Anxiety-Free Haircuts for Aspergers and HFA Kids

With Aspergers and High Functioning Autism (HFA), the brain seems unable to balance the senses appropriately. It's common for these youngsters to have sensory problems. They may be hypo-active (low sensitivity) or hyper-reactive (high sensitivity) or lack the ability to combine the senses.

Aspergers and HFA kids often have a "fight or flight" response to sensation. This condition is called "sensory defensiveness" and may be diagnosed as a "sensory processing disorder." These children can be sensitive to many things (e.g., the noise hair clippers make, the sensation of cutting hair, feeling loose hairs on their body, seeing hair fall on their clothing or the floor, etc.). When their perceptions are accurate, they can learn from what they see, feel, or hear. On the other hand, if sensory information is faulty, their experiences of the world can be confusing. Many young people with Aspergers and HFA are highly attuned - or even painfully sensitive - to certain sounds, textures, tastes, and smells.

Here are some proven strategies that will facilitate your Aspergers or HFA child getting an anxiety-free haircut:

1. Allow your youngster to give an old doll or teddy bear a haircut while his own hair is being cut. This may help your youngster learn to generalize the experience. You or the barber can also use the doll or teddy bear to demonstrate what it is you need or expect your youngster to do. For example, act out directions to "turn your head to the right" or "hold your head down." These are strong visual cues and may be better understood.

2. At home, find opportunities to teach daily living skills, particularly hygiene and grooming. For example, your youngster may learn how to:
  • choose an appropriate outfit to wear
  • clean the shower/tub
  • determine how long to stay in the shower or tub
  • put his dirty clothes away
  • run his own bath water at the right temperature
  • shower or take a bath independently
  • undress/dress
  • use deodorant
  • wash his body properly

3. Before you begin, it is better to wash the hair to remove any hair products build-up. Cutting clean, dry hair with clippers is much faster and easier. Use unscented shampoo and conditioner if your youngster is sensitive to smells or odors. (Warning: Some kids on the autism spectrum do not like having their hair washed.)

4. Be sure your youngster has a cape, sheet or towel draped over him.

5. Buy a good quality home hair-cutting kit. Look for clippers with blade guards to avoid cutting the hair too short.

6. Develop a routine for haircuts. Does your youngster need a haircut or trim every week, every other week or once a month? Try to schedule them for the same day of the week and time of day whenever possible (e.g., every other Saturday morning). Be consistent.

7. Edge the front, sides and nape of the neck first for a shape-up then cut the hair. Should your youngster not tolerate a haircut before you or the barber is done, a shape-up will give him a clean, fresh haircut look, even if the hair has not been entirely cut.

8. Explain to your youngster exactly what you are planning to do during the haircut. Use short sentences or visual supports using personal photos or picture icons. Take pictures while your youngster is getting a haircut. Take a picture of all the items used.

9. Focus on the task at hand. Try to cut the hair as fast as you can without rushing. Try not to stop cutting hair to talk to others, in person or on the phone.

10. For a youngster that is sensitive to the buzz sounds of the clippers or the snap of a scissor, try using soft, flexible ear plugs. Does your youngster like to sing? Sing a song. Play some of their favorite music.

11. Observe your youngster while cutting his hair. Is there anything he particularly dislikes or finds intolerable? If so, try to eliminate it or make it better.

12. Once the haircut is done, admire your youngster's clean-cut appearance (e.g., "You look handsome!"). Show him how he looks in the mirror, if tolerated. Take before and after photos so he can see the benefits of getting a haircut. Use this opportunity to begin to teach him how to comb and brush his own hair.

13. Help your youngster learn how to help put items away, clean and oil the clippers, sweep or vacuum cut hair off the floor, put dirty clothes and towels in the hamper or washing machine, etc. He can also learn how to sort laundry, load and wash his clothes, put clothes in the dryer, fold clothes, and iron.

14. Reassure your youngster during the haircut. Explain each step of the way in a slow and steady voice. Praise him (e.g., "Good job keeping your head still"). Let your youngster know that there is an end in sight. This step may be faded out gradually as your youngster becomes more familiar with the process.

15. Remember to give your youngster a reward or bonus that he will enjoy. Give your youngster a choice for his bonus. A reward or bonus will show him that although we must do unpleasant things sometimes, we also get to do things that we enjoy.

16. Schedule a haircut when your youngster is least likely to be sensory overloaded or feeling overwhelmed by the information he is taking in through the five senses: hearing, vision, touch, smell and taste. Try to avoid scheduling haircuts after school or when your youngster is ill or tired.

17. Take each haircut session one at a time. Observe your youngster, take notes if necessary. You will learn more about him each time.

18. Think of a few activities, toys or food your youngster really enjoys to use as his special reward or bonus. What does he like to do? What makes him happy?

19. Under supervision allow your youngster to handle the clippers and other items used for the haircut. At home, allow him to help you prepare for it (e.g., he can get a towel and the comb or brush). Teach him how to clean the clippers (e.g., brush off any loose hairs from the blade and oil the clippers). This can be a good motivator – and it's fun learning in the natural environment.

20. Unless your youngster is better able to tolerate a haircut, keep their hairstyles simple (e.g., "fades" and elaborate parts and designs in the hair will take longer to cut).  

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism


Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.



Aspergers 101: The Basics

Essential Aspergers Information That All Parents And Teachers Need To Know:


Aspergers/HFA Children and Dental Appointments: 40 Tips for Parents

Taking your Aspergers (high functioning autistic) son or daughter to the dentist can be a difficult experience for both child and parent. Here are some helpful tips to effectively deal with dentist appointments:

1. Ask the dentist to lean the chair back before your child gets in it, because sometimes Aspergers and HFA children don’t like the feeling of being moved backwards.

2. Bring along a sibling or friend and let your child watch as the doctor or hygienist performs the task on them first.

3. Collaboration and teamwork are essential for a successful trip to the dentist.

4. Consider some physical exercise (e.g., riding a bike) to be done before and after the visit for calming.

5. Create and read a social story about going to the dentist with your child. The social story should take the uncertainty out of what will happen at the dentist office.

6. Deep pressure can be used before and during the visit for calming.

7. Dentists should review your youngster’s medications and supplements.

8. Discover what could potentially be difficult at future visits.

9. Find some good books about practicing good oral hygiene and going to the dentist that you can read with your child.

10. For those children who grind their teeth or engage in self-injurious behaviors (e.g., picking at the gums, biting the lip), a mouth guard may be recommended.

11. Having a dental professional who can communicate with your child effectively will be very important.

12. If the noises of the office are upsetting, request to be moved to a more quiet or private area. If not available, the use of headphones or an iPod are good ways to limit noise.

13. If you have any dietary or chemical restrictions that you are following for your youngster, be sure to make your dentist aware of these before the appointment begins.

14. If your child has seizures, you will need to discuss this with your dentist. The mouth is always at risk during a seizure, because kids may chip teeth or bite their tongue or cheeks.

15. Ignoring inappropriate behaviors is something you’ll want to inform the staff about.

16. Include an incentive/motivator for when the appointment is over (e.g., stop for a treat afterward).

17. Instruct the staff that your youngster responds best to immediate praise for good behavior (e.g., “Great job keeping your mouth open” … “I like how you are holding still” … “You did great while I cleaned your back teeth”).

18. Instruct the staff to prompt the child with time durations as they work (e.g., “This will be all done when we finish counting to 10” … “I need to touch 20 teeth, so help me count them all” … “That gritty paste will only be there for 1 minute and then you can rinse and spit”).

19. Is your child familiar with daily tooth brushing? If not, consider working with an occupational therapist to teach him good oral hygiene habits.

20. Know that lighting in a dental office is often too strong for a child on the autism spectrum. Let him wear sunglasses and request that the staff try to keep the light out of his eyes as much as possible.

21. Let your child get familiar with the dentist office environment before the actual dental work is performed (e.g., let the child try out the chair, let the hygienist look in his mouth or count his teeth, let him listen to the sound the drill makes, etc.).

