17.2.11

Aspergers Symptoms in Infants, Toddlers, and Older Children

Aspergers (high functioning autism) consists of problems with socializing and communication with others. While the average age of diagnosis of Aspergers in kids is around age 7 to 9, recent research regarding early warnings signs may enable clinicians to diagnosis prior to 12 months.

Aspergers Symptoms in Infants—

Many infants and toddlers exhibit signs or symptoms of Aspergers from time to time; however, this may reflect normal youngster behavior. Failure to meet expected developmental milestones doesn’t necessarily reflect a symptom of Aspergers. With these facts in mind, symptoms of Aspergers may be detected in infancy.

• Early Signs— Kids generally attain certain developmental milestones within the first year of life. Some of these include unassisted standing, crawling, and simple gestures, including waving. Some kids with Aspergers fail to attain these milestones within the first year, potentially serving as an early warning sign. Within the first several months of life, an infant with Aspergers may fail to interact appropriately with his environment. These infants may avoid eye contact and interactions, prefer solitude, and avoid attention and affection. Later in infancy, some kids with Aspergers may show problems reacting with activities and objects. These kids may over react or fail to react at all. Initial signs of repetitive behaviors may emerge at this time as well, such as rocking.

• Abnormal Non-Verbal Communication— Babies with Aspergers might exhibit abnormal methods of non-verbal communication. Normally, a youngster will look another person in the eye and have appropriate facial expressions or exhibit predictable body postures or gestures. Infants will not look at people speaking to them or react to auditory stimuli. They will have subdued facial expressions. Body posture, or body language, will be noticeably abnormal in babies with the disorder.

• Lack of Social Skills— A problem with the development of social skills is one of the most common symptoms of Aspergers. This manifests as an inability to communicate properly with others. Infants and toddlers will exhibit this symptom by showing delays in social development. Babies may not exhibit a social smile until much later on in their life. Infants may totally ignore the voices of the moms and dads or strangers, or conversely cry and become irritable when confronted with any form of social contact. As the youngster ages, the lack of normal social skills becomes more apparent.

• Language Development— A key difference between autism and Aspergers is the normal development of language found in kids with Aspergers. By 12 months, a youngster should begin saying single words, including kids with Aspergers. The Aspergers child’s first words are often unusual despite reaching this developmental milestone. More complex words, such as "mountain" or "sheetrock" tend to emerge before simpler words, such as "Mama" or "Dada."

• Obsession with Complex Topics— Young kids with Aspergers may become obsessed with complex topics, such as intricate patterns or music. Toddlers will become enraptured by a stylized pattern on a fabric or in a book. Babies may also listen to music that would typically be ignored by a normal youngster. This obsession becomes more apparent as the youngster ages. These children may be unable to focus on any other aspect of the environment once they notice the object of their obsession. Behavioral conditioning will be necessary to help alleviate this symptom.

• Poor Coordination— Uncoordinated movements are a common symptom in Aspergers. Kids may be seen moving clumsily and be unable to coordinate movements of the hands or feet. They might exhibit an odd posture or have a stiff, rigid gait. Infants may show a delay in learning how to crawl or walk, and may also exhibit a delay in fine motor movements, such as grasping an object.

• Reflex Abnormalities— Infants with Aspergers appear to demonstrate abnormal reflexes versus normal kids. Kids with Aspergers tend to exhibit a persistence of the asymmetrical tonic neck reflex beyond their fourth month of life, when the reflex generally disappears. When infants 4 months and older without Aspergers roll over, they turn in the same direction as their head is facing. Asymmetrical tonic neck reflex is the opposite of this; the infant turns over in the opposite direction to where the head is facing. Kids with Aspergers in general continue to show other reflexes that disappear in other kids at the same age. Additionally, they may lack reflexes that should develop by a certain age, such as the head-verticalization reflex at 6 to 8 months. An infant who has developed this reflex will maintain his head in a vertical position when his body is tilted. Infants with Aspergers show delays in this reflex; their heads will tilt along with their bodies. Detection of these reflex problems in infants requires assessment by professionals trained in special techniques.

• Intervention— Detecting Aspergers is crucial in improving the long-term outcomes for these kids. Prevention of later life problems, such as mental illness, social illness, and underemployment, may be avoided with early intervention. Therefore, knowledge of early symptoms of Aspergers disorder in infants remains paramount in mitigating outcomes for these kids.



Aspergers Symptoms in Toddlers—

Toddlers (approximately ages 1 to 4), may not show specific symptoms, but certain behavioral abnormalities may be noted.

