Aspergers Children: Medication & Side Effects

Kids who have Aspergers (high functioning autism) think and function very differently than other kids. In most cases, they need special help and coaching to function more successfully in their school and home environments. Treatments for Aspergers focus on helping kids manage in these settings.

Special education services, behavior therapy, speech therapy, and physical or occupational therapy may help the youngster learn to function more effectively and harmoniously with others. Training and counseling for parents and other family members also may be helpful.

There are no specific medications used to treat Aspergers. However, kids who suffer from anxiety, depression, hyperactivity, or obsessive-compulsive disorder as a result of Aspergers may benefit from medication to help with these symptoms. When these medications are prescribed, the youngster will be monitored by his or her health care provider at regular intervals throughout treatment.

To treat depression, drugs such as fluoxetine (Prozac®, Sarafem®) may be prescribed. It is important for parents to work closely with the youngster's health care provider and to fully understand how to monitor the youngster for side effects of antidepressant medication. In some kids and teenagers, these medications may increase suicidal thoughts and actions.

Other side effects that should be reported to the youngster's health care provider immediately include the following:

• Aggressive or impulsive behavior

• Agitation or restlessness

• Increased activity level

• Increased chattiness

• Increased depression or anxiety

• Increased irritability

• Panic attacks

• Sleep difficulties

• Strange moods or behavior changes

Kids should be monitored especially closely when they first begin taking antidepressant medication or if the dosage of the medication is changed. These medications should not be discontinued or the dosage changed without consulting a qualified health care provider.

To treat obsessive-compulsive behavior (OCD), clomipramine (Anafranil®) may be prescribed. Clomipramine is also an antidepressant and increases the risk for suicidal thoughts and actions in kids and teens. Patients should be monitored closely while taking this medication. Side effects that should be reported immediately to the youngster's health care provider include the following:

• Weakness

• Tremors

• Tiredness

• Seizures

• Muscle stiffness

• Loss of bladder control or difficulty with urination

• Increased heart rate

• Hallucinations

• Eye pain

• Depression

• Breathing difficulties

The following side effects, which generally are less serious, should be reported to the youngster's health care provider if they persist or cause particular discomfort:

• Sinus congestion

• Nervousness

• Loss of memory or difficulty concentrating

• Intestinal symptoms

• Headache

• Drowsiness

• Changes in appetite

These medications should not be discontinued or the dosage changed without consulting a qualified health care provider.

To treat inattentiveness or hyperactivity, stimulants such as methylphenidate (Concerta®, Ritalin®) or dextroamphetamine (Dexadrine®) may be prescribed. These medications can be habit forming and should be used with caution in patients who have heart problems or psychiatric conditions. The youngster's health care provider will take a careful health history and perform a medical evaluation before prescribing this medication.

Methylphenidate and dextroamphetamine can interfere with the youngster's growth and weight gain. If this occurs, the youngster's health care provider should be contacted right away. The following serious side effects also should be reported immediately:

• Vision problems

• Speech difficulties

• Shortness of breath

• Seizures

• Pounding heartbeat

• Numbness in arms or legs

• Muscle weakness

• Mood changes

• Hives

• Hallucinations

• Extreme tiredness

• Dizziness

• Distorted perceptions of reality

• Chest pain

The following side effects generally are less serious and should be reported to the youngster's health care provider if they persist or cause particular discomfort:

• Sleep problems

• Shakiness, nervousness, or restlessness

• Nausea or vomiting

• Loss of appetite

• Headache

• Gastrointestinal distress

• Dry mouth

These medications should not be discontinued or the dosage changed without consulting a qualified health care provider.

==> VIDEOS: Understanding Your Partner or Spouse on the Autism Spectrum

Aspergers in Grown-ups

More males than females have Aspergers (high functioning autism). While every man or woman who has the syndrome will experience different symptoms and severity of symptoms, some of the more common characteristics include:

• Adherence to routines and schedules, and stress if expected routine is disrupted
• Average or above average intelligence
• Difficulties in empathizing with others
• Hampered conversational ability
• Inability to manage appropriate social conduct
• Inability to think in abstract ways
• Problems with controlling feelings such as anger, depression and anxiety
• Problems with understanding another man or woman's point of view
• Specialized fields of interest or hobbies

The emotions of other individuals—

A man or woman with Aspergers may have trouble understanding the emotions of other individuals, and the subtle messages that are sent by facial expression, eye contact and body language are often missed. Because of this, a man or woman with Aspergers might be seen as egotistical, selfish or uncaring. These are unfair labels, because the affected individual is neurologically unable to understand other individual's emotional states. They are usually shocked, upset and remorseful when told their actions were hurtful or inappropriate.