22. Let your child squeeze a therapy ball in his hands while he is in the chair (if he finds it comforting).

23. Let your child touch and examine the dentist’s tools before the dentist starts working, if possible.

24. Letting your child know ahead of time how long something is going to last can be very helpful.

25. Maintaining a calm voice may help to minimize behavior problems.

26. Make a fun game out of counting your child’s teeth before the dentist appointment.

27. Schedule a few short “trial visits” to start off with. Keep these visits very positive and short.

28. Sedation is sometimes a good idea (e.g., if the youngster has high levels of anxiety or discomfort, for uncontrolled movements like gagging, when extensive dental treatment is going to take place).

29. Share your child’s coping strategies with the dental staff before the visit.

30. Show the tool or action they are going to use before the procedure.

31. Slowly desensitize your child to the experience by talking about your personal experience with the dentist.

32. Tell your child what they are going to do before you ever get to the dentist.

33. There are many potential sensory challenges at a dentist’s office (e.g., tastes, smells, textures, sounds, lights, etc.). Knowing what areas your child tends to be sensitive will help you know what coping strategies to try.

34. To ensure that tastes are familiar and favorable, bring your child’s own toothpaste and toothbrush to the visit.

35. Try using a bean bag chair in the dentist’s chair during the exam to provide some snug comfort.

36. Use of visual routines and a timer are helpful for good daily brushing habits.

37. Use the child’s toothbrush or a plastic tooth mirror and get him comfortable with letting you put it in his mouth.

38. Vibration toys that are safe for oral use, or even electric toothbrushes, are good for getting your youngster accustomed to the strange sensations in his mouth.

39. Ask if the dentist has experience with Aspergers and HFA kids and if he/she has special procedures in order to optimize each visit. Ask about those procedures. Some procedures you might ask about are:
  • having a short wait time
  • having an appointment at a time of day when your child is at his best
  • having the same staff at each visit for consistency
  • sitting with your child in the room while doing the exam

40. Consult your child’s Occupational Therapist for additional suggestions.  

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism


Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.



Effective Teaching Strategies for Aspergers and HFA Students (Summary of PowerPoint Presentation)

The following summary identifies the specific learning difficulties of Aspergers and high functioning autistic students and suggests a number of possible classroom strategies:

Difficulties with language—
  • “Comic Strip Conversations” can be applied to a range of problems with conversation skills
  • difficulty understanding complex language, following directions, and understanding intent of words with multiple meanings
  • encourage the student to ask for an instruction to be repeated, simplified or written down if he does not understand
  • explain metaphors and words with double meanings
  • limit oral questions to a number the student can manage
  • pause between instructions and check for understanding
  • small group instruction for conversational skills
  • teach appropriate opening comments
  • teach rules and cues regarding turn-taking in conversation and when to reply, interrupt or change the topic
  • teach student to seek assistance when confused
  • tendency to interrupt
  • tendency to make irrelevant comments
  • tendency to talk on one topic and to talk over the speech of others
  • use audio taped and videotaped conversations
  • watch videos to identify nonverbal expressions and their meanings

Insistence on sameness—
  • use pictures, schedules and social stories to indicate impending changes
  • wherever possible prepare the student for potential change

Impairment in social interaction—
  • difficulty reading the emotions of others
  • difficulty understanding "unwritten rules" and when they do learn them, may apply them rigidly
  • difficulty understanding the rules of social interaction
  • educate peers about how to respond to the student’s disability in social interaction
  • encourage cooperative games
  • explicitly teach rules of social conduct
  • interprets literally what is said
  • lacks tact
  • may be na├»ve
  • may need to develop relaxation techniques and have a quiet place to go to relax
  • may need to provide supervision and support for the student at breaks and recess
  • problems with social distance
  • provide clear expectations and rules for behavior
  • structured social skills groups can provide opportunity for direct instruction on specific skills and to practice actual events
  • teach flexibility, cooperation and sharing
  • teach the student how to interact through social stories, modeling and role-playing
  • teach the student how to start, maintain and end play
  • teach the students how to monitor their own behavior
  • use a buddy system to assist the student during non-structured times
  • use other children as cues to indicate what to do

Restricted range of interests—
  • incorporate and expand on interest in activities and assignments
  • limit perseverative discussions and questions
  • set firm expectations for the classroom, but also provide opportunities for the student to pursue his own interests

Poor concentration—
  • break down assignments
  • difficulty sustaining attention
  • distractible
  • frequent teacher feedback and redirection
  • may be disorganized
  • often off task
  • reduced homework assignments
  • seating at the front
  • timed work sessions
  • use nonverbal cues to get attention

Poor organizational skills—
  • help the student to use "to do" lists and checklists
  • maintain lists of assignments
  • picture cues in lockers
  • pictures on containers and locker
  • use schedules and calendars

Poor motor coordination—
  • consider the use of a computer for written assignments, as some students may be more skilled at using a keyboard than writing
  • involve in fitness activities
  • may prefer fitness activities to competitive sports
  • provide extra time for tests
  • take slower writing speed into account when giving assignments (length often needs to be reduced)

Academic difficulties—
  • areas of difficulty include poor problem solving, comprehension problems and difficulty with abstract concepts
  • avoid verbal overload
  • be as concrete as possible in presenting new concepts and abstract material
  • break down tasks into smaller steps or present it another way
  • capitalize on strengths, e.g., memory
  • check for comprehension, supplement instruction and use visual supports
  • do not assume that they have understood what they have read
  • don’t assume that the student has understood simply because he/she can re-state the information
  • good recall of factual information
  • may do well at mathematical computations, but have difficulty with problem solving
  • often strong in word recognition and may learn to read very early, but difficulty with comprehension
  • provide direct instruction as well as modeling
  • show examples of what is required
  • use activity-based learning where possible
  • use graphic organizers such as semantic maps
  • use outlines to help student take notes and organize and categorize information
  • usually average to above average intelligence

Emotional vulnerability—
  • easily stressed due to inflexibility
  • educate other students
  • help the student to understand his/her behaviors and reactions of others
  • may be prone to depression
  • may have difficulties coping with the social and emotional demands of school
  • may have difficulty tolerating making mistakes
  • may have rage reactions and temper outbursts
  • often have low self-esteem
  • provide experiences in which the person can make choices
  • provide positive praise and tell the student what she/he does right or well
  • teach techniques for coping with difficult situations and for dealing with stress
  • teach the student to ask for help
  • use peer supports such as buddy systems and peer support network
  • use rehearsal strategies

Sensory Sensitivities—
  • be aware that normal levels of auditory and visual input can be perceived by the student as too much or too little
  • confusing, complex or multiple sounds such as in shopping centers
  • having the student listen to music can camouflage certain sounds
  • high-pitched continuous noise
  • it may be necessary to avoid some sounds
  • keep the level of stimulation within the student’s ability to cope
  • minimize background noise
  • most common sensitivities involve sound and touch, but may also include taste, light intensity, colors and aromas
  • sudden, unexpected noises such as a telephone ringing, fire alarm
  • teach and model relaxation strategies and diversions to reduce anxiety
  • types of noises that may be perceived as extremely intense are:
  • use of ear plugs if very extreme

***Additional Guidelines***

General Behaviors—
  • At times, the student may experience "meltdowns" when nothing may help behavior. At times like this, please allow a "safe and quiet spot" where the student will be allowed to "cool off." Try to take note of what occurred before the meltdown (was it an unexpected change in routine, for example) and it's best to talk "after" the situation has calmed down.
  • Foster a classroom atmosphere that supports the acceptance of differences and diversity.
  • Generally speaking, a grown-up speaking in a calm voice will reap many benefits.
  • It is important to remember that just because the student learns something in one situation, this doesn't automatically mean that they remember or are able to generalize the learning to new situations.
  • Note strengths often and visually. This will give the student the courage to keep on plugging.
  • The student may have vocal outbursts or shriek. Be prepared for them, especially when having a difficult time. Also, please let the other students know that this is a way of dealing with stress or fear.
  • The student may need help with problem-solving situations. Please be willing to take the time to help with this.
  • The student reacts well to positive and patient styles of teaching.
  • This syndrome is characterized by a sort of "Swiss cheese" type of development (i.e., some things are learned age-appropriately, while other things may lag behind or be absent).
  • Students may have skills years ahead of normal development (e.g., a student may understand complex mathematics principles, yet not be able to remember to bring their homework home).
  • When dividing up assignments, please ASSIGN teams rather than have the other students "choose members", because this increases the chances that the student will be left out or teased.
  • When it reaches a point that things in the classroom are going well, it means that we've gotten it RIGHT. It doesn't mean that the student is "cured", "never had a problem" or that "it's time to remove support". Increase demands gradually.
  • When you see anger or other outbursts, the student is not being deliberately difficult. Instead, this is in a "fight/fright/flight" reaction. Think of this as an "electrical circuit overload." Prevention can sometimes head off situations if you see the warning signs coming.

