The Warning Signs of Aspergers

Moms and dads should ask their youngster’s doctor for referral to a developmental pediatrician for assessment if there are concerns with any of the following...

Communication Red Flags:

• Loss of any language or social skills at any age
• No babbling by 11 months of age
• No response when name is called, causing concern about hearing
• No simple gestures by 12 months (e.g., waving bye-bye)
• No single words by 16 months
• No two-word phrases by 24 months (noun + verb – e.g., “baby sleeping”)

Behavioral Red Flags:

• Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)
• Lacks interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)
• Odd or repetitive ways of moving fingers or hand
• Oversensitive to certain textures, sounds or lights
• Preoccupations with unusual interests, such as light switches, doors, fans, wheels
• Unusual fears

Social Red Flags:

• Avoids or ignores other children when they approach
• Does not play peek-a-boo
• Doesn’t make attempts to get parent’s attention; doesn’t follow/look when someone is pointing at something
• Doesn’t point to show things he/she is interested in
• Doesn’t respond to parent’s attempts to play, even if relaxed
• More interested in looking at objects than at people’s faces
• Prefers to play alone
• Rarely makes eye contact when interacting with people
• Rarely smiles socially
• Seems to be “in his/her own world”

Are you wondering whether or not your pre-school aged youngster has Aspergers (high-functioning autism)? Take this simple little quiz:

1. Are they attracted to shows like Wheel of Fortune or Jeopardy?
2. Are they fascinated with numbers and letters?
3. Do they lack the ability to play "with" other children interactively?
4. Do they like to line objects up in rows?
5. Do they like to watch the same movie over and over again?
6. Do they seem unafraid of things that they should be afraid of?
7. Do they shun away from being touched or arch their back when held?
8. Do they spin objects around and around?
9. Do they walk up or down stairs always leading with the same foot?
10. Is it hard for them to make eye contact or they simply don't?
11. Is their speech repetitive, like an echo?

If you notice some or multiple signs in your child, write them down. Your concerns and observations are of great value for your pediatrician or professionals who are trying to diagnose your child.

Is it ADHD or Aspergers?

1. Discuss your concerns with your youngster's teacher. Kids who have ADHD and Aspergers often act very differently at school than they do at home due to over stimulation. Your youngster's teacher can offer important information that can lead to a proper diagnosis.

2. Notice if the youngster can stay focused under certain circumstances. Kids with Aspergers can sit still for long periods of time if they are interested in something. For example, they can still to watch a movie they are interested in or stay focused on a computer activity they enjoy. Kids who have ADHD will have trouble focusing on an activity even if they are interested in it.

3. Observe your youngster's behavior. Is your youngster's erratic behavior an everyday thing or is it in response to a traumatic event? All kids are hyper sometimes but a divorce or the death of a family member can cause kids to act out. Generally, if the behavior lasts for more than six months, it may be due to a disorder.

4. See how the youngster responds to medications and other behavior modification treatments. There are a number of medications to treat kids who are hyper active. But generally, you can find a medication to help calm a youngster who has ADHD. Kids who have Aspergers will not be calmed by medications such as Ritalin and Adderall. This is a big red flag since nearly every youngster who is diagnosed with Aspergers is initially diagnosed with ADHD.

5. Understand the differences between ADHD and Aspergers. Kids who have Aspergers typically engage in repetitive behavior, have a hard time dealing with change and are so inner-focused that they may appear to be self absorbed. Kids who have ADHD have a hard time focusing and sitting still but tend to be more aware of their surroundings than kids with Aspergers.

The Aspergers Comprehensive Handbook

Girls with Aspergers and HFA

More often identified in males than females, Aspergers and High-Functioning Autism (HFA) are characterized by compulsive pursuits, awkward communication skills, and problems with social cues.

The signs and symptoms of the disorder in females are often exhibited in a more subtle manner, which leads to missed or incorrect professional diagnoses, a lack of access to special education services and provisions in education, along with an increased potential for interpersonal and psychological difficulties in the adult years.

A number of unique differences exist regarding the ways that young ladies versus males with Aspergers behave:

• Females that have Aspergers and HFA aren't usually aggressive once they get irritated; instead, they tend to be withdrawn and may very easily "fly under the radar" in classrooms and other interpersonal situations. 
• Females with the disorder can communicate their feelings in a more calm way than their male counterparts. 
• Aspergers and HFA females tend to be safeguarded and nurtured by their neurotypical friends, who assist them to deal with challenging interpersonal situations. Acceptance from friends can occasionally cover up the problems these girls have so they aren't recognized by educators and moms and dads. Consequently, grown-ups are not as likely to suggest psychological and social evaluations.

