Asperger's Syndrome

You'd be hard pressed to find a school-age child who hasn't at one time or another embarrassed his parents with inappropriate behavior, a seeming inability to interact well with other kids (you know—sharing, hitting, even biting), or at least been affected by another child's inappropriate behavior. And it's no wonder, since growing up is not all smooth sailing, especially when it comes to social development. As adults, many of us are apt to forget that children aren't born with social graces and must learn to share and empathize. While learning these social and interactive skills takes time for many children, for as many as four out of every thousand children—those with Asperger's syndrome (AS)—it's much more challenging.

Parents today may or may not have come across the term Asperger's syndrome, but chances are that even if you haven't, many of you will cross paths at one time or another with a child or adult with AS. Affecting boys three times as often as girls, AS is considered to be one of the less severe forms of social language disorders within the spectrum of autism. Characterized by social difficulties without other evidence of developmental delay, AS is sometimes referred to as "high-functioning" autism.

While the exact cause of this disorder has yet to be discovered, extensive research done in recent years has allowed us to more accurately define AS. Experts in the field believe AS is a genetically-based neurologic disorder that children are born with. Quite often, someone else in the family is found to have some of the characteristic traits of AS.

Asperger Syndrome Defined

As an overview, children with this disorder often have very limited interests, rely heavily on predictable routines, don't interact well with others, and have a hard time understanding the many subtleties of social interaction. At the same time, they often have impressive memory and language skills.

First dubbed "Asperger's syndrome" in 1944, AS was not officially recognized as a diagnosis by the American Psychiatric Association until 1994. Today, if you were to flip open the "bible" of psychiatric diagnoses (known as the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV), you'd find a list of specific criteria that help to define this syndrome. In an abbreviated form, they include:

  • Significant difficulty with social interaction. Quite simply, kids with AS not only have a hard time making friends, but they have a difficult time understanding how to even go about it. To better understand this important aspect of AS, imagine if you found yourself unable to "read between the lines." You'd be left with a literal interpretation of everything that was going on around you. For kids with AS, this means daily problems interacting with the world around them such as misinterpreting humor and sarcasm, and having a difficult time distinguishing between good-natured fun and teasing. Similarly, if you weren't able to pick up on subtle non-verbal clues, you'd miss all of the facial expressions, gestures, and body postures we all use to guide our daily social interactions. Without a diagnosis (and sometimes even with one), you'd likely be looked upon as socially inept.
  • Repetitive, stereotyped behaviors and interests. This characteristic of AS is what makes many people relate AS to autism. In addition to the stereotyped movements commonly associated with autism, such as hand flapping, children with AS tend to become preoccupied with specific and often eccentric interests. As an example, imagine a young child who is "into" trains. This is certainly not uncommon—as evidenced by the Thomas the Tank Engine aisle of your local toy store (or even, perhaps, the playroom in your own house). But now imagine a child who is not just into trains, but really into trains, and who has the ability to memorize endless details about anything and everything to do with trains that defies the abilities of most adults ... and that characterizes AS.
  • No significant delay in language or cognitive development, or in normal, age-appropriate self-help skills and behaviors that don't involve social interaction. This is in contrast to autistic children. For example, children with AS not only tend to have normal language development, but many are actually quite precocious—learning to speak at an early age, rapidly building an extensive vocabulary, and having impressive memories.
  • Sensory Overload

    Along with the criteria spelled out in the DSM-IV, another interesting characteristic noted in children with AS (as well as many who do not have AS) is an increased or unusual sensitivity to sounds, smells, and/or sensations. For some, this hypersensitivity makes tags, elastic waists and cuffs on clothing particularly irritating. For others, sounds that are barely audible to others become distractions, and loud noises such as alarms, fireworks, vacuum cleaners, or telephones unbearable.

    The Impact of AS

    For a child with AS, life typically becomes more frustrating right around the time when other children begin to master important social skills. At age two, a child who refuses to share or who copes with change by throwing a tantrum is hardly noticed. But as 4- or 5-year-olds begin to feel empathy, learn to "go with the flow," share, play together and interact, AS children begin to stand out in their inability to do so. While parents often detect some social problems on their own, it's often not until children go to school that their significant inability to socialize becomes more obvious. This is why the diagnosis is often made between the ages of 5 and 9. This also explains why children with AS—especially those who have yet to be diagnosed—have problems in and out of school. Any of a variety of simple triggers such as misinterpretation (childhood slang, expressions, and jokes), deviation from routine (a substitute teacher), or exposure to overwhelming stimuli (classroom chatter or a fire drill) can cause them to not only become inwardly anxious, but outwardly upset and on occasion, even unacceptably violent.

    An Approach But No Cure

    Just as there is not a blood test or X-ray that can diagnose AS, there is no pill to offer as a cure to those diagnosed with it. Although there's no complete cure for the condition, quite a bit can be done to help children (and adults) with AS function more acceptably in society. Simple modifications such as offering concrete explanations of expressions we typically take for granted, specifically discussing how to handle predictable social situations, and creating structured environments with less distracting stimuli and regular routines help tremendously. So does having a better understanding of the syndrome and knowing where to get help. While this article offers you a very basic overview, it doesn't begin to get into all of the details of living with AS. Fortunately, there are many useful resources available to you for more information. A few of the many available include:

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