• Communication— Unlike toddlers with autism, a toddler with Aspergers generally does not experience difficulties in language development and speech. Vocabulary is often advanced in toddlers with Aspergers, though as language develops, moms and dads may notice that the youngster has difficulty properly using their vocabulary. Toddlers may talk incessantly about one subject, without acknowledging the listener.

• Delayed Concept of Joint Attention— The idea of joint attention is the rather abstract concept that two individuals (e.g., the toddler and his parent) can be focused on the same thing. An example of joint attention is looking at a picture in a book together. A toddler with Aspergers may have a hard time getting this concept.

• Delayed Pointing— One of the developmental milestones of the first year of life is to be able to point to a desired object. By one year of age, a youngster will probably be pointing to objects that interest him. However, a toddler with Aspergers may not reach this milestone until later.

• Delayed Use of Gestures— Actions such as waving or giving a toy when asked seem like simple tasks. However, to a youngster with Aspergers, these simple gestures may not occur "on schedule" and may instead be delayed. This is because such gestures involve interaction between the youngster and another individual; such social interactions are difficult for the youngster with Aspergers.

• Motor Skills— Problems with motor skills are a common symptom of Aspergers. Delayed learning in playing catch, potty training, learning to ride a bike or walking on tip toes are usually noticeable in kids by the age of 3. Their movement may be described as clumsy or uncoordinated. While symptoms are sometimes noticeable as early as infancy, many moms and dads sense something different about a youngster with Aspergers by the youngster's 3rd birthday. In some cases, early language skills are retained, but the lag in motor development may be the first sign that something is different than "typical" 3-year-old behavior.

• Nonverbal Communication— Abnormalities in nonverbal communication are often apparent in kids with this condition. A lack of eye contact may occur accompanied by limited facial expressions which correspond with words the toddler is speaking. The youngster may also exhibit unusual body movements and gestures.

• Preoccupation— One of the most apparent symptoms of Aspergers in toddlers is their intense interest in a single topic, such as trains or maps. Kids with Aspergers want to know and spend a lot of time trying to learn about their hobby or interest, and they may use an advanced vocabulary and exhibit a high level of expertise on the subject. Some Aspergers toddlers need to establish rigid repetition and routine in their daily activities.

• Reading— Toddlers with Aspergers are often not diagnosed until later in childhood as they sometimes learn to read very early. The perceived advancement overshadows the fact that the youngster with Aspergers often cannot comprehend the words he is reading.

• Repetitive Behaviors— Repetitive interests and behaviors are defining components of the diagnosis of Aspergers. However, repetitive interests are actually quite normal in toddlers. While it is very difficult to determine with such young kids, some signs that behaviors and interests have crossed the line from "normal toddler who loves trucks" to "concerning toddler who seems too wrapped up in trucks" may be noted. These include a very specific interest (e.g., not just "trucks" but "the front bumper of trucks"); an interest that is unusual compared to his peers (e.g., a 3-year-old who intensely focuses on brooms); and an inability to shift focus from the area of interest to other things.

• Sensitivity to Stimuli— Some toddlers with Apsergers will have an unusual sensitivity to loud sounds or lights. They may also be bothered by other physical stimuli (e.g., they may be sensitive to the way certain clothing or material feels or need their socks to be on their feet in a particular way).

• Social Difficulties— Toddler’s with Aspergers usually have difficulty in social situations, such as when playing with other kids. This could be due to delayed motor skill development causing clumsiness, notes Toddlers Today. The interests of a toddler with Aspergers tend to be very limited, causing the youngster to have a very narrow focus of activities and interests.

• Social Skills— A common aspect of Aspergers is demonstrated by poor social interactions. Toddlers with Aspergers may seem to have one-sided social interaction and limited ability to form friendships. Non-verbal behaviors are also notable in these kids (e.g., unusual facial expressions, failure to gesture, aloofness or the inability to make eye contact). These symptoms become more apparent by the age of 3, and most kids are diagnosed between the ages of 5 and 9.

• Symptoms Related to an Associated Condition— Though there is still a lot of research that must be done, it seems that certain disorders may be associated with Aspergers (i.e., kids who have Aspergers may be at higher risk for having other disorders). For example, one study found that ADHD was often seen in a population of kids with Aspergers. So a toddler with Aspergers may also show symptoms of ADHD. Other conditions that have been found in kids with Aspergers include anxiety disorder and depression.