  • Allowing the student to write down the question or thought and providing a response in writing may break the stresses/cycle.
  • It is more helpful if you avoid being “pulled in” by answering the same thing over and over or raising your voice or pointing out that the question is being repeated. Instead, try to redirect the student's attention or find an alternative way so he/she can save face.
  • The student may repeat the same thing over and over again, and you may find that this increases as stress increases.

  • Giving one or two warnings before a change of activity or schedule may be helpful.
  • The student may have a great deal of difficulty with transitions. Having a picture or word schedule may be helpful.
  •  Please try to give as much advance notice as possible if there is going to be a change or disruption in the schedule.

Sensory Motor Skills/Auditory Processing—
  • Breaking directions down into simple steps is quite helpful.
  • Directions are more easily understood if they are repeated clearly, simply and in a variety of ways.
  • The student has difficulty understanding a string of directions or too many words at one time.
  • The student may act in a very clumsy way; she may also react very strongly to certain tastes, textures, smells and sounds.
  • Speaking slower and in smaller phrases can help.
  • Using picture cures or directions may also help.

  • Allow the student to "move about" as sitting still for long periods of time can be very difficult (even a 5 minute walk around, with a friend or aide can help a lot).
  • He may get over-stimulated by loud noises, lights, strong tastes or textures, because of the heightened sensitivity to these things.
  • Unstructured times (e.g., lunch, break, PE) may prove to be the most difficult for him. Please try to help provide some guidance and extra adults help during these more difficult times.
  • With lots of other kids, chaos and noise, please try to help him find a quiet spot to which he can go for some "solace".

Visual Cues—
  • Hand signals may be helpful, especially to reinforce certain messages, such as "wait your turn", "stop talking" (out of turn), or "speak more slowly or softly".
  • Some Aspergers and HFA students learn best with visual aids, such as picture schedules, written directions or drawings (other students may do better with verbal instruction).

  • At times, it may take more than few seconds for my student to respond to questions. He needs to stop what he's thinking, put that somewhere, formulate an answer and then respond. Please wait patiently for the answer and encourage others to do the same. Otherwise, he will have to start over again.
  • When someone tries to help by finishing his sentences or interrupting, he often has to go back and start over to get the train of thought back.

Eye Contact—
  • At times, it looks as if the student is not listening to you when he really is. Don't assume that because he is not looking at you that he is not hearing you.
  • She may actually hear and understand you better if not forced to look directly at your eyes.
  • Unlike most of us, sometimes forcing eye contact BREAKS her concentration.

Social Skills and Friendships—
  • Identifying 1 or 2 empathetic students who can serve as "buddies" will help the student feel as though the world is a friendlier place.
  • Students with Aspergers and HFA may be at greater risk for becoming "victims" of bullying behavior by other students. This is caused by a couple of factors: (1) there is a great likelihood that the response or "rise" that the "bully" gets from the Aspergers or HFA student reinforces this kind of behavior; (2) Asperger kids want to be included and/or liked so badly that they are reluctant to "tell" on the bully, fearing rejection from the perpetrator or other students.
  • Talking with the other members of the class may help, if done in a positive way and with the permission of the family. For example, talking about the fact that many or most of us have challenges and that the Aspergers or HFA student's challenge is that he cannot read social situations well, just as others may need glasses or hearing aids.
  • They may want to make friends very badly, yet not have a clue as to how to go about it.

  • Let him know, if possible, when there will be a substitute teacher or a field trip occurring during regular school hours.
  • Please let the student know of any anticipated changes as soon as you know them, especially with picture or word schedules.
  • This is very important to most students o the autism spectrum, but can be very difficult to attain on a regular basis in our world.

  • Sarcasm and some forums of humor are often not understood by my student. Even explanations of what is meant may not clarify, because the perspectives of an Aspergers or HFA student can be unique and, at times, immovable.
  • Although his vocabulary and use of language may seem high, students on the autism spectrum may not know the meaning of what they are saying even though the words sound correct.

Organizational Skills—
  • If necessary allow her to copy the notes of other students or provide her with a copy.
  • It may be helpful to develop schedules (picture or written) for him.
  • Many students on the spectrum are also dysgraphic and they are unable to listen to you talk, read the board and take notes at the same time.
  • Please post schedules and homework assignments on the board and make a copy for him. Please make sure that these assignments get put into his backpack because he can't always be counted on to get everything home without some help.
  • The student lacks the ability of remember a lot of information or how to retrieve that information for its use.

==> The Complete Guide to Teaching Students with Aspergers and High-Functioning Autism


How to Conduct an Assessment for Aspergers

How does a diagnostician or clinician conduct an assessment for Aspergers?

Autism Spectrum Disorders are very complex, yet their features can be very subtle; they are not always obvious on the surface. As a result, an Aspergers (high-functioning autism) assessment will take more time than most other assessments. Below are the methods that clinicians who are new to the field of Aspergers can use as a guide. These are also the methods that moms and dads should look for to make sure they are getting a good assessment for their Aspergers child.

An assessment should be conducted by a doctor, psychologist, or psychiatrist who has expertise in Autism Spectrum Disorders (ASD). This is important because most degree programs may only give passing information about Aspergers. A clinician may have a lot of experience in evaluating and may know the DSM criteria for Aspergers – but knowing the criteria on paper is not the same as having the background to really know all of the subtle features to look for. If you are a clinician and do not have the background experience with Aspergers yet, consult with a clinician who does. If you are a mother or father getting an Aspergers assessment done, ask about the background experience of the clinician.

Assess each of the core areas of difficulty along with the more subtle characteristics. Aspergers involves qualitative difficulties in language, social interactions, and more stereotyped and repetitive behaviors and interests; however, there cannot be a real delay in language – but it does often involve difficulties in how language is being used.

It is not enough to question parents about language delays or social interactions or interests. A good assessment will look at how behaviors are being exhibited. Even if the Aspergers child is social, the clinician needs to look at whether he/she can take other people's perspective:
  • Does he have imaginative play?
  • Does he demonstrate sensory preferences that interfere with required or socially desires activities?
  • Does he approach others and initiate interactions?
  • Can he talk about someone else' preferred topic?
  • Can he switch tasks when redirected fairly easily?
  • Can he listen as well as talk?

These are just some of the more subtle behaviors that need to be observed in Aspergers kids who may be higher functioning. This goes beyond just asking, "Does your son or daughter socialize?"

Use observation in a variety of settings as the core of the assessment. Behaviors can be exhibited for more than one reason. For example, escape, reactions to sensory processing difficulties, attention seeking, and seeking rewards can all be the basis for behaviors. A question on a form reveals that a behavior is being exhibited, but does not reveal why or exactly what the behavior looks like. The only way to know the "why" of many behaviors is to observe in natural settings and to spend time with the Aspergers youngster.

It is not enough to simply observe the Aspergers child in a clinical setting. If clinicians take the child to an unfamiliar location and put her in a room with grown-ups that she has never seen before and then ask the parent to leave the room, you will not get a good picture of how this child interacts with others. If it is not possible to observe the child in a natural setting, then ask the parents if they can videotape their child during various activities.

It is critical to observe the child – close up – in a small playgroup. Observing play and social interactions may look good from a distance; however, when the clinician can (a) hear everything that is being said, (b) follow the child’s eyes, (c) see how he responds to interruptions and so forth, then the clinician can really assess the details of those interactions and begin to interpret them as possibly on the spectrum or not. The clinician can also tell if the child’s play is “parallel play” or if it is really “cooperative play.” Observations not only support the diagnosis, but they are essential in order to give individualized, rather than generic, recommendations.

