"What does treatment involve for a child with asperger syndrome? We are strongly considering getting our 7 y.o. some type of therapy, but do not know where to start. Also, what can we do as parents to assist in treatment ...or perhaps any self-help strategies to use? Lastly, any tips that we can pass on to our son's teacher to help with this?"Treatment is geared toward improving communication, social skills, and behavior management. A treatment program may be adjusted often to be the most useful for your youngster.
Take advantage of your youngster's strengths by encouraging him or her to explore interests at home and at school. Activity-oriented groups and focused counseling can also be helpful.
Many kids with Aspergers (high-functioning autism) also have other coexisting conditions, including attention deficit hyperactivity disorder (ADHD), bipolar disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, and depression. These conditions can place extra demands on parents who are already dealing with a youngster with extra needs. These conditions may require treatment with medicines and other therapies.
Medications:
There are no medications to treat Aspergers. But some medications may improve specific symptoms that may be complicating his or her progress — such as anxiety, depression or hyperactivity — that can occur in many kids with Aspergers.
Many kids with Aspergers do not require any medication. For those who do, the drugs that are recommended most often include psychostimulants (methylphenidate , pemoline), clonidine , or one of the tricyclic anti- depressants (TCAs) for hyperactivity or inattention; beta blockers, neuroleptics (antipsychotic medications), or lithium (lithium carbonate) for anger or aggression; selective serotonin reuptake inhibitors (SSRIs) or TCAs for rituals (repetitive behaviors) and preoccupations; and SSRIs or TCAs for anxiety symptoms. One alternative herbal remedy that has been tried with ASPERGERS individuals is St. John's wort.
Psychotherapy:
Aspergers individuals often benefit from psychotherapy, particularly during adolescence, in order to cope with depression and other painful feelings related to their social difficulties. Many kids with Aspergers are also helped by group therapy, which brings them together with others facing the same challenges. There are therapy groups for parents as well.
Therapists who are experienced in treating kids with Aspergers disorder have found that the youngster should be allowed to proceed slowly in forming an emotional bond with the therapist. Too much emotional intensity at the beginning may be more than the youngster can handle. Behavioral approaches seem to work best with these kids. Play therapy can be helpful in teaching the youngster to recognize social cues as well as lowering the level of emotional tension.
Adults with Aspergers are most likely to benefit from individual therapy using a cognitive-behavioral approach, although many also attend group therapy. Some adults have been helped by working with speech therapists on their pragmatic language skills. A relatively new approach called behavioral coaching has been used to help adults with Aspergers learn to organize and set priorities for their daily activities.
Cognitive behavior therapy:
This general term encompasses many techniques aimed at curbing problem behaviors, such as interrupting, obsessions, meltdowns or angry outbursts, as well as developing skills like recognizing feelings and coping with anxiety. Cognitive behavior therapy usually focuses on training a youngster to recognize a troublesome situation — such as a new place or an event with lots of social demands — and then select a specific learned strategy to cope with the situation.
Communication and social skills training:
Kids with Aspergers may be able to learn the unwritten rules of socialization and communication when taught in an explicit and rote fashion, much like the way students learn foreign languages. Kids with Aspergers may also learn how to speak in a more natural rhythm, as well as how to interpret communication techniques, such as gestures, eye contact, tone of voice, humor and sarcasm.
Home treatment:
You can best serve your youngster by learning about Aspergers and providing a supportive and loving home environment. Remember that your youngster, just like every other child, has his or her own strengths and weaknesses and needs as much support, patience, and understanding as you can give.
Educating yourself about the condition and knowing what to expect is an important part of helping your youngster succeed outside of home and develop independence. Learn about Aspergers syndrome by talking to your doctor or contacting Aspergers organizations. This will reduce your and your family members' stress and help your youngster succeed.
The following are some suggestions on how to help your youngster who has Aspergers. Some of the ideas will be helpful, and some may not work for you. Flexibility, creativity, and a willingness to continue to learn will all help you as you raise your youngster.
General strategies for success--
• Be aware that background noises, such as a clock ticking or the hum of fluorescent lighting, may be distracting to your youngster.
• Kids with Aspergers benefit from daily routines for meals, homework, and bedtime. They also like specific rules, and consistent expectations mean less stress and confusion for them.
• Kids with Aspergers often mature more slowly. Don't always expect them to "act their age."
• Many people with Aspergers do best with verbal (rather than nonverbal) teaching and assignments. A direct, concise, and straightforward manner is also helpful.
• People with Aspergers often have trouble understanding the "big picture" and tend to see part of a situation rather than the whole. That's why they often benefit from a parts-to-whole teaching approach, starting with part of a concept and adding to it to demonstrate encompassing ideas.
• Try to identify stress triggers and avoid them if possible. Prepare your youngster in advance for difficult situations, and teach him or her ways to cope. For example, teach your youngster coping skills for dealing with change or new situations.
• Visual supports, including schedules and other written materials that serve as organizational aids, can be helpful.
Strategies for developing social skills--
• Encourage your youngster to learn how to interact with people and what to do when spoken to, and explain why it is important. Give lots of praise, especially when he or she uses a social skill without prompting.
• Foster involvement with others, especially if your youngster tends to be a loner.
• Help your youngster understand others' feelings by role-playing and watching and discussing human behaviors seen in movies or on television. Provide a model for your youngster by telling him or her about your own feelings and reactions to those feelings.
• Practice activities, such as games or question-and-answer sessions, that call for taking turns or putting yourself in the other person's place.
• Teach your youngster about public and private places, so that he or she learns what is appropriate in both circumstances. For example, hugging may not be appropriate at school but is usually fine at home.
• Teach your youngster how to read and respond appropriately to social cues. Give him or her "stock" phrases to use in various social situations, such as when being introduced. You can also teach your youngster how to interact by role-playing.
• Your youngster may not understand the social norms and rules that come more naturally to other kids. Provide clear explanations of why certain behaviors are expected, and teach rules for those behaviors.
Strategies for school--
• Ask your youngster's teacher to seat your youngster next to classmates who are sensitive to your youngster's special needs. These classmates might also serve as "buddies" during recess, at lunch, and at other times.
• Be aware of and try to protect your youngster from bullying and teasing. Talk to your youngster's teacher or school counselor about educating classmates about Aspergers.
• Encourage your youngster's teacher to include your youngster in classroom activities that emphasize his or her best academic skills, such as reading, vocabulary, and art.
• Orient your youngster to the school setting. Before the school year starts, take time to "walk through" your youngster's daily schedule. You can also use pictures to make your youngster familiar with the new settings before school starts.
• Set up homework routines for your youngster by doing homework at a specific time and place every day. This will help your child learn about time management.
• Some kids with Aspergers have poor handwriting. Typing schoolwork on a computer may be one way to make homework easier. Using computers can also help kids improve fine motor skills and organize information. Occupational therapy may also be helpful.
• Use rewards to motivate your youngster. Allow him or her to watch TV or play a favorite video game or give points toward a "special interest" gift when he or she performs well.
• Use visual systems, such as calendars, checklists, and notes, to help define and organize schoolwork.