There are specific personality characteristics and warning signs that moms and dads, educators, and specialists can search for when they believe that a young female may have Aspergers or HFA:

• Females with the disorder often exhibit compulsive traits regarding animals, dolls, and other female-oriented pursuits. While neurotypical females will play with dolls by pretending that they're interacting socially, Aspergers and HFA females might collect dolls and never use them to interact socially with other females. 
• Their passion for certain subject matter can result in them lagging behind their friends in terms of maturation and age-appropriate conduct (e.g., a pre-teen on the autism spectrum may be captivated by stuffed animals or cartoons long after other females their age have outgrown this stuff.
• Females that have Aspergers and HFA may be incorrectly assumed to possess a character disorder simply because they imitate typical kids - but use phrases inappropriately. 
• They are usually bored with kids their age and possess problems empathizing with their friends' concerns/problems. 

While their behaviors tend to be less aggressive than males on the spectrum, grown-ups who pay close attention to females with social and psychological delays can make sure that correct diagnosis and therapy will take place. The younger a female is when she starts to receive the appropriate speech, occupational, and psychological services, the greater likelihood she'll have a completely independent and functional adult life.

Females with Aspergers and HFA have the same difficulties with sensory processing and social navigation as males. In addition, they have telltale intense focus on a particular subject of interest.

Symptoms include:

Routine—

o Appears anxious when there are changes in routine

o Intense focus on a particular subject

o Practices rituals that appear to have no function

o Resists change

Physical—

o Difficulty coordinating movements

o Odd posturing

o Repetitive movements (stims)

Sensory processing—

o Dislikes textures in foods, clothes or objects

o No response or extreme response to noises

o Resists activities that involve movement (slides, escalators…)

o Seeks out sensory experiences (spinning, rocking…)

o Strong aversion to certain smells

Social difficulties—

o "Scripts" daily conversations

o Appears excessively shy

o Appears uncomfortable during conversation

o Avoids interacting with others

o Hesitant to make the first move

o Tends to "blend" into the crowd

o Tends to mimic rather than providing natural responses

It's not uncommon for females with Aspergers and HFA to go undiagnosed well into adulthood. Like heart disease, autism spectrum disorders are 10 times more prevalent in boys, so doctors often don't think to look for it in girls. But some experts have begun to suspect that unlike heart disease, the disorder manifests differently - and less obviously in females - which is also causing them to slip through the diagnostic cracks.

This gender gap may have implications for the health and well-being of females on the spectrum, and some specialists predict that as we diagnose more females, the profile of the disorder as a whole will change. Unlike males, females with ASpergers and HFA seem to have less motor impairment, a broader range of obsessive interests, and a stronger desire to connect with others despite their social impairment.

More resources for parents of children and teens with Asperger's and High-Functioning Autism:

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

==> Discipline for Defiant Asperger's and HFA Teens

==> Teaching Social Skills and Emotion Management

==> Launching Adult Children with Asperger's and HFA: How to Promote Self-Reliance

==> Everything You'll Ever Need to Know About Parenting Asperger's Children

==> Parenting Children and Teens with High-Functioning Autism

==> AudioBook: Unraveling The Mystery Behind Asperger’s and High-Functioning Autism

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Comments:

Anonymous said... Dear Dr. Mark, I am speaking at a retreat Aug 4 on the female perspective of AS. I am co-founder of Asperfemme, a support group for self- and officially-diagnosed women with ASD in Ottawa, Canada. I was 48 when I was diagnosed, three years after my two-decade long married ended, and have splinter skills in music (absolute pitch) and language (hyperlexia) which I have parlayed into self-employment as a private music teacher (after several failed careers.) We older women are struggling with financial needs, broken or troubled relationships, sometimes children on the spectrum, on top of the regular aging stuff. I would be interested if any of your research and writing deals with this largely unexplored group (a subgroup of "the spectrum within the spectrum" as Dr. Kevin Stoddart of Toronto's Redpath Centre calls Asperger's). I do find we women are less rigid about routines, and have fewer self-soothing behaviors (stims) than the men. We also tend to get sad and anxious rather than angry, a fact my marriage counselor could not deal with. I was introduced to you in the article "Children with High-Functioning Autism: 'Gifted' or Hyperlexic" on the My Aspergers Child web site (excellent by the way.) My precocious reading skill was considered cute, and not a sign in 1963 that anything was wrong. I think my parents were relieved that I amused myself with books, because I was quiet and no trouble while they dealt with my two rambunctious younger brothers born 11 months apart. I ended up in a Gifted class for 4 years (Grades 5 to 8) and had few friends, being chosen only for the spelling team. I flew entirely under the radar with my good academic record--a child seen and not heard. Looking back I also had selective mutism, excellent mimicry, apraxia and poor executive function. I firmly believe the piano saved my life, as it gave me an outlet and later a means to communicate. Public performance was very hard, but I learned to develop 'show' and private persona.