Clinicians should pair observations with interviews, ratings scales and direct assessment. One rating scale alone should not be the actual assessment. However, rating scales should be given to support observations. If the results do match what is being observed, then check to make sure that the rating scales were completed correctly and ask the rater for examples of what was being rated high in the scales. For example, a behavior could be rated as being "frequently" observed. If it is occurring about 2 times per day, it may seem frequent, but according to the key on some scales, "frequent" is defined as 6 or more times in a 6 hour period. Thus, 2 times per day should be rated as "sometimes" observed. Also, make sure that the scoring follows the key, and get information about what the behavior looks like as well as examples of when and how it occurs. Many of the rating scales (e.g., Gilliam scales, CARS) have a high validity rating, and they are usually fairly correct; however, they are not always correct and cannot be used to make a diagnosis because the reported behaviors could be due to different causes.

Rule out other disorders that have similar characteristics. Many behaviors can be associated with more than one diagnosis. The trick is to look at what the underlying causes of the behaviors are – and what is maintaining the behaviors. With an Aspergers diagnosis, it is crucial to put all of the information together to get the big picture because Aspergers is a spectrum disorder (i.e., a spectrum of behaviors across three major areas of difficulty). If the clinician only looks at behaviors on the surface, then multiple diagnoses will be given for the same behaviors – or the child will get a misdiagnosis. If, for example, a child receives the diagnoses of ADHD, Bipolar, Autism, and ODD all at the same time, it’s likely that the clinician “cut some corners” and conducted a poor assessment. It is definitely possible to have a dual diagnosis that is accurate, but a good assessment will differentiate between diagnoses.

The Aspergers Comprehensive Handbook


The Benefits of "Therapy Pets" for Kids on the Autism Spectrum

Pets and kids with Asperger's or High-Functioning Autism (HFA) can be a great combination and give these children an opportunity to relate to another living being. Children with behavioral and social issues can be difficult to work with, and most of them have trouble trusting others. Dogs, cats, elephants, lizards, rabbits and horses can successfully be used in animal therapy (called Animal Assisted Therapy).

Animal Assisted Therapy provides an experience with an animal that is non-judgmental, gives affection unconditionally, and provides opportunities for physical and emotional therapy. This includes therapy for strengthening muscles through horseback riding, low-impact swimming with dolphins, and a boost of confidence with service dogs and companion dogs. These pets promote confidence and self-esteem while motivating children on the autism spectrum to interact and get stronger.

There are many cases in which kids with Asperger's and HFA have close relationship with special pets (e.g., dogs, cats, rabbits, etc.). The violent tendencies of "special needs" kids disappear while they play with the pet. Having a pet often promotes a healthy personality in kids, including trusting, respecting, contributing, self-confidence, commitment and responsibility. It also can teach these kids problem-solving skills, decision-making skills, language and social skills.

A meta-analysis found that animal-assisted therapy is associated with improving medical difficulties, behavioral problems, and emotional problems in kids on the spectrum. They also report the following improvements in:
  • Attention skills (i.e., paying attention, staying on task)
  • Leisure/recreation skills
  • Reducing anxiety
  • Reducing loneliness
  • Self-esteem
  • Verbal interactions between group members

The research into Animal Assisted Therapy is relatively new, and professionals believe more research is needed. However, there's a general consensus that “therapy pets” aid in the treatment of kids with Asperger's and HFA. As with other types of animal assisted therapy, the introduction of the animal seems to calm and soothe these kids. Often, they begin making eye contact with the animal first, then with people. Therapy usually results in these kids becoming more open – first with the pets, and then with people.

Moms and dads often bring a pet into the family to teach their child a sense of responsibility, or perhaps to provide him/her with a playmate. But these kids often learn something more fundamental about themselves and the world: how to empathize with others, how to understand subtle feelings, and how to look at the world from a vastly different perspective. The youngster learns how the world and living things are interconnected.

On the emotional level, pets can teach autistic kids many things, including:
  • Communication: The kids learn the subtle cues their pets give them to indicate their feelings. They can later apply this lesson to human interaction because they are more attuned to watching for body posture.
  • Confidence: The kids go through life under constant evaluation. They are rated by their behavior, grades and athletic performance. This is especially true of middle school students. Pets have no such expectations; they're delighted that the youngster is with them. Pets give kids the sense of unconditional acceptance. No judging or rating is involved.
  • Empathy: The kids often become curious about the emotions their pets feel. This curiosity will extend itself to others. Animals offer an avenue for kids to explore their curiosity. For a youngster, curiosity can lead to hope and to greater engagement with the world around them.
  • Nurturing skills: If properly supervised by adults, a youngster learns how to take care of another living being, and take pleasure in keeping the pet healthy and happy.
  • Resilience to change: The kids who undergo traumatic experiences often cope better when they have a pet to confide in. Loneliness is very dangerous to kids. Having an animal companion can make them feel a part of something.

One study explored the relationship between pets and Asperger's kids. Specifically, the study, conducted by a child psychologist in New Mexico, looked at the effect dog ownership had on 10- to 12-year-olds. The researcher was surprised at the difference in empathy and self-esteem between pre-adolescents who owned a dog and those who did not. This research supported the growing body of evidence that shows dog ownership has statistically significant impact on self-esteem and sensitivity toward others. A pet has no such measures of success or failure; acceptance is total, which provides a sense of self worth.

Pets also teach these young people about the importance of taking care of themselves. For instance, one therapist says she teaches kids why it is important to take care of a pet, brush his teeth and keep him clean. When they understand the importance, the therapist turns the focus on the kids themselves. If brushing a dog's teeth is important for his health, then naturally it is important for the youngster's well being.

This doesn't necessarily mean that all kids with the disorder are ready for pet ownership. Moms and dads should first make sure their youngster desires a pet before rushing out to get one. Together, they should decide what type of pet is best. Moreover, don't assume your youngster will take care of the pet. The ultimate responsibility usually falls on the parent, not the kid, to make sure the pet is healthy.

As most of us with pets realize, pets can be a source of comfort and happiness. It is no surprise that they can also have therapeutic and healing benefits. The playful nature of pets seems to help bring kids with Asperger's and HFA out of isolation.  

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism


Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.



Aspergers and Leaky Gut Syndrome (LGS)

Leaky Gut Syndrome (LGS) is a gastrointestinal disorder that affects the lining of the digestive tract. Some researchers believe that this digestive problem is a contributing factor to Aspergers (high functioning autism). The digestive tract lining becomes irritated and permeable. As a result, undigested food particles (particularly proteins) and toxins end up leaking into the blood stream. This leakiness can lead to disturbances in neurological brain function.

Part of the problems inherent in LGS is that the body is naturally designed to fight off foreign entities. The food particles and toxins cause the body to put the immune system into overdrive, which is suspect for causing autoimmune disorders. Specific symptoms indicate that there might be a problem with a permeable intestinal tract. They include:
  • aggressive behavior and mood swings
  • anxiety, confusion, and nervousness
  • asthma
  • bed-wetting
  • bloating and constipation
  • chronic pain
  • diarrhea and gas
  • discomfort in the abdominal area
  • disorientation and memory problems
  • fatigue
  • indigestion and heartburn
  • poor immunity
  • recurrent infections
  • shortness of breath
  • skin rashes

Aspergers kids who suffer with LGS are bound to suffer frequent bouts of allergies or common illnesses as protein substances and other “hard-to-break-down” molecules filter through their intestinal tracts into the intestines, causing the body to misinterpret them as a harmful substance (such as a virus) and go into an anti-body production overdrive to combat these.

Other complications arising from LGS are caused when the child’s body starts to cause an auto-immune disease. As a result, (a) the body begins to attack itself, and (b) bacteria (that should only be found in the intestinal tract) gets transported to bloodstream, which causes infections and weakens the liver besides resulting in increased toxicity elsewhere in the body.