Aspergers Symptoms in Older Children—

Kids with Aspergers have deficits in three areas: communication, physical coordination and development of a range of interests. Aspergers is an autism spectrum disorder, meaning that it is on a continuum of development disorders that includes classic autism. Most kids with Aspergers are able to function with less difficulty than those with classic autism. A set of classic symptoms define Aspergers. A youngster with Aspergers may or may not display all of the symptoms listed below.

• Clumsiness— A youngster with Aspergers may seem clumsy and drop things. He may fall easily and try to avoid physical games that his peers are playing. He may have odd, repetitious movements or walk stiffly, as though he is in pain.

• Inadequate Math Skills— The youngster with Aspergers may have inadequate math skills, but will do well in vocabulary. He may have noted deficits in his ability to learn some subjects, but will speak like an expert about another. Learning abilities may vary greatly from child to child.

• Lack of Empathy— Although a youngster with Aspergers is not mean, he may seem to be oblivious to the feelings of others. If someone's pet dies, he may not show sympathy as other kids might. He may seem to be interested in himself only, but does not purposefully do cruel things. H may seem emotionally immature for his age.

• Limited Non-Verbal Communication— A lack of eye contact when communicating is a sign of Aspergers. The youngster may have few facial expressions, and he may stare into space while speaking. He may make few gestures while speaking and adopt an odd body posture. He may not watch the facial expressions or body posture of the person who is speaking with him. The youngster with Aspergers may not seem to pick up on humor or any speech that is not direct, such as sarcasm or the use of figures of speech.

• Obsessive Interests— Another sign of Aspergers is obsessive interests. The Aspergers child may hone in on one or two topics and devote an extraordinary amount of time to studying them, looking at them or talking about them. This topic may vary, with some examples including an object, a musical score, an animal, the weather, sports history or visual patterns. He may seem uninterested in any other subjects, and most of the conversations he begins may be about his topic of interest.

• Unusual Speech— A youngster with Aspergers may have an unusual speech pattern, as though he is reading what he is saying. His voice may remind you of a robot, or he may have a monotone, as if he is depressed. His speech may seem overly formal or well thought out, instead of spontaneous. Alternatively, he may speak rapidly, without noticing that others speak more slowly.


16.2.11

Adults on the Spectrum: What Other Family Members Need To Know

ASD level 1 (high functioning autism) is typically first diagnosed in children. In contrast to those with ASD level 3, people at level 1 acquire language skills normally, develop appropriately in cognitive abilities, and tend to have higher-than-average verbal skills. The most significant feature of ASD is the inability to interact appropriately on a social basis. If untreated, many difficulties continue into adulthood.

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15.2.11

Aspergers and HFA Child Discipline 101

My 10-year-old son has been getting into trouble on multiple levels lately. He’s had two referrals at school within the last week, and his behavior at home is totally unacceptable. We've tried about everything we know to do at this point. How do you effectively discipline an obstinate child with autism (high functioning)?
 
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14.2.11

Aspergers Teens and Online Gaming Obsessions

Question

Our 15y/o son has always ‘marched to his own drummer,’ we just never really had a label for it. He is very smart and the computer became his life. In November, I ended up taking his computer away because he was failing his classes (we home school and he was taking some on-line classes), he was spending too much time on-line gaming and he was very involved with an on-line gaming clan that was appearing to be a very negative influence. (He has a history of ADHD treated with meds.)

After taking away the computer he had a major meltdown and refused to eat, leave his bed, participates in school/outside activities. We didn't know what to do. Consulted with several treatment centers, none of which would work with him b/c he is not violent, not in trouble with the law and not on drugs or alcohol. We are very thankful for that, but don't want to let it get to that point.

We met with a family counselor (we have tried counseling in the past without any progress) that was recommended and just couldn't seem to get anywhere so we insisted on a psychological evaluation - there had to be something we weren't seeing. His diagnosis came back as Aspergers, Depression and ADHD. We have had a lot of lying, refusal to do his responsibilities, refusal to do his school work etc... We have had to keep all computers and internet modems under lock and key. He can ‘hack’ into any password.

We have been working with Boy's Town in our home for the past two months. They have helped me a lot by being a sounding board, but nothing with my son. Their plan consisted of a parent class of which we watched the 5 or 6 videos, filled out an answer book and now they want us to find more in-depth work for his Aspergers because they don't feel trained in that.

I feel that the intense crisis is past but now we need to help our son learn to lead a responsible, successful life. I have been reading your handout that I purchased. Now where to begin...