CoolMama said... I'm glad to see someone writing about girls/women on the spectrum. Like ADHD, women tend to present differently than boys/men do with regard to "symptoms" or characteristics. For myself, when I got into middle school (junior high back then), I learned about acting. For me, being involved in theater classes allowed me to become someone else, someone who wasn't "weird", who wasn't bullied or teased. I learned about personas, roles, and finally felt like I'd found a group where being a misfit was accepted and even embraced. Some might think being on stage as completely opposite to the social awkwardness inherent to ASD/Asperger's--I disagree. When you act, you aren't yourself, so you have the freedom and confidence to overcome your weaknesses. Plus, most interactions are scripted (I didn't do so well at improv, for example). You memorize your lines, and you learn techniques for portraying emotion. It's pretend play at the highest level. Not only was it a life-saver for me in school, it helped me once I tried to get a professional job. Interviews are all about presenting an image, and presenting an image is about projecting a persona, or playing a role. Other ASD individuals may have difficulty with "feeling like a fraud", and I totally get that--but I chose to look at it as being on stage. The "role" I created was just the best parts of me, the parts I wanted to stand out and be noticed. Theater isn't the solution for every person with ASD...but it is something to consider.

Aspergers Teens and Online Gaming Addiction

For many children and teens, computers offer an escape from difficult social situations along with a partial remedy for the loneliness of Aspergers (High-Functioning Autism).

The PC itself offers a predictable false-companionship, and teens who use computers may also band together in common-interest clubs. Such teens may become involved with PCs to the exclusion of almost every other hobby.

Despite the fact that there's a lot of mayhem on the web, inter-personal contact on the web can provide a "nerdy child" a level of defense against actual face-to-face contact. For example, in chat rooms, body language, facial expression, intonation, pacing, and timing of speech are removed in the interpersonal exchange. In role playing games, the interactions between participants are influenced by guidelines associated with traits the virtual person has accrued throughout play. A young man who's just a geek in class may become a strong and dreaded warrior within an online fantasy game.

Since a number of these children are so hungry for interpersonal connection, most of them invest a massive amount of time at their PCs, ignoring family members, homework, and much of the "real world." Even worse, for sleep patterns, the PC is "usually open." A number of these kids fall asleep later and later, particularly in the summertime, ultimately moving their sleep cycle so that they snooze when the rest of the family is up. This only worsens their lack of social skills, regardless of how successful their virtual character is becoming inside an online fantasy game.

While such cases are rare, mental-health professionals say the fantasy worlds offered by video games can become the stuff of very real addictions that destroy the education of an Aspergers teen. It's a huge and growing problem with older teenage males and young adult males with Aspergers. I've seen a number of cases with 18- to 23-year-old males where they have an Internet connection, and they basically haven't left the house for years. I had one young man who was trying to get on Social Security disability for agoraphobia. He didn't really have agoraphobia …he just didn't want to leave his computer.

My Aspergers Teen: Discipline for Aspergers Teens

Aspergers and Lack of Eye Contact

Eye-to-eye contact is a type of communication. However, there ought to be a shared language involving two individuals when eye-to-eye contact is made. A person should be able to read what the other person is thinking and feeling. That's the way "neurotypical" (i.e., non-Aspergers) eye contact functions. With Aspergers (high functioning autism) however, that's not often the situation.

Eye-to-eye contact isn't something that is natural or even desirable to Aspies. They have trouble with the interpretation of this language. Many reasons exist why they can't share the language.

First, looking at someone's eye balls is extremely awkward. It is just like looking at the headlights of a train. Eye balls flicker and move, which can be unpleasant for those who have Aspergers. Even if they do make eye contact, they do not know the silent language. They need to learn each thing that the eyes tell them, from very obvious to very subtle.