To avoid these problems associated with LGS, it is advisable for parents with Aspergers children to raise their awareness of this disorder. This includes avoiding intake of a diet that is high in carbohydrates, alcohol and caffeine content, and drugs such as ibuprofen and antacids – all of which work to reduce the impermeable nature of the intestinal walls that is a measure of disease control. Also, since the digestive system of Aspergers kids is very sensitive, medical advice strongly recommends going on a gluten and casein free diet – and avoiding spicy food.

There's a variety of supplements for LGS. The process of choosing the right ones for a specific case can be time consuming, but the results can be quite dramatic! While a diet composed of a combination of vitamins and minerals can be ideal, it might be better to take a gradual approach to introducing these elements into Aspergers children’s diet.

1. Shark liver oil often tops the lists of supplements that can be used to treat LGS.

2. Vitamins and minerals that can be used in the treatment of LGS include:
  • beta carotene
  • co-enzyme Q10
  • digestive enzymes
  • glutamine
  • methyl sulfonyl Mmethane (MSM)
  • selenium
  • vitamins A, C, and E

3. Other dietary supplements include:
  • aloe vera juice
  • barley grass powder
  • bovine colostrums
  • garlic
  • Kolorex Intenstical Care capsules
  • lactobacilus
  • lactoferrin
  • olive leaf extract
  • virgin coconut oil

Frequently track your youngster’s progress, and make sure to use a systematic approach for introducing different elements. After you've selected the best supplements for LGS, the results can be well worth the effort. Consult your child’s doctor before beginning any program.

Part of answering the questions about LGS revolves around finding out how the condition affects the brain. Research is a continuing process, which we hope will provide more answers in the near future.

The Aspergers Comprehensive Handbook


Aspergers Teens Talk About Their Struggles

Teens with Aspergers Talk About Their Life-Challenges:

Your older teenager or young “adult child” isn’t sure where he is going in life, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent?

Click here to find out...

Help for Neurotypical (non-Aspergers) Siblings

Caring for an Aspergers (high functioning autism) youngster takes a tremendous toll on the whole family, and neurotypical siblings are no exception. As moms and dads, our exhaustion, stress, and uncertainty about how to respond to the needs of other children can leave us feeling guilty and drain our reserves — and might tempt us to downplay or ignore the impact a youngster's disorder may have on his siblings. By being aware of what neurotypical (i.e., non-Aspergers) brothers and sisters are going through and taking a few steps to make things a little easier, moms and dads can address many issues before they unfold.

Family routines and dynamics naturally change when a youngster has Aspergers, which can confuse and distress neurotypical siblings. In addition to fear and anxiety over the disorder, they often experience the feeling of loss of a "normal" family life, and loss of their identity within the family.

It's normal for neurotypical siblings to:
  • worry about the Aspergers sister/brother
  • fear that they or other loved ones will catch the sibling's “disease”
  • feel guilty because they're “functional” and can enjoy activities that the sibling cannot
  • be angry because moms and dads are devoting most of their time and energy to the Aspergers sibling
  • feel neglected and worried that that no one in the family cares
  • resent the sibling who may never have to do chores
  • resent that the family has less money to spend now because the sibling is receiving services and/or treatment
  • be nostalgic for the past (wishing things could be like they were before the Aspergers sibling came along)
  • feel residual guilt for being "mean" to the sibling in the past
  • experience generalized worry or anxiety about an uncertain future

The way brothers and sisters express their needs will vary considerably — some may act out, some may try be the perfect youngster, and many will do both. Most studies find that siblings of a youngster with Aspergers or Autism are not at any increased risk for mental disorder, although they may be at greater risk for behavioral and emotional manifestations of their distress.

Pay attention to any changes in children' behavior, and talk to them frequently about how they're doing and what they're feeling. The more room children have to express their emotions, the less emotional turmoil and fewer behavioral problems they're likely to have. Signs of stress in children can include any changes in sleep patterns, appetite, mood, behavior, and school functioning. Younger kids may pick up on parental stress and show regressed behaviors (i.e., doing things they did when they were younger and had already outgrown). Even if you don't see any signs in your children, you can be pretty sure that changes to their routine and seeing their moms and dads and other family members upset is likely to be causing them stress.

While you may not be able to take away the source of your children's emotional pain, you can help alleviate their stress and make them feel secure, cared for, and supported. These suggestions will help, but it's also helpful to seek support (e.g., through counseling) to help you take better care of all your kids:

1. Accept the situation for what it is. Realize just as you may mourn the loss of a more mainstream child, the Aspie’s brothers and sisters may also be sad they don't have the kind of sibling-relationship that other siblings enjoy. Let them talk about those feelings.

2. Be patient and attentive. Have a lot of patience with regressive behavior, especially on the part of neurotypical children, who may have trouble making sense of emotions. At a time when moms and dads' nerves are frazzled, it can be hard to stay patient and attentive, but it's essential for siblings. However, it's not a good idea to let children behave inappropriately or get away with behaviors that you would not have allowed before the Aspie received an Aspergers diagnosis. Rather than make a youngster feel relaxed, this can increase anxiety, jealousy, or feelings of abandonment.

3. Become informed. Fully educate yourself about your Aspergers child and then inform his brothers/sisters 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. Even a young sib can understand that, "Michael gets upset when we stop talking about trains, but we're working on ways to help him."

4. Include siblings in the treatment and care. Including neurotypical children in some of the treatment sessions can help demystify the disorder. They also can benefit from connections to other client’s' siblings. In addition, giving neurotypical children specific, non-threatening "jobs" can help them feel like an important part of the treatment process. Encourage their involvement in a variety of ways, and let them tell you how they'd like to be involved — maybe helping with social skills training to keep a the Aspergers youngster connected to life at home and school. Many treatment centers offer sibling counseling groups, workshops, and other programs that can help your neurotypical children feel less alone.

5. It's OK to have fun. Enjoying yourself and having fun can go a long way toward relieving stress and recharging your battery. In addition to trying to maintain a normal schedule of activities, whenever feasible set aside some time for your children to spend with friends and family without focusing on the disorder. You also can set aside one-on-one time with your neurotypical children where the focus is on them and everything that's going on in their lives other than their sibling's disorder.

6. Keep it "normal" as much as possible. Try to maintain continuity and treat your children equally. Stick to existing rules and enforce them. In addition to minimizing jealousy and guilt, this also can send a strong optimistic message about your Aspergers youngster's progress. And try not to fall into the trap of relying on neurotypical children as caregivers before they're ready. Accept help so that your neurotypical children can stick to their typical routines as much as possible. Also, do not coddle the Aspergers child any more than is necessary. He will need to learn how to hold his own in life, and dealing with siblings is a normal part of gaining this independence.

7. Keep the lines of communication open. Pay attention to siblings' needs and emotions. Encourage them to talk about their feelings — the good, the bad, and the guilt-inducing — and try to read between the lines of their actions. This can be difficult when you're exhausted and stressed due to caring your Aspergers child, but a little attention and conversation can let your neurotypical children know that they're important and their needs matter.

8. Look forward – not back. If you find yourself feeling guilty for not being a perfect parent to your neurotypical kids, don't beat yourself up — dwelling on the past is not productive. Instead, try to make a point of recognizing your children' feelings and needs now, and move on from there.

9. Say yes to help. Accepting help with transportation, meals, childcare, and other daily activities can take some pressure off of you so that you have the emotional reserves to be there for your family. You'll also be teaching your children a valuable lesson about accepting generosity from others.

10. Understand that Aspergers is an "invisible" disability. Siblings may be embarrassed in front of their peers when, for example, their brother (who looks no different than any other child) can't stop clenching and unclenching his fists.

Can you treat the child with Aspergers the same way you treat his siblings? Unfortunately, you can’t. The Aspie will probably need a lot more support than his siblings do. But at the same time, there are many things you can try to limit the amount of jealousy that the siblings will feel because of this inequality.

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children


Autism Spectrum Disorders and the Brain

"A lot of literature on autism says that the brain of a child on the spectrum is 'wired differently'. Can you elaborate of this difference?"