Answer

Obsessions are one of the hallmarks of Aspergers, High-Functioning Autism, and other Autistic Spectrum Disorders. In order to cope with the anxieties and stresses about the chaotic world around them, Aspergers teens often obsess and ritualize their behaviors to comfort themselves.

Online gaming is a very popular obsession with Aspergers. However, don’t completely forbid your son to engage in this obsession. His use of the computer can be a great bargaining chip for you (i.e., he won’t work for what you want, but he will work for what he wants – and he wants to play computer games).

Breaking an obsession is like running a war campaign. If not planned wisely, or if you attempt to fight on many fronts, you're guaranteed to fail. The real issue here is the fact that your son spent too much time playing games, which resulted in poor academic performance. This resulted in a second issue, namely, his behavior took a turn for the worse after you took his computer away. Thus, he should be able to play video games, but within limits.

To make his games less seductive, find ways to minimize your son's downtime at home, especially those times when he is alone. Maybe he would be interested in arts and crafts, theater, martial arts, bowling, swimming, or movie-making. Maybe a social-skills group would be a good idea. Maybe he could join a youth group at your church or synagogue. Help your son find some activity that he likes and a place where he can do it.

Children with Aspergers and ADHD often lack the "internal controls" needed to regulate how much time they spend playing computer games. It's up to moms and dads to rein-in the use of the games. The first step is often the hardest. Both parents must agree on a set of rules:
  • How much time may be spent on a weekend day?
  • How much time may be spent playing the games on school nights?
  • If the child plays Internet-based games, which sites are acceptable?
  • Must chores be done first?
  • Must homework be done first?
  • Which games are taboo, and which are O.K.?

Once parents agree, sit down with your son and discuss the rules. Make it clear which rules are negotiable and which are not. Then announce that the rules start right now. Be sure you can enforce the rules (e.g., if your child is allowed to spend 30 minutes at computer games on school nights - and only after homework and chores are done - the game and game controls must be physically unavailable when he gets home from school). If games involve a computer or a television set, find a way to secure the system until its use is permitted. When the 30 minutes of playing are up, retake the controls. If he balks, he loses the privilege to play the game the following day. If you come into his bedroom and find him playing the game under the covers, he might lose the privilege for several days.

Give warning times: "You have 15 more minutes... You now have 10 minutes... There are only five minutes left." A timer that is visible to your son can be helpful. When the buzzer rings, say, "I know you need to reach a point where you can save the game. If you need a few more minutes, I will wait here and let you have them." If he continues to play despite your step-by-step warnings, do not shout or grab the game or disconnect the power. Calmly remind him of the rules, and then announce that for each minute he continues to play, one minute will be subtracted from the time allowed the next day (or days). Once you get the game back, lock it up. When he finally regains the privilege to play, you can say, "Would you like to try again to follow the family rules?"

Discipline for Defiant Aspergers Teens
 
COMMENTS:

