HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

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Comprehensive Assessment for Asperger’s and High-Functioning Autism

Asperger’s and High Functioning Autism (HFA) involve delays and deviant patterns of behavior in multiple areas of functioning that often require the input of specialists with different areas of expertise, particularly overall developmental functioning, neuropsychological features, and behavioral status. Thus, the clinical assessment of children with Asperger’s and HFA is most effectively conducted by an experienced interdisciplinary team.

Let’s look at a few important points that should be made clear before we discuss the various areas of assessment…

First, most children with Asperger’s and HFA have average- to above average- levels of Full Scale IQ. As a result, they are often not thought of as in need for special programming. All too often, people view the “special needs” child as a person who is simply experiencing difficulties in behavior, social interaction, or in peer relationships. This is a true down-play of what is really going on. Asperger’s and HFA is a serious and debilitating developmental disorder impairing the child's capacity for socialization. It is NOT a transient or mild condition. Moms and dads need to be aware of the current lack of knowledge about Asperger’s and HFA, and the common confusions of use and abuse of the disorder currently prevailing in today's society.

Second, given the complexity of the disorder, the importance of developmental history, and the common difficulties in securing adequate services for kids on the autism spectrum, it is very important that moms and dads observe and participate in the assessment.

Third, assessment findings should be translated into a single, coherent view of the child (i.e., easily understood, detailed and concrete – with realistic recommendations). When writing their reports, specialists should strive to express the implications of their findings to the child's day-to-day adaptation, learning, and vocational training.

In the majority of cases, a comprehensive assessment will involve the following components: psychological assessment, neuropsychological assessment, psychiatric examination, history, and communication assessment.

Psychological Assessment—

This component attempts to establish the overall level of intellectual functioning, profiles of strengths and weaknesses, and style of learning. The specific areas to be examined and measured include:
  • academic achievement
  • adaptive functioning (e.g., degree of self-sufficiency in real-life situations)
  • neuropsychological functioning (e.g., problem-solving, concept formation, visual-perceptual skills, motor and psychomotor skills, memory, executive functions)
  • personality assessment (e.g., mood presentation, common preoccupations, compensatory strategies of adaptation)

Neuropsychological Assessment—

The neuropsychological assessment of children with Asperger’s and HFA involves certain procedures of specific interest. Whether or not a Verbal-Performance IQ discrepancy is obtained in intelligence testing, it is advisable to conduct a fairly comprehensive neuropsychological assessment including:
  • concept formation (both verbal and nonverbal)
  • executive functions 
  • facial recognition
  • gestalt perception
  • measures of motor skills (e.g., coordination of the large muscles, manipulative skills, visual-motor coordination, visual-perceptual skills)
  • parts-whole relationships
  • spatial orientation
  • visual memory

A recommended protocol would include the measures used in the assessment of children with Nonverbal Learning Disabilities. Particular attention should be given to demonstrated or potential compensatory strategies (e.g., children with significant visual-spatial deficits may translate the task or mediate their responses by means of verbal strategies or verbal guidance, which may be important for educational programming).

Psychiatric Examination—

The psychiatric examination should include observations of the child during more and less structured periods (e.g., while interacting with the mother or father, while engaged in assessment by other members of the evaluation team). Specific areas for observation and inquiry include:
  • ability to intuit other's feelings
  • ability to infer other's intentions and beliefs
  • capacities for self-awareness
  • development of peer relationships and friendships
  • level of insight into social and behavioral problems
  • patterns of special interest and leisure time
  • perspective-taking
  • quality of attachment to family members
  • social and affective presentation
  • typical reactions in novel situations

Problem behaviors that are likely to interfere with remedial programming should be noted (e.g., marked aggression). The child's ability to understand ambiguous nonliteral communications (e.g., teasing and sarcasm) should be examined, because misunderstandings of such communications may elicit aggressive behaviors. Other areas of observation involve:
  • anxiety
  • coherence of thought
  • depression
  • panic attacks
  • presence of obsessions or compulsions

History—

A careful history should be obtained (e.g., information related to pregnancy and neonatal period, early development and characteristics of development, medical and family history). A review of previous records including previous evaluations should be performed. Also, several other specific areas should be directly examined because of their importance in the diagnosis of Asperger’s and HFA, including:
  • areas of special interest (e.g., favorite occupations, unusual skills, collections)
  • development of friendships
  • development of motor skills
  • emotional development
  • history of onset/recognition of the problems
  • language patterns
  • mood presentation
  • past and present problems in social interaction
  • patterns of attachment of family members
  • self-concept
  • social development

Communication Assessment—


The communication assessment attempts to obtain both quantitative and qualitative information regarding the various aspects of the child's communication skills. It should go beyond the testing of speech and formal language (e.g., vocabulary, articulation, sentence construction, comprehension), which are often areas of strength. The assessment should examine:
  • content, coherence, and contingency of conversation
  • nonliteral language (e.g., humor, metaphor, irony, absurdities)
  • nonverbal forms of communication (e.g., gestures, gaze)
  • pragmatics (e.g., adherence to typical rules of conversation, turn-taking, sensitivity to cues provided by the speaker)
  • prosody of speech (e.g., pitch, melody, volume, stress)

Asperger’s can be diagnosed through several different assessment tools, most of which are targeted toward kids and young adults (e.g., Australian Scale for Asperger's Syndrome, Asperger's Syndrome Diagnostic Scale, Childhood Autism Spectrum Test, Adult Asperger Assessment). Asperger's assessment tests are performed in conjunction with behavioral evaluations and analysis of intake information provided by moms and dads, educators, and the child himself or herself. These assessments help to ensure accuracy in diagnosing Asperger's so that future treatments and accommodations can be implemented.