The next issue is in what they send. They have no clue about what messages they're sending using their eyes. That triggers confusion for the one who is attempting to read them, because they don't send obvious messages. With this confusion on both sides, conversation using this method doesn't work well. The big deal relating to this whole eye-to-eye contact issue is the fact that our culture has built in a lot of meaning into the use of eye contact. We've interpreted this as an indication of trustworthiness and not hiding something, being secure, and the skill of listening.

These are the expectations that are put on everyone in this culture, whether we are able to make eye contact or not. If you don't use it, you are charged with lying, not being comfortable, having something to hide, not listening, etc. This may not seem sensible when you have Aspergers. I have yet to meet individuals with Aspergers who are natural liars. A number of them have had to learn to be devious when they need to be and tell the little white lies, so they don't hurt the feelings of non-Aspergers individuals. Bluntness has never harmed anybody. They lie only if they have to, and it is not very natural to them. Therefore, convinced that they lie due to not having eye-to-eye contact makes no sense.

Eye contact has nothing to do with listening. The eyes as well as the ears aren't linked on a single band. Aspergers people may hear and learn without needing to really look at somebody. There's also peripheral vision, which is looking - but from the sides of the eyes. Non-Aspergers individuals believe that if the eye-to-eye contact isn't full in the face, it's not eye contact. Aspergers individuals can be comfortable and never give eye-to-eye contact. Actually, they're much less comfortable should they have to give it every time. It is stressful and diminishes their self-ease. The truth is, should they meet someone who they don't know, they don't give eye-to-eye contact. They have a tendency to avoid stressing themselves to provide eye-to-eye contact and have a dialogue simultaneously.

Eye-to-eye contact is for the benefit of non-Aspergers individuals and not much of a benefit for the people with Aspergers. They can't do it adequately, nor communicate it very well. Additionally, it stresses them and makes them uneasy.

The Aspergers Comprehensive Handbook

Grandmothers Raising Aspergers Grandchildren

More than 3.9 million grandmothers are raising their grandkids in their homes. Overall, about 5.4 million kids nationwide live with their grandmothers. In fact, one in 10 grandmothers has been the primary support of a grandkid at some time in their lives. While this is not a new phenomenon in this country, the rate of grandmothers raising their grandkids is increasing, and there is every reason to believe the numbers will continue to grow.

Kids with Aspergers (high-functioning autism) have a special need in their lives for ‘safe’ people who won’t criticize them or put them down for their differences. They need loving, non-judgmental grandmothers who accept them as they are and make a place for them in their lives. If you can reach out to them, they will treasure your relationship with them for the rest of their lives.

Many grandmothers in this care taking role underestimate or are unaware of the added burdens their new role as "mothers" will place upon them. Grandmothers often assume their role will be to nurture and reward kids without having to set limits. When grandmothers serve as mothers, however, they must learn to set limits and establish controls as they did with their own kids.

Grandparents raising Aspergers grandchildren should provide the following:

• advocacy that builds a support system around the kids in their family, neighborhood, and community
• affection and compassion freely given
• guidance modeled by the grandparents’ behaviors
• establishing and maintaining reasonable limits, direction, and activities to meet their needs
• motivation that models and stimulates curiosity and imagination in learning about the world
• nurturing with kindness and attentive listening to feeling and ideas
• understanding that takes into consideration how the grand kids view, influence, and respond to the world around them

In the best of circumstances, kids who are being raised by their grandmothers are going to experience loss and abandonment as well as other issues relating to their place in the family. This is not what they expected out of life.

Nobody knows what causes Aspergers, though most scientists acknowledge a genetic factor. So the deficits your grandkid has can only be understood, minimized and worked around. They will require accommodating on everyone’s part. But in time, with proper programming, the kid’s behavior and understanding of the world should improve.

Often, grandmothers take on the parenting role when the grandkid's own mothers abandon them or when the kids can no longer live with them because of the parent's mental disorder, substance abuse, or incarceration. Thus, you may have the added burden of caring for kids who suffered from abuse or neglect from their own mothers. These kids may feel insecure and afraid; they may be angry at their situation and even embarrassed by it. It will take time for these kids to feel safe and secure. You can encourage these good feelings and ease their adjustment to their new home in a number of ways:

• Help your grandkids to feel that they are "home" by making room for them and their belongings. Your home needs to be welcoming, safe, and kid-friendly.
• Practice positive discipline that emphasizes education, not punishment, and that rewards good behavior with praise.
• Set up a daily routine of mealtimes, bedtime, and other activities so that the kids have some predictability in their lives.
• Set up a few rules, and explain the rules to the kids. Then, enforce them consistently.
• Work on communication skills. Talk to your grandkids, and make sure that the kids know that they can always talk to you.