Over the past few years, a number of studies have been published linking differences in brain structure and function to Autism Spectrum Disorders (ASD). For example, researchers have noted that:
  • At a certain point in post-natal development, ASD brains are larger
  • Certain parts of the brain may function differently in ASD children
  • Certain portions of the brain, such as the amygdala, may be enlarged in ASD brains
  • “Minicolumns” in the brain may be formed differently and be more numerous in ASD brains
  • Testosterone may be linked to ASD
  • The entire brain may function differently in ASD children

What all of these brain findings have in common is that they point to ASD as a disorder of the cortex. The cortex is the proverbial "gray matter" (i.e., the part of the brain which is largely responsible for higher brain functions, including sensation, voluntary muscle movement, thought, reasoning, and memory).

In many ASD children, the brain develops too quickly beginning at about 12 months. By age ten, their brains are at a normal size, but "wired" differently. The brain is most complex thing on the planet, so its wiring has to be very complex and intricate. With ASD, there's accelerated growth at the wrong time, and that creates havoc. The consequences, in terms of disturbing early development, include problems within the cortex and from the cortex to other regions of the cortex in ways that compromise language and reasoning abilities.

Minicolumns (i.e., small structures within the cortex) are also different among children with ASD. They have more minicolumns, which include a greater number of smaller brain cells. In addition, the insulation between these minicolumns is not as effective as it is among typically developing children. The result may be that children with ASD think and perceive differently and have less of an ability to block sensory input.

ASD really impacts behavioral function in the brain very broadly. It affects sensory, motor, memory, and postural control – anything that requires a high degree of integration of information. The symptoms are most prominent in social interaction and problem solving because they require highest degree of interaction. In fact, ASD children are socially/emotionally far more delayed than anyone ever thought, even if they have a high IQ.

While social and communication skills may be compromised by unique wiring in the brain, other abilities are actually enhanced. For example, ASD children have a really excellent ability to use the visual parts of the right side of the brain to compensate for problems with language processing. This may be the basis for detail-oriented processing – and may be a decided advantage!

ASD children think differently because their brains are wired differently. They think logically and predictably, but differently. It's as if they're colorblind. You wonder why someone doesn't stop at a red light – because they can't see it. Teachers need to be taught this. When the teacher says, "Close your books and hop over to the door" …and the child hops, the teacher feels mocked. But she hasn't been mocked – she's been obeyed.

Understanding differences in the ASD brain may also provide hints for better communication. For example, since it may be harder for a child with ASD to process multiple ideas, or to multi-task, it makes sense to (a) say less, (b) give the facts, and (c) don't give a lot of tone of voice, gestures or distractions. You'd be surprised how many behavior problems are related to that. Remember that the child is dealing with facts, not concepts.

In ASD brains, circuitry is developing into adulthood – but it's not developing in the right way, and it stops developing too soon. With the right treatment, though, it can be pushed.

Animal scientist Temple Grandin has an extraordinary mind. Probably the world’s most famous person with autism, she “thinks in pictures.” Overall, the right side of her brain dominates. Grandin’s enlarged left ventricle is a sign of abnormalities in her left hemisphere, which typically handles language, and may account for the difficulties she has with processing words. To make up for this, the right hemisphere sometimes overcompensates, which can lead to special abilities in music, art, and visual memory. Grandin’s amygdala (the almond-shaped organ said to play an important role in emotional processing) is larger than normal. This is not a surprising finding because among other functions, this region processes fear and anxiety, which are emotional states often affected by autism. Her fusiform gyrus is smaller than normal – also not a surprise, since this region is involved in recognizing faces, which is a social skill that autism may disrupt.


2011 Seminar on Aspergers (High-Functioning Autism): Transcript of Q & A Session

Question #1: Can you give us just a basic summary of Aspergers for those of us who are not familiar with the disorder?

Generally, Aspergers is understood to involve problems with social skills and relationships, nonverbal communication difficulties, restricted, repetitive behaviors, narrow areas of interest, and adequate development of language skills and intelligence.

Since 1944 when Hans Asperger first wrote of the symptoms he observed, professionals have included different groupings of the following symptoms in their definitions of the condition:

• compulsive adherence to nonfunctional routines
• delayed motor skills
• lack of delay in speech or language comprehension skills
• motor clumsiness
• narrow interest
• nonverbal communication problems
• normal intellectual development
• odd speech
• preference for solitary activities
• preoccupation with parts of objects or nonfunctional aspects of toys, tools, machines, etc.
• problematic peer relationships
• repetitive routines
• restricted interests
• social impairment
• stereotyped behaviors

The following symptoms were required for a DSM-IV diagnosis of Aspergers:

• impaired social interaction
• lack of delay in cognitive skills, age-appropriate adaptive or self-help skills
• lack of significant delay in language skills
• limited, habitual, stereotyped patterns of behavior, activities or areas of interest
• presence of curiosity in the outside world or the environment
• the first two symptoms must lead to problems in social, occupational, or other types of functioning for the individual
• the symptoms are not related to a diagnosis schizophrenia or another pervasive developmental disorder.

These criteria attempt to describe individuals who:

1. Appear to experience a lack of reciprocity in social interactions. This means an individual who does not understand nonverbal communication (e.g., gestures, facial expressions) and, for example, may continue a conversation even though the individual he is talking to is looking at his watch trying to get away. The individual with Aspergers has difficulty recognizing and understanding others’ use of facial expression and gestures during conversation. Their lack of response to this type of communication creates great difficulty for them in social relationships. Similarly, an individual with Aspergers may not use nonverbal communication and may appear expressionless in most conversations or interactions with others.

2. Have an area of special, sometimes obsessive interest. Many times, individuals with Aspergers develop this interest as a way to overcome fear - however this does not always have to be the case. Weather, especially tornadoes and hurricanes, can be fearful or even terrifying. A youngster with Aspergers may develop a preoccupation with weather to cope with this fear. He might watch the Weather Channel continuously, read the weather report in the paper numerous times across the day, or read about different weather phenomena and be able to share details of past storms when the weather worsens. Trains are often a focus of interest for many kids with autism. Video games and computers also appear to be strong interests as the younger kids mature.

3. Have great ability to attend to detail and recall detailed information about their areas of interest. While individuals with Aspergers can amaze others with the amount of detailed information they have stored on certain topics, they often have difficulty using and applying this information constructively. They can experience difficulty recognizing the “big picture”, or recognizing the forest from the trees. The relevancy of the information they know is often limited.

4. Have unusual speech patterns. While individuals with Aspergers may have begun talking at an appropriate age, they often used a rather pedantic, long-winded and sometimes rather concrete or literal style of speaking. Pedantic describes speech that is overly focused on the details of its topic. It is speech that appears to list details about a topic one after the other. In an individual with Aspergers, this type of speech does not appear to be impacted by the environment (such as by the nonverbal cues of others), and therefore seems less conversational and more like a monologue. Individuals with Aspergers often also understand and use words concretely and literally. An example could be when a teacher discussed possible consequences for misbehavior with a student who has Aspergers. The student heard that if he did not complete his homework or class work at any one time, that he would receive a detention. He became very angry over this perceived injustice. He did not understand that the teacher had meant that when she saw a pattern of incomplete work, she would provide the consequence of a detention. With such a concrete way of understanding others, the individual with Aspergers can easily misinterpret others’ intent and respond in an unexpected and possibly inappropriate way.

5. Lack a theory of mind (the ability to understand what another person may be thinking in a given situation). They have difficulty imagining or understanding how someone else’s thoughts, experiences, knowledge, or desires could influence their behavior. This concept has also been called “mind blindness”.

6. Tend to prefer routine, repetitive activities and to avoid and dislike transitions and change. They have been described as often having a “one track mind”. They can have a plan, and if it fails, will continue with it until it does work.

Question #2: How is Aspergers “related” to Autism?

Aspergers and some other disorders are believed to fall along a spectrum. This spectrum has been called the autism spectrum, and also the pervasive developmental disorder spectrum. Whatever it is called, Autistic Disorder (or autism) would fall at one end of the spectrum, while “average” or “neurotypical” functioning would be found at the other end. Aspergers has been conceptualized as a mild, less problematic form of autism that falls between average functioning and autism on this continuum.