The Aspergers Comprehensive Handbook
  

COMMENTS:

•    Anonymous said... Getting through a school day without upset at kids teasing......Good day today.
•    Anonymous said... I am new to this site and grateful for it
•    Anonymous said... I ended up going to our Minister of Education to get help for my son as he is well above average in schooling, but because of his behaviour he was close to being suspended and the RBLT said she could not put anything in place as he didn't need it. The Minister got something's put in place, but we ended up changing schools and the RBLT at that school put in a socializing programme for him to teach him how to play with kids, and this was everyday during class time. What a difference it made, he was actually able to be in the playground at breaks.
•    Anonymous said... Just having this epiphany myself this week. I've felt inappropriate thinking of my asperger son as special needs as his physical and intellectual abilities are fine. But when I found myself celebrating with his teacher that my 11 year old was sitting in a chair and doing his schoolwork... I was like yeah, duh, that's kinda special needs.
•    Anonymous said... my 18 year old who has been attending a wonderful exclusionary school for his needs that are increasingly aspergers believes he needs to curse to get past his anger. I don't allow cursing. he wont consider other options also he persevered when he's agitated and that's when I tend to lose my cool. I practice disengagement but fear he feels abandoned and since he's adopted I might be inadvertently hurting him. any thoughts? thank you hope im not out of order here
•    Anonymous said... My son is 3 with aspergers. And too is swearing, we have got most of the bad words out of his temper swearing. Now he only goes too bullshit+t. He says this when angry happy, even today he changed his name to Gordon bullshit+t. For a couple of hours and when I wouldn't say it. He got angry at me for not saying his new name. Its just a dealing mechanism. I also have asperges, and when I am really anxious, or very angry and defensive, I have a truckers mouth as well. Its just all about love and acceptence. He may acknowledge that you don't like it, but it also could be a eternal comfort for his brain too.

Please post your comment below…

4 comments:

Valerie Beachley said...

Thank you for this thorough article. I have my work cut out to fill in the gaps of the assessments that should be done. What I fail to see many times is once the assessments are complete, how to implement the results in a way that really help the child across settings. It would be helpful if you listed the ways of which someone could get these assessments and what professional would be doing the assessment so we could have a term to use for the insurance companies.

lisa embery said...

In the UK they are not testing children for autism properly.ive been pushed away so many times.its been 6 years now with my son and I'm sure he has aspergers.they Don't test anything like what your saying here.dont think there is enough awareness.

lisa embery said...

I don't think that there is enough awareness with the doctors as I've been fighting for 6 years with my son they have done no testing like this with my son

Jackie Van said...

Thank you for this article. I will be emailing it to my son's teacher. He has a great teacher, who "gets" him, and advocates for him. Sadly, it has taken us 3 yrs to get an IEP in place that works for him.

I wish more schools would train lower elementary teachers to spot this, instead of saying "non compliant child".

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. Thus, the best treatment for Aspergers children and teens is, without a doubt, “social skills training.”

Click here to read the full article…

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.

If your child suffers from Asperger’s Syndrome, expect him to experience both minor and major meltdowns over incidents that are part of daily life. He may have a major meltdown over a very small incident, or may experience a minor meltdown over something that is major. There is no way of telling how he is going to react about certain situations. However, there are many ways to help your child learn to control his emotions.

Click here for the full article...

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.

The standard disciplinary techniques that are recommended for “typical” teenagers do not take into account the many issues facing a child with a neurological disorder. Violent rages, self-injury, isolation-seeking tendencies and communication problems that arise due to auditory and sensory issues are just some of the behaviors that parents of teens with Aspergers will have to learn to control.

Parents need to come up with a consistent disciplinary plan ahead of time, and then present a united front and continually review their strategies for potential changes and improvements as the Aspergers teen develops and matures.

Click here to read the full article…

Aspergers Children “Block-Out” Their Emotions

Parenting children with Aspergers 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.

Although they may vary slightly from person to person, children with Aspergers tend to have similar symptoms, the main ones being:

=> A need to know when everything is happening in order not to feel completely overwhelmed
=> A rigid insistence on routine (where any change can cause an emotional and physiological meltdown)
=> Difficulties with social functioning, particularly in the rough and tumble of a school environment
=> Obsessive interests, with a focus on one subject to the exclusion of all others
=> Sensory issues, where they are oversensitive to bright light, loud sounds and unpleasant smells
=> Social isolation and struggles to make friends due to a lack of empathy, and an inability to pick up on or understand social graces and cues (such as stopping talking and allowing others to speak)

Click here to read the full article…

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."

Parents face issues such as college preparation, vocational training, teaching independent living, and providing lifetime financial support for their child, if necessary. Meanwhile, their immature Aspergers teenager is often indifferent – and even hostile – to these concerns.

As you were raising your child, you imagined how he would be when he grew up. Maybe you envisioned him going to college, learning a skilled traded, getting a good job, or beginning his own family. But now that (once clear) vision may be dashed. You may be grieving the loss of the child you wish you had.

If you have an older teenager with Aspergers who has no clue where he is going in life, or if you have an “adult-child” with Aspergers still living at home (in his early 20s or beyond), here are the steps you will need to take in order to foster the development of self-reliance in this child.

Click here to read the full article…

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