•    Anonymous said... As a parent of two sons with Asperger Syndrome, I learned that children have a very heightened sense of justice. Instead of giving ultimatums, give them fair choices. Children know when a choice is not really a choice but a parent leveraging a demand. My two sons are grown adults now, 30s. Oppositional Defiant Disorder is part of the puzzle here: so it is important to give them choices, reward for good choices, and lots of routine and structure. My oldest son with Asperger could not function without his computer. Taking it away completely would cause a meltdown of cosmic significance--you might as well melt the sun. Instead, time at the computer was earned. Having visual written cues to transition from one thing to the next, rewards for completing. Once we learned about O.D.D.S. and how that works into O.C.D. and the Pervasive Depressive Disorder, I learned as a parent, to provide routine, structure, and fair choices not ultimatums. Putting an Asperger child into a meltdown by taking away their only means of real communication or escape (cocooning) would perhaps cause my oldest son to end his life. In fact, it wasn't until my son was in his second hospitalization for suicidal intent that the psychiatrist who debriefed us explained the 7 major components of Asperger Syndrome and explained some very important parenting styles which would help our son function much more smoothly in our world. Accepting that my sons are different and not forcing them into social situations where their peers hurt them and made fun of them, but only in structured social activities where they are not at risk was important. If any of this is helpful, hope it gives hope and that your son feels better soon.
•    Anonymous said... I've endured many harsh ignorant comments from family, church members, etc. who only see biological age but do not understand that my two sons are at about 8-10 years old as to mental maturity and they will never be like other adults. They can't live on their own because they don't have a sense of personal safety, don't understand money, time management, and would be extremely at risk for unscrupulous folks who might hurt them or take advantage of them. In my case, I am so thankful their older brother grew up and matured and he and his wife stepped in. The boys' father and step-mother have called my two sons idiots, lazy, rebellious...they were cruel. I'm am glad to read all the wonderful gifts and abilities your son has. My family participated in the U of WA Family Study of Autism with Dr. Geraldine Dawson and Dr. Julie Osterling--both very highly respected. I've learned so much over the last two decades. Very little, almost zero support back then for my boys and for parents. It has been a long road. My sons suffered so much from peers in school. And even a year or so ago, the one did not want to participate in board games and his older brother made a comment. I waited until the room was clear and said to my oldest, "Do you understand that for your brother, he loses these games every single time and it is not fun for him? Please do not ridicule or ever taunt him like that again. Look at it from his point of view." That is why I think they like their computers so much, because for the first time they can WIN at something and they don't have to try to be normal and fit in. I'm glad I could share anything about what I've been through and with my two sons if it helps. I got help 11 years ago from the DSHS here in my state for Phil's SSI from a social worker. My two sons are so smart and gifted musically, artistically, writing, and total masters of the computer and they're so nice and kind and just great young men. Praying you will make sure you get enough sleep and eat well, take your vitamins, and set a goal for getting the SSI application completed. Ask for help. Here we have an organization called WAPAS and they advocate for people with disabilities. Have you asked the ARC for help?
•    Anonymous said... I've met too many moms on these groups in the same boat as me and we all feel hopeless. People don't understand. They think he is full of excuses and lazy. I've seen my sons pain. They haven't. He says he isn't normal and life is too hard for him so why bother. He has in home therapy but is refusing services. I've been so occupied I haven't had the time or energy for an ssi application. I hear lots get denied. My son is so smart. He's a gifted writer and artist and I just want for him to be able too live independently some day. I recently went to court to gain guardianship of him because his functioning is very low. Thank you for your story. It gives me hope
•    Anonymous said... We got our son to the local community college at age 16 and he took the test for his HS diploma, passed with flying colors and began college at 16. Needed 504 Accommodations so we went through the college disability office. Is there counseling available? Someone who can come to the home through a community health care organization? I remember watching Rain Man, the movie, and understanding that these young men must be allowed to have their support systems. The computer seems to be the most non-threatening form of social communication. If you can, make peace with your son over his connection with his computer and ask him what he would like. If he understands that his computer will never be taken away, he may be much more willing to take the other little baby steps in his life. We make lists and do our best to avoid showdowns and do not give ultimatums. ODDS, OCD, and Pervasive Depressive Disorder are part of the Asperger 7 major components of behavior...so I heartily recommend that as the parent, you get as much support and help as you can. Also, introducing your son to other Asperger young men his age who are also computer nerds would help. My oldest son and his wife opened their home to the two with Asperger so they are no longer living with me and that seems to help also. Because sometimes I found my relationship with my oldest, who was the most depressed and most connected to his computer, needed some space of his own. He is doing much better. But the teen years and early 20s were a challenge. I had to learn to accept that my son's computer attachment represented an escape from what is mostly too much stimulation from the real world that he could not handle. And we regularly replace his 16" Peekachoo plush "friend" as that is his dearest companion that my son uses to talk to and he can express himself to that Peekachoo that he can't to people. These kids are so ignored by their peers or bullied by their peers and mostly invisible. It's hard on them. When the they know they are "different" they can get very depressed. But when they can reach out to others through their computers, that helps. Did you get SSI for your son? Hope so. We did and that pays for his medical and prescriptions. Hope this is helpful...in no way meant to soapbox...but having been through this, it is a long road but so worth it. My two sons are multi-geniuses and such wonderful kind individuals. But take away their computers would be like declaring WWIII, so once that issue was resolved, they could see the rest of life with a lot more cooperation They are both happy today and although they'll always live with their older brother and his wife, through their older brother they have friends. And the friends they make online through their music, animation and artistic gifts, are a blessing also.
•    Anonymous said... Your oldest son sounds like my 18 yo son. He threatens self harm at any attempt to take way his computer. He hadn't completed past 9th grade, isn't going to school or working or leaving the house and now not participating in in home therapy or behavior services. What's a parent to do? I worry about his future immensely

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Raising Kids with Autism Spectrum Disorder: Parents' Grief and Guilt

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