This means that kids with autism experience many of the same symptoms as individuals with Aspergers. However, the symptoms of kids with autism are usually more severe and their functioning is much more impaired. For example, while a youngster with Aspergers may have difficulty using language socially, a youngster with autism may be mute. Both Aspergers and Autistic Disorders may involve social rejection, lack of understanding or interest in other individual’s feelings, difficulties interacting with others, some rigidity (instead of flexibility) in play, difficulty using language socially, poor nonverbal communication skills, odd motor behaviors, and narrow interests or abilities.

Question #3: How is Aspergers “different” from Autism?

Autism is the more severe form of problems with social interaction, restricted behaviors and areas of interest, and impaired language skills. For example, while a youngster with Aspergers may have difficulty interacting with others socially and forming friendships, a youngster with autism may often avoid direct eye contact with any individual, dislike physical touch including the experience of hugs or loving touches, and may not develop verbal skills (a more severe expression of impaired social skills). According to the present diagnostic criteria, individuals with autism usually experience significant delay in the acquisition of language skills (e.g., the youngster did not use single words before the age of 2; communicative phrases were not used until after age 3). Cognitive skills are also often impaired. In contrast, individuals with Aspergers should not have experienced delay or impairment in cognitive or language skills.

The differences between autism and Aspergers can be summarized as:

• “visuospatial development” - which means skill at processing and understanding visual, nonverbal information (in some kids with autism this could be a strength, whereas this was never addressed by Asperger)
• cognitive skill (Asperger wrote about kids with normal intelligence; research has demonstrated that the majority of kids with autism are cognitively impaired)
• differences in motor ability (original descriptions of kids with autism did not suggest any motor difficulties, while early descriptions by Asperger did)
• language ability

Others have suggested that while individuals with autism show little interest in peer interaction, individuals with Aspergers often seek such companionship.

Question #4: What is the difference between Aspergers and High Functioning Autism?

Many individuals identified as having high functioning autism (or HFA) had more pronounced symptoms of autism as kids. As they aged, the development of basic social skills, age appropriate cognitive skills, and verbal ability occurred. Tony Attwood, a psychologist who has much experience and expertise in Aspergers, has written that HFA is a phrase that is most often used in the United States and often applies to individuals who qualified for a diagnosis of autism as kids.

Controversy still exists within the literature about the differences between these diagnoses. Some individuals use the terms interchangeably. At this point, differences between the two labels (HFA and Aspergers) have yet to be effectively clarified.

Question #5: How is Aspergers treated?

Different symptoms of Aspergers can be treated with the goal of reducing the problems they create for the youngster or individual. Treatment can include medication management of problems such as anxiety and depression, conditions that often occur as a result of the difficulties experienced by the individual with Aspergers. Medication has also been used to manage the obsessive (recurring, bothersome thoughts) and compulsive traits (behaviors used to get rid of the bothersome thoughts) that can be exhibited. Historically, these individuals have been incorrectly diagnosed with other types of disorders including schizophrenia, personality disorders, Attention Deficit Hyperactivity Disorder (ADHD), and Obsessive Compulsive Disorder (OCD). Medications, such as anti-psychotics, have been prescribed. The problem with this approach is that although individuals with Aspergers may experience obsessive thinking, repetitive thoughts or interests, or exhibit unusual social behavior, their symptoms are best reflected by the criteria for Aspergers rather than these other diagnoses.

Behaviorally, interventions targeting skill development tend to be the most common and can be affective at any age. Early intervention with young kids often relies on behavioral principles. Kids are taught new behaviors and rewarded based on their ability to engage in that behavior with increasing frequency. Consequences may also be applied to decrease negative behaviors. Interventions for older kids and teens focus more on educating them about their diagnosis, developing new skills, and providing opportunities to practice those skills. Moms and dads, educators, and / or therapists can all play a role in this process. Often however, there needs to be some intervention at school if a youngster is going to successfully learn new behaviors. Moms and dads need to talk to school staff (educators, administrators) to determine what resources are available for their youngster within the school (such as counselors, special programs, teacher assistance, etc.). Therapy also provides a means of learning new skills. Individual therapy helps address emotional difficulties that may arise as a result of the Aspergers. Social skill training can be a part of this work. Group therapy offers a chance to learn new skills in a setting designed to offer the chance to practice and receive feedback on what is being learned.

Question #6: What is the difference between a “disorder” and the normal range of abilities and personality?

It is important to remember that all behaviors fall along a continuum or spectrum. At one end of the spectrum is “normal” behavior, or abilities, traits, and individual characteristics that are considered appropriate (or typical) on the basis of an individual’s culture, age, gender, etc. At the other end of the spectrum are groups of behaviors that, when exhibited regularly by an individual, create problems for that person in terms of his or her functioning socially, emotionally, or occupationally.

Many individuals have certain eccentricities, including unusual hobbies, anxiety or awkwardness in social situations, or clumsiness. This is considered well within the range of normal behavior. However, when these behaviors coincide, form a pattern across time, and negatively impact an individual’s ability to function, then they are viewed as “clinically significant”, and as requiring diagnosis and treatment.

There is a lot of controversy about the diagnosis of Aspergers. Added to the mix is concern that individuals with poor social skills are being “pathologized”. Put another way, the “loners” are now qualifying for a diagnosis. Our society expects individuals to be social. When they are not do we view them as disabled? Simon Baron-Cohen explored this argument and looked at both sides. He suggested that many of the behaviors associated with Aspergers represent a focus on things rather than on individuals. If placed in a different environment, he believed that Aspergers would not be seen as a “disorder”. He also pointed out that kids with Aspergers tend to meet the majority of developmental milestones on time, and emphasized the typical or “normal” aspect of their development. In contrast, he also discussed two reasons for continuing to consider Aspergers a “disability”: (1) so that individuals with this diagnosis could have access to support at school (possibly through special education services) and within the community (some insurance companies will pay for an individual with Aspergers to get treatment in outpatient therapy); and (2) because lack of empathy (or theory of mind) can create significant problems emotionally for individuals with Aspergers.

Question #7: Do females experience Aspergers differently?

Yes, however far fewer females are diagnosed with Aspergers than males. Earlier, the ratio was believed to be one girl to every ten males was diagnosed with Aspergers. Currently however that ratio is believed to be more in the range of one girl to every four males. As professionals become more familiar with the diagnostic criteria, more females appear to be receiving the Aspergers diagnosis.

Generally, it is believed that females experience a much milder form of the difficulties associated with Aspergers. American society emphasizes and pushes females to develop strong social skills at an early age. This may benefit females with Aspergers by helping them learn compensatory skills or address any deficits earlier in life. Alternatively, it has been suggested that females use different coping strategies when dealing with social situations. Females tend to hide in social situations, and remain on the periphery. This allows them to observe the behaviors of others, and once comfortable with the process, to mimic those behaviors (e.g., facial expressions, gestures, tone of voice). Doll play allows younger females to re-experience social situations, replay them, alter them, and learn from them. Females also often have invisible friends - a safe tool to use when practicing social skills. Among females, Aspergers may express itself more through immaturity. Topics of special interest also may not be as intense as the interests exhibited by males. Females’ areas of special interest seem to be different from those of males. Their preoccupations center more on animals and classical literature. The long-term prognosis for females with Aspergers also seems better than for males, largely because of the females’ ability to hide their difficulties from others over time.

Question #8: What other problems may an individual with Aspergers experience?

A number of difficulties can accompany the behaviors that define Aspergers. As individuals with limited social skills and awareness of others, who tend to have areas of unusual or intense interest, a strong need for routine, and unusual mannerisms, individuals with Aspergers often experience emotional difficulties, including depression, anxiety, and anger. Social interaction and negative feedback from others creates stress. Individuals react differently to such stress. Some individuals internalize distress through the experience of feelings of low self-esteem, hopelessness, helplessness and sadness. Some internalize the distress through feelings of anxiety. Others externalize the distress through angry, aggressive, destructive, or rule-breaking behaviors. These reactions can be triggered by teasing, perceptions of being treated unjustly, frustration and confusion in response to certain situations - many triggers can exist and depend solely on the individual. If any of these additional problems (depression, anxiety, or anger) affect the individual’s ability to function and are pervasive, they may require diagnosis and treatment as well.

Other conditions can also occur with Aspergers, but are not part of the criteria for the Aspergers diagnosis. Problems with attention, concentration, and/or impulsive, distracted, or hyperactive behaviors might suggest a possible diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). The occurrence of motor and verbal tics could suggest problems associated with Tourette’s Disorder. For individuals who experience these problems as well as the difficulties associated with Aspergers, a dual diagnosis may be necessary.

Question #9: What are the advantages and disadvantages of having the label Aspergers?

The advantages tend to be personal and emotional. For moms and dads, the diagnosis and label provides them with a sense of relief. Many moms and dads of kids with Aspergers say that they have known that something was “wrong”, but felt that they could not get “the problem” properly identified. When such difficulties are identified and labeled, moms and dads and individuals are better able to understand the nature of the problems and how to remedy them. By labeling the disorder, it is easier to address any problems that are associated with it, and allows moms and dads and individuals the opportunity to maximize the positive aspects of the disorder. Individuals with Aspergers often have a unique ability to focus, and to catalogue detailed information about their areas of interest. In many situations, these talents can be put to very positive, constructive uses. One only needs to look at the celebrities who some suggest may qualify or may have qualified for an Aspergers diagnosis to realize what talents can be associated with what is called a “disorder”.

Other advantages to “labeling” include providing moms and dads and educators with a way to learn about a youngster’s behaviors. By learning about Aspergers individuals can better understand its implications so that parental, teacher, and community expectations of the individual are realistic, reasonable, and do not require that person to meet standards that are outside his/her range of abilities. Additionally for kids, the diagnosis qualifies the youngster for assistance in the schools as defined by IDEA. This means that the schools are required to provide special accommodations for the youngster’s education. The accommodations need to be tailored to the youngster’s condition so that they help create a learning environment that is best suited to the youngster’s abilities.

Disadvantages associated with the label of Aspergers are similar to the disadvantages associated with any label, and generally refer to individual’s tendency to think in stereotypes. Labeling an individual gives others the ability to “pigeonhole” or make assumptions about the individual based on the diagnosis, or their understanding of the diagnosis. This can lead individuals to make decisions and judgments about the individual based on the diagnosis rather than on the needs and characteristics of that person.

It is always important to remember that no person is a diagnosis, and that no diagnosis is an individual. Aspergers is merely one quality of an individual. That person will have many other traits, characteristics, and aspects of his/her personality. Readers are encouraged to learn about the individual first, then to explore the way the Aspergers diagnosis affects his/her functioning.

Question #10: What is meant by “impaired social interaction”?

Essentially, this means that the individual with Aspergers experiences difficulty developing relationships, responding appropriately, and interacting with others with ease. Certain qualities of human interaction are very difficult for individuals with Aspergers. Individuals communicate with each other through verbal (e.g., speech) as well as nonverbal (e.g., eye-to-eye gaze, gestures, body posture) communication. While verbal ability is often a strength for individuals with Aspergers, nonverbal communication is usually an area of difficulty. Individuals with Aspergers have trouble understanding the nonverbal communication of others. They overlook or don’t recognize the meaning behind another person’s gestures or facial expressions. This means that they frequently miss the cues they are given that an individual wants to leave, is getting bored, or wants to say something herself. The individual with Aspergers can also have difficulty using nonverbal communication, for example: hand gestures do not fit with what is being said, or there is an absence of gesturing or a complete lack of nonverbal communication.

Impaired social interaction also means that an individual has difficulty making and keeping friends. As can be imagined, interacting with someone who does not understand or use nonverbal communication can be unsettling and uncomfortable. As a result, many individuals avoid the individual with Aspergers and relationships do not develop. When friendships do occur, they are usually built on a shared area of interest. That interest is typically the focus of the intense interest and preoccupation of the individual with Aspergers. Maintaining such friendships can be difficult because the individual with Aspergers can be rigid and inflexible regarding the area of interest. In other words, their conversation rarely addresses other topics, and they tend to be the center of any conversation about the topic (leaving the other youngster to listen rather than contribute to a discussion). Because the individual with Aspergers is so focused on this interest, s/he often knows a great deal of detailed information about it. This can often be intimidating to other kids who do not feel as much an “expert”.

Lastly, impaired social interaction also encompasses the distressing social situations that many individuals with Aspergers encounter. The term “playground predator” has often been used to describe kids who appear to purposefully, intentionally, and vindictively single out a youngster with Aspergers for teasing and taunting. Bullies often do pick on kids who are “easy targets” or vulnerable. With their difficulties understanding nonverbal cues, and having limited social support, individuals with Aspergers are often the targets of bullies.

Question #11: What is pedantic speech?

Pedantic describes speech that is overly focused on the details of its topic. It is speech that appears to list details about a topic one after the other. In an individual with Aspergers, this type of speech does not appear to be impacted by the environment (such as by the nonverbal cues of others), and therefore seems less conversational and more like a monologue. This includes the individual’s likely idiosyncratic, or unusual use of words, e.g., a “Hoover for the face” being used for razor, or tendency to make up words to communicate their thoughts. The volume of the individual’s speech may be off - either too loud or too quiet for the environment or situation. The individual with Aspergers may also vocalize his or her thoughts rather than keeping those thoughts to themselves.

Question #12: What is “theory of mind” or “mind blindness”?

It has been suggested that kids with Aspergers (and autism) lack a theory of mind (the ability to understand what another person may be thinking in a given situation). They have difficulty imagining or understanding how someone else’s thoughts, experiences, knowledge, or wishes could influence their behavior. This concept has also been called “mind blindness”.

Question #13: What are “stereotyped behaviors”?

Stereotyped behaviors are those that are repetitive and unvarying. They are behaviors that do not have to serve any apparently useful, constructive purpose, but instead have only personal meaning to the individual with Aspergers. They reflect the individual’s adherence to a routine way of behaving.

Question #14: What are “stim behaviors” and why does the individual with Aspergers do them?

Stim behaviors refer to behaviors that tend to appear in response to an anxiety-provoking situation or experience, they are repetitive, and often times appear unusual or inappropriate socially. Kids with Aspergers often become obsessed with the need for sameness or routine. When changes occur in their environment that deviate from that sameness, anxiety is produced and repetitive, ritualistic behaviors restore some of the sense of “sameness” that was lost. These behaviors are the way the individual with Aspergers copes with change, unpredictability, and anxiety. Attempts by educators, moms and dads, or significant others to stop these behaviors may lead the individual with Aspergers to feel panic, anger, and/or extreme anxiety and can results in extreme behaviors (screaming, temper tantrums) that are often less desirable than the stim behavior. In these instances, it is often best to try to help the individual with Aspergers learn an alternative, more socially acceptable behavior to achieve this same goal.

Question #15: How can I find out if my son has Aspergers?

Currently, awareness of Aspergers appears to be increasing. While this is positive, some confusion continues to exist among professionals about diagnosing the condition. For this reason, it will be important to work with someone who either has some pre-existing knowledge of Aspergers, or who is willing to learn more about it. Physicians, psychologists, therapists, and educators are usually among the first individuals to identify Asperger symptoms. Consulting with a trusted person in any of these fields would likely be a good first step. They can then either help you directly, or can refer you to someone else within the community who can.

Accurate diagnosis often involves testing by the use of questionnaires, check lists, clinical interview, psychological tests and possibly medical examination. Different professions emphasize different means of identification. If you believe you or your youngster may qualify for a diagnosis of Aspergers, or another autism spectrum disorder, taking that first step of contacting a trusted professional will be very important.

Question #16: When is it good to look for help for my Aspergers child?

The earlier the better... interventions targeted at young kids can help them learn social skills and ways of interacting with others that will help them avoid the social difficulties (such as teasing, bullying, social rejection and isolation, and social anxiety) that affects older kids, teens, and grown-ups with the disorder. Alternatively, older kids and grown-ups can benefit tremendously from learning about the disorder, and ways to address its negative aspects while maximizing its positive side. The key is to seek help. Without knowledge of the disorder and proper diagnosis, many individuals can continue to experience difficulties that can affect them for a lifetime.

The Aspergers Comprehensive Handbook

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