The deficits that comprise Aspergers are not always readily apparent, especially in milder cases. The kid is usually of average intelligence or higher, yet lacks what are essentially instincts for other kids. If your grandkid seems “perfectly normal” despite the diagnosis you’ve been told about, then he is probably working very hard to make sure he fits in - and it’s not as easy as it looks. It is best to treat your grandkid for what he is - normal. But be prepared to take some advice from those closest to him regarding what is the best way to handle certain situations.

Building new relationships can be difficult. Sometimes, it helps to find things that you can do with your grandkids to nurture your relationship and to make them feel secure and happy in their new home:

• There are many local support groups for grandmothers raising grandkids, and a number of these groups also provide activities for the kids. You might also find welcoming groups at your place of worship or in the local schools or library.
• If you don't have your own computer, use the one at the public library. The library may have classes or other free help for you. You'll find lots of things that you and your grandkids can do on the computer, from games to school research.
• Kids of all ages need to be active. Physical activity may help your grandkids feel better and develop a healthy lifestyle, and it can be an important stress reliever for you.
• Kids love to hear stories, and even older kids may surprise you by sitting quietly as you read aloud. Kids who see you read have a better chance of becoming readers themselves.

Look for ways to be supportive. Let them know that there is another heart tugging at the load - and it’s yours. Keep on the lookout for articles about Aspergers and send them copies. This shows that you are interested. Ask lots of questions about the special programs the kid is in. Be enthusiastic and optimistic. Let them know you think they’re doing a great job. At other times, you can be a sympathetic sounding board when they have difficult decisions to make, or when they just need to tell someone what an awful day they’ve had.

If you're feeling stressed, overwhelmed, and unhappy, you are not going to be able to provide the best care for your grandkids. It's important that you take care of yourself and not allow yourself to be overwhelmed by your parental responsibilities. Here are some suggestions:

• Talk to someone. This could be a friend or relative or a professional, such as a counselor, family doctor, or someone at your church or temple. Unburdening yourself can be a stress reliever.
• Take a parenting class. A class may help you to feel more comfortable with your status as a caregiver for young kids. It will also provide resources in the form of your teacher and the other students in the class.
• Take a break. A short time away from your grandkids may give you some time to relax. Look for a trusted adult who can babysit or take over while you're out.
• Learn to say "no." You don't have time to do everything. Learn to make priorities, and eliminate the unnecessary tasks in your life.
• Find a support group—either a group specifically for grandmothers raising grandkids or some other support group where you can share your challenges with others who will understand.

Your grandkid needs to know that you are a safe haven in a bewildering world. It may seem a lot to ask to be flexible with a kid who appears to be misbehaving, but inflexibility will only put distance between you and the kid. If the kid’s manners and mannerisms drive you crazy, ask others for suggestions on how to set expectations for your house.

It might be helpful to think of yourself as a seeing-eye dog. Remember, your Aspergers grandchild is “blind” in certain ways. Point out trouble-spots and guide him around them, explain social situations that he can’t “see,” and narrate what you are doing as you do it. By doing so, you’ll help him to feel more secure with you, and you’ll be actively participating in his special programming.

Watch the emotional levels. Asperger kids often have great difficulty sorting out emotions. If you get angry, the kid could lose control because she is unable to deal with your anger and her own confusion at the same time. Reign in your temper when the kid is clumsy, stubborn, or frustrated. In situations where you feel you really need to be firm, keep your tone calm, your movements slow and even, and tell the kid what you’re going to do before you do it. Get advice from others on how to deal with little meltdowns so that you are prepared in advance, but do your best to avoid triggering them.

Here are some simple DO’s to remember:

• Do acknowledge the kid’s expressions of frustration.
• Do control your anger.
• Do get involved in the kid’s interests.
• Do learn what sorts of activities are recommended for the kid.
• Do praise the kid for his strengths.
• Do respect the kid’s fears, even if they seem senseless.

Here are some simple DON’T’s to remember:

• Don’t compare him with his siblings.
• Don’t feel helpless - ask for help.
• Don’t joke, tease, shame, threaten, or demean the kid.
• Don’t talk to him as if he were stupid.
• Don’t tell the kid he will outgrow his difficulties.

There is lots of useful free information for grandmothers. Much of it is available on the Internet. If your computer skills are a little rusty, you can find help at your public library.

The Aspergers Comprehensive Handbook