by law to provide accommodation to your child and it can be costly. See a doctor - see several doctors. Learn the IEP process and your power to get services. My daughter and I went through a long process with our 12 year old starting before he was 2, ruling out physical causes, reluctance of doctors to say the word "autism",obtaining an ADHD diagnosis, obsessive/compulsive, and others before we ever heard the word Aspergers. Our family, too, refused to support us, especially when we finally started getting him medication. Sometimes Aspies can be very manipulative which causes some family members to think they are just behaving badly. We only just now started getting some acknowledgement from the family that we did the right thing. Hang in there, join support groups, get help for your child.

Manic Mom said...

This is a great break down and screams my little guy. Once again you give us such useful info, Thank you!!! I just meet a real nice lady that would benefit from this list so I will be passing this on to her. Thanks!!!!!
Check out my little guys journey. www.kadensaspergerworld.blogspot.com

Anonymous said...

I think other web site proprietors should take this site as an model, very clean and great user friendly style and design, as well as the content. You're an expert at this stuff!

aspergers  said...

I really appreciate your work.How clearly you have defined the aspergers sydrome.

'Enjoying The Hi-5s of Autism - A Family Experience' said...

always relevant, reliable and relatable info.

Neurotic Iraqi Mom said...

I had a similar problem when I was living abroad, in the Emirates to be precise. They didn't diagnose My son with the most apparent genetic disorder, NF1. He had all the classic cafe au lait spots. But no they had no idea. No idea about his seizures and ofcourse no clue about autism.

Your list is fantastic I have to say!

Anonymous said...

You describe my son so very well. It's amazing how much was present from an early age, yet we didn't get a diagnosis until the end of first grade.

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

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

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How to Prevent Meltdowns in Aspergers Children

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

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Parenting Defiant Aspergers Teens

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

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Aspergers Children “Block-Out” Their Emotions

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

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

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

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Living with an Aspergers Spouse/Partner

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

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Online Parent Coaching for Parents of Asperger's Children

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

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

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

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Parenting Children and Teens with High-Functioning Autism

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

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