Sexual codes of conduct—

Research into the sexual understanding of individuals with Aspergers is in its infancy. Studies suggest that affected individuals are as interested in sex as anyone else, but many don't have the social or empathetic skills to successfully manage adult relationships.

Delayed understanding is common; for example, a man or woman with Aspergers aged in their 20s typically has the sexual codes of conduct befitting a teenager. Even affected individuals who are high achieving and academically or vocationally successful have trouble negotiating the 'hidden rules' of courtship. Inappropriate sexual behavior can result.

Being a partner and parent—

Some affected individuals can maintain relationships and parent children, although there are challenges. Dutch research suggests that the divorce rate for individuals with Aspergers is around 80 per cent.

A common marital problem is unfair distribution of responsibilities. For example, the partner of a man or woman with Aspergers may be used to doing everything in the relationship when it is just the two of them. However, the partner may need practical and emotional support once children come along, which the individual with Aspergers is ill equipped to provide. When the partner expresses frustration or becomes upset that they're given no help of any kind, the individual with Aspergers is typically baffled. Tension in the relationship often makes their symptoms worse.

The workplace—

The Commonwealth Department of Family and Community Services, in conjunction with a range of specialist employment services, help to place individuals with disabilities in the workforce. A man or woman with Aspergers may find their job opportunities limited by their disability. It may help to choose a vocation that takes into account the individual's symptoms, and plays to the strengths rather than the weaknesses. The following career suggestions are adapted from material written by Temple Grandin, who has high-functioning autism and is an assistant professor at Colorado University, USA.

Careers to avoid—

Careers that rely on short term memory should be avoided. Examples include:

• Air traffic controller
• Cashier
• Receptionist
• Short order cook
• Taxi dispatcher
• Waitress

Career suggestions for visual thinkers—

Suggestions include:

• Appliance repair
• Building maintenance
• Building trades
• Commercial art
• Computer programming
• Drafting
• Equipment design
• Handcraft artisan
• Mechanic
• Photography
• Video game designer
• Webpage designer

Career suggestions for those good at mathematics or music—

Suggestions include:

• Accounting
• Bank teller
• Computer programming
• Engineering
• Filing positions
• Journalist, copy editor
• Mathematician
• Physician
• Piano (or other musical instrument) tuner
• Statistician
• Taxi driver
• Telemarketing

Common issues for partners—

An adult's diagnosis of Aspergers often tends to follow their child's diagnosis of autism spectrum disorder. This 'double whammy' can be extremely distressing to the partner who has to cope simultaneously with both diagnoses. Counseling, or joining a support group where they can talk with other individuals who face the same challenges, can be helpful. Some common issues for partners include:

• A sense of isolation, because the challenges of their relationship are different and not easily understood by others.
• After accepting that their partner's Aspergers won't get better, common emotions include guilt, despair and disappointment.
• Difficulties in accepting that their partner won't recover from Aspergers.
• Failure to have their own needs met by the relationship.
• Feeling overly responsible for their partner.
• Frequent wondering about whether or not to end the relationship.
• Frustration, since problems in the relationship don't seem to improve despite great efforts.
• Lack of emotional support from family members and friends who don't fully understand or appreciate the extra strains placed on a relationship by Aspergers.

Depression—

Like all mental conditions which cause people to behave differently from the norm, Aspergers is associated with depression. Depression can be caused by a number of things including:

• Anxiety and Panic Attacks
• Fatigue or Tiredness due either to the condition that all to the treatment of the condition
• Guilt or regret over past actions/outburst/meltdowns
• Miscommunications / Misunderstandings
• Overwhelming feelings and thoughts
• Social troubles because you do not seem to fit in

Recent research suggests that depression is common in individuals with Asperger syndrome with about 1 in 15 people with Aspergers experiencing such symptoms. There are a number of factors which would influence the onset of depression. These include as follows:

• Difficulty reading of other people's body language expressions and tone (leading to misunderstandings)
• Obsession with completeness, order and patterns
• Obsessive compulsion
• Unusual world view/Paradigm
• Very good long term memory

Things to remember—

A man or woman with Aspergers often has trouble understanding the emotions of other individuals, and the subtle messages that are sent by facial expression, eye contact and body language are often missed. Research suggests that the divorce rate for individuals with Aspergers is around 80 per cent. Social training, which teaches how to behave in different social situations, is generally more helpful to a man or woman with Aspergers than counseling.

==> VIDEOS: Understanding Your Partner or Spouse on the Autism Spectrum

Examples of Schedules for Children on the Autism Spectrum

A daily schedule benefits Aspergers (high functioning autistic) children by providing the structured environment that is critical to their sense of security and mastery. If you spend any time in a kindergarten or elementary school, you will marvel at the teacher's ability to organize the kid's day.

