The vast majority of referrals for a diagnostic evaluation for
High-Functioning Autism (HFA) are boys. The ratio of males to females
is roughly around 10:1; however, the epidemiological research for HFA
suggests that the ratio should be 4:1. Why are girls less likely to be
identified as having the characteristics indicative of an autism
spectrum disorder?
Early detection of Aspergers is difficult because kids who have this disorder are high-functioning.
Here are some signs and symptoms reported by parents with children who were later diagnosed with Aspergers:
• As their language develops, Aspergers kids often have pronoun reversal, such as saying, “you want help” instead of “I want help.”
• Aspergers infants are often described as having been “serious” and or “thoughtful.”
• Aspergers kids often do not wave “hi” or “bye” when expected and do not use a pointing gesture to share items of interest.
• Kids with Aspergers begin to talk at the expected age, saying their first words around 12 months of age. However, their actual first words are often unusual (e.g., such first words as palm pilot, sheetrock, clock, mountain, fish, hammer). These words are generally used before the youngster says “mommy” or “daddy.”
• Language is often interpreted extremely literally (e.g., one 4-year-old boy would get upset when his mother said that she was going to “fix dinner” because the dinner was not broken).
• Many moms and dads also report extreme “stranger anxiety,” where their babies would fuss or become highly anxious whenever anyone other than mom and dad were around.
• Many moms and dads of kids with Aspergers report that their newborns were excessively fussy or “colicky.” The babies were difficult to comfort and were often soothed by unique means (e.g., listening to the dishwasher, being held high in the air, laying on a running washer or dryer).
• The infants often show more interest in objects than people.
• They are often able to memorize phrases or chunks of dialogue which they use in their everyday speech (e.g., one 34-month-old would say, “Junky, that’s a big one” whenever he saw an animal of any size).
• Use of gestures is often either absent or exaggerated.
Here is an informal test parents can conduct to determine whether or not further testing is needed:
1. Choose a time when the baby is alert and calm. A tired, cranky infant may not yield accurate results in this test. Hold the infant at the waist in the upright position over a bed, couch or other soft surface.
2. Slowly tilt the infant to the left. Stop when the baby is at a 45 degree angle. Repeat this test by slowly leaning the infant to the right until the infant is at a 45 degree angle.
3. Note whether the infant tries to keep his head upright or if he keeps it aligned with the rest of his body. A baby with Aspergers will try to keep his head aligned with his body. A typical infant will try to keep his head in the upright position.
4. Repeat steps 2, 3 and 4. Repeating the test will ensure that the results are accurate. The second trial could be conducted by another adult.
5. Check for other signs. Does the child respond to his name? Does she smile at others? Does he make sounds or babble? A "no" to these questions is a red flag.
6. Follow through with a visit to the doctor. Any hint that your baby has Aspergers deserves an examination. The doctor can offer formal screening tools if it is deemed necessary.
Kids with Aspergers seem to evoke either the maternal or the predatory instinct in others. Aspies often lack subtlety in retaliating. Other kids may wait for an appropriate moment to respond without being caught. The youngster with Aspergers can also lack sufficient empathy and self-control to moderate the degree of injury inflicted on others. The Aspie is in a blind fury that gets him into trouble. The teacher sees the Aspergers youngster being aggressive and may not be aware of the taunts by his peers that precipitated the anger.
Parents often assume that their teenager with Asperger's (AS) or High-Functioning Autism (HFA) tries alcohol and/or drugs to rebel or to "fit in" with his peer group. However, teens with undiagnosed depression often use drugs and alcohol as a way to relieve their frustrations. A depressed teen on the autism spectrum may self-medicate with alcohol to escape the terrible sense of hopelessness. Unfortunately, alcohol only exacerbates the problem.
Some drugs may even make him feel "normal," when for weeks he has felt miserable. The impact of such drugs on serotonin, dopamine and endorphins (i.e., chemicals in the brain that regulate mood) can be devastating for these teenagers. The damage they do to receptors in the brain can make the road back from depression even harder.
Often parents approach the issue of drug and alcohol use as simply a discipline issue for a teen who is "bad." However, your "special needs" teen may be sick. He may be unable to express to you exactly how he feels. If your adolescent is self-medicating to treat depression, anxiety, or other emotional or behavioral disorders, simply applying more discipline and creating more rules will not impact the underlying problem that led to substance abuse in the first place.
While some teens on the spectrum self-medicate to treat depression, others end up with a serious mental disorder due to abuse of drugs or alcohol. Abusive drinking or drug use can seriously undermine your teen's physical, emotional, and psychological health. Some drugs, such as methamphetamines, can seriously affect the neurotransmitters, which are known as the "messengers of the brain." Recent studies suggest this damage can be long-lasting and even permanent.
Many AS and HFA teens have the mistaken notion that club drugs are benign. In fact, while they might feel "good" while taking them, they can make it difficult for the teenager to feel good naturally for a long time to come. The longer teens use these drugs, the more difficult treatment and the higher rate of relapse due to their inability to "feel good" or even "normal" because of the damage to their neurotransmitters.
Is your teen depressed? Answer these questions to find out:
1. Does your teen have little interest in his future?
2. Does your teen drink alcohol?
3. Does your teen smoke cigarettes?
4. Does your teen use drugs?
5. Has your teen quit activities he used to enjoy?
6. