Does Your Child Really Have Aspergers?

Question

How can I know for sure whether or not my 8-year-old son truly has Aspergers? I'm not totally convinced at this point. There is some speculation based of observations of some of his behaviors - but I still have my doubts.

Answer

A comprehensive psychiatric evaluation from a Child and Adolescent Psychiatrist who specializes in Aspergers (high functioning autism) will be able to give you a definitive answer to that question.

Aspergers has a specific set of symptoms. However, each individual with Aspergers is unique; not everyone experiences the same combination of symptoms. Below is a basic list to help you identify whether or not your son has Aspergers-related symptoms:

Cognitive and Motor Skill Impairments—

Cognitive and motor skill problems are common in Aspergers. Typical cognitive and motor skill issues include:

• Difficulty with imaginative play: The Aspie does not engage in imaginative play as a child.
• Learns best visually: She has trouble learning without visual aids.
• Mindblindness: She has mindblindness, meaning she cannot determine what others are thinking and feeling in social situations or in relationships.
• Organizational skills difficulties: The Aspie experiences difficulty with planning, implementing and completing tasks.
• Problems with coordination: She may have problems with both fine and gross motor skills. Common examples of motor skill difficulty include bike riding, handwriting and playing ball games.
• Problem-solving issues: She has trouble figuring out how to solve problems outside of her routine.

Communication Problems—

An Aspie experiences a number of communication difficulties. Communication problems can include the following symptoms:

• Easily distracted: The Aspie has trouble concentrating her attention on people and objects that are not connected with her favorite subjects.
• Eye contact: He may not make eye contact.
• Facial expression: Facial expressions are either absent or inappropriate to the conversation or situation. She may have facial tics.
• Monotone speech: He may speak in a monotone voice, without expression or emotion.
• Personal space issues: He might stand too close to a person during conversation.
• Unusual gestures: The Aspie might make unusual or inappropriate gestures during conversation.

Language Skill Challenges—

An Aspie generally has a large vocabulary, but experiences problems with language processing. Language skills challenges may include:

• Difficulty processing language: The Aspie does not always understand the verbal speech of others or misunderstands the meaning of a conversation. He may have trouble making a decision or answering a question.
• Language rituals: He might have certain word scripts that he repeats ritualistically in conversation with others.
• Literal interpretation of words: The Aspie interprets most language on a literal level and misses abstract meanings.
• Trouble with language use: He has trouble using language appropriately in social situations. He may also misunderstand common word meanings.
• Unusual use of words: He may use words in an unusual way or create her own words.

Limited Interests and Unusual Behavior—

An Aspie often has a limited range of interest and may exhibit bizarre behavior. Interests and behavior may include:

• Narrow range of interests and obsessions: The Aspie is intensely interested in a small number of activities and subjects and refuses to engage in other activities.
• Self-stimulatory behavior: He may engage in stimming behavior such as hand flapping, rocking back and forth or twirling.
• Strict schedule: He prefers a rigid schedule and experiences anxiety when the schedule is interrupted.

Sensory Input Issues—

Many Aspies have sensory difficulties and may have unusual reactions to certain sights, smells, sounds or tastes. Sensory problems include:

• Limited food choices: The Aspie may choose and reject foods based upon smell or texture.
• Odors: She may react strongly to certain smells.
• Sounds: She might be hypersensitive to different sounds.
• Touch: The Aspie may not want to be touched.

Social Interaction Difficulties—

An Aspie may have difficulty with the following features of social interaction:

• Difficulty playing with others: The Aspie may not understand how to initiate play with his peers or how to play by common social rules. For example, he may take a ball from a group of children playing a game without asking to join the game first. He will not return the ball if they ask for the ball back because he does not understand the negative reaction.
• General social skills: He wants to socialize with others,, but does not understand how to interact.
• Inability to understand common social cues: The Aspie may not comprehend common social cues such as facial expressions, body language or gestures.
• Inappropriate responses: He may behave or respond to social situations in an unusual or inappropriate manner. For example, he/she may laugh at something sad.
• Problems with two-way conversation: He has trouble with initiating and maintaining a two-way conversation. He may appear to “talk at” someone rather than “with” them. Conversation topics may focus on an obsessive interest. He speaks inappropriately such as talking too loudly or softly.
• Relating to others: The Aspie does not understand other's emotions or social responses accurately in a group situation. He may not understand if an activity or conversation is boring or upsetting to another person.
• Rigid range of interests for social interaction: He will only engage in a narrow range of activities or talk about certain subjects.

The Aspergers list above can help you recognize common symptoms of Aspergers. If you believe that your youngster or teenager has this disorder, contact your pediatrician for an Aspergers screening. Early intervention provides the best chance for your son or daughter to live a healthy and fulfilling life.

The Aspergers Comprehensive Handbook

Aspergers Children and Poor School Attendance

Question

My child with Aspergers often convinces me that he is too sick to attend school. I end up calling-in for him at least a couple times a month. How can I tell if he’s really sick – or if he just doesn’t want to go to school that day?

Answer

Is your Aspergers (high functioning autistic) child really too sick to attend school - or is he faking it?

Many moms and dads have a hard time deciding if their children are well enough to go to school. After all, what well-intentioned mother or father hasn't sent a youngster off with tissues in hand only to get that mid-morning "come get your son" phone call? But making the right decision isn't as tough as you might think. It basically boils down to one question: Can your youngster still participate in school activities? After all, having a sore throat, cough, or mild congestion does not necessarily mean a student can't be active and participate in school activities.

Determining whether or not a youngster has a fever offers a fairly reliable way of judging whether or not he is truly too sick to go to school. Additionally, it is one of the few symptoms that can actually be quantified. States often have requirements regarding the exact temperature at which kids need to be sent home, especially in early childhood and child-care settings.

The time of day during which a youngster is experiencing a fever can also make a difference. Fevers usually run a bit higher in the evening than they do in the morning. So a high temperature in the evening may abate overnight. However, a high temperature in the morning will likely only get worse as the day progresses, so moms and dads should consider keeping children home in this case.

The child should probably stay home if it is the first day of the illness and the temperature is over 101. If it is the third day or later, and the youngster has been acting well during the day, but has a 101 temperature in the evening, he probably should go to school.

A fever isn't the only symptom to track when it comes to judging a kid's ability to attend school. Vomiting, diarrhea, rashes and a host of other indicators can also mean the difference between a desk at school or the couch at home.

Vomiting and diarrhea can also be a tremendous source of discomfort for kids if severe or uncontrolled. In these cases, a day at home may be the best option. If the youngster is vomiting, it is inconvenient for the teacher and the other classmates. If mild and controllable, however, a bit of diarrhea may not be a big problem. In elementary age kids, diarrhea isn't as much of an issue if it doesn't interfere with their ability to remain in the classroom and if they aren't sick enough to potentially have accidents, have to run to the bathroom, or be in pain.

Rashes, particularly those that cannot be readily explained, may also be cause to keep your kid at home -- and perhaps even require a doctor's opinion.

And kids with severe cases of conjunctivitis -- commonly known as pink eye -- should also be kept home from school. However, some doctors note that mild cases of this affliction may not warrant a day off.

Many moms and dads may also wonder when it is safe for their youngster to go back to school after recovering from their illness. The answer to that one is a little bit trickier. In general, nobody would recommend that a youngster goes back to school unless he has been fever-free for 24 hours, and some would even say 48 hours. A full day of fever-free downtime is probably sufficient to safeguard the youngster's health, as well as that of his peers. It is fairly standard that kids are required to be fever-free for 24 hours before returning, which is a useful method of limiting the spread of infection during the febrile period when kids are thought to be most contagious. When the fever is gone for 24 hours, the contagiousness is greatly diminished.

The 24-hour rule may prove to be more than sufficient for vomiting. Vomiting is a temporary nuisance most of the time. So if the youngster feels OK and has not vomited since midnight, consider allowing him to go the next morning.

In most cases, however, the decision of whether or not to send a sick kid to school will not be clear-cut. In these cases, moms and dads must ask themselves certain questions to help them decide. Will the illness prevent the youngster's participation in normal school activities? Also, will the youngster's illness place an unusual burden on the staff? A third and very important question to consider is whether or not the illness that the youngster has poses a risk to other kids and adults.

Moms and dads must also keep in mind that those complaints of abdominal pain could be from a food-borne illness -- or they could just be due to anxiety over the prospect of going to school. But in these situations, it may be better to err on the side of caution.

Moms and dads have to be willing to trust their instincts. Even when their youngster is not having any objective signs of illness, if they think that the youngster is different from how she normally is, they need to trust their instincts and keep her at home until they figure out what's wrong.

Moms and dads should also be aware of symptoms that suggest the youngster should be brought to a doctor. If the youngster cannot touch her chin to her chest, it could be a sign of meningitis, a serious infection that warrants immediate medical attention.

Deciding whether or not to send your kid to school can sometimes be a tough call. After all, it's not always easy to distinguish simple theatrics from true illness. Worse yet, a diagnosis and decision must often be made in the few spare moments after breakfast (and before an angry call from your boss). Fortunately, there are a few rules of thumb that you can follow when determining whether a youngster is up to the task of a full day at school. And doctors say a mild case of sore throat or the sniffles is not necessarily a mandate to keep children at home.

Trust your instincts. If your child has the sniffles but hasn't slowed down at home, chances are he's well enough for the classroom. On the other hand, he may need to take it easy at home if he's been coughing all night and needs to be woken up in the morning.

My Aspergers Child: Preventing Meltdowns at Home and School