In this post, we will look at the following:

• Analyzing The Day 
• Brainstorming What You Want
• Writing Everything Down 
• Following the Schedule for a Week 
• Tweaking the Schedule
• An in-depth example of a schedule

Click here for the full article...

Diagnosing "Asperger's Syndrome" in Children

When moms and dads seek help for their youngster, they encounter varied opinions – he'll outgrow it, leave him alone, it's no big deal, he just wants attention, and so on. Many professionals try to work with the Aspergers (high-functioning autistic) youngster as if his disorder is like other developmental disorders, but it is quite different. In most cases, there is a great misunderstanding by many people of the needs of these special individuals.

For the inexperienced, recognizing the six defining characteristics of Aspergers as outlined in the introduction can be difficult, and misdiagnoses are quite common. This is further complicated by the fact that an Aspergers youngster or teen has many of the same characteristics found in other disorders. These various characteristics are often misinterpreted, overlooked, under-emphasized, or over-emphasized. As a result, a youngster may receive many different diagnoses over time or from different professionals.

For example, if a youngster with Aspergers demonstrates a high degree of attention deficit hyperactivity disorder (ADHD) -- that might be the only diagnosis he receives. However, this is a common characteristic of Aspergers kids. The same holds true if obsessive or compulsive behaviors are displayed – the youngster gets labeled with obsessive-compulsive disorder (OCD) instead of Aspergers. The following traits are also commonly seen in those with Aspergers in varying degrees. However, just because these traits are there, it doesn't mean that the youngster should be diagnosed differently; these traits should be noted as significant features of Aspergers:

• Anxiety

• Difficulty with pragmatic language skills

• Hyperlexia (advanced word recognition skills)

• Motor deficits

• Oppositional defiant disorder (ODD)

• Sensory difficulties

• Social skills deficits

As mentioned, professionals who do not have much experience with Aspergers have a hard time identifying the defining characteristics. For example, social skill deficits may be noted by a professional, but then they are often downplayed because the youngster or adolescent appears to be having appropriate conversations with others or seems to be interested in other people. But with an Aspergers youngster, the conversations are not generally reciprocal, so the youngster must be carefully observed to see whether or not there is true back-and-forth interaction.

Also, many Aspergers kids have an interest in others, but you need to clarify if the objects of their interest are age appropriate. Do they interact with peers in an age-appropriate fashion? Can they maintain friendships over a period of time or do they end as the novelty wears off? These are the types of observations and questions that must be asked in order to ensure a proper diagnosis.

Another example of an overlooked area is the narrow routines or rituals that are supposed to be present. This does not always manifest as obsessive-compulsive behavior in the typical sense, such as repeated handwashing or neatness, but rather in the insistence on the need for rules about many issues and situations. These kids may not throw tantrums over their need for rules, but may require them just as much as the person who has a meltdown when a rule is violated. In essence, there is no single profile of the typical Aspergers individual. They are not all the same, as you will see in later chapters.

Because of these subtleties and nuances, the single most important consideration in diagnosis is that the person making the initial diagnosis be familiar with autistic spectrum disorders – in particular, Aspergers. They should have previously diagnosed numerous kids. To make a proper, initial diagnosis requires the following:

1. An evaluation by an occupational therapist familiar with sensory integration difficulties may provide additional and valuable information.

2. It is important to include a speech and language evaluation, as those with Aspergers will display impairments in the pragmatics and semantics of language, despite having adequate receptive and expressive language. This will also serve to make moms and dads aware of any unusual language patterns the youngster displays that will interfere in later social situations. Again, these oddities may not be recognized if the evaluator is not familiar with Aspergers.

3. The youngster should see a neurologist or developmental pediatrician (again, someone familiar with autistic spectrum disorders) for a thorough neurological exam to rule out other medical conditions and to assess the need for medication. The physician may suggest additional medical testing (blood, urine, fragile X, hearing).

4. You and your youngster should have sessions with a psychologist where your youngster is carefully observed to see how he responds in various situations. This is done through play or talk sessions in the psychologist's office and by discussions with both moms and dads. The psychologist may ask you to complete checklists or questionnaires to gain a better understanding of the youngster's behaviors at home and/or school. If the youngster is in school, the psychologist may call the youngster's teacher or ask her to complete additional checklists. The checklists or questionnaires used should be ones that are appropriate for individuals with Aspergers. It is important to determine the IQ level of your youngster as well. An average or above-average IQ is necessary for a diagnosis of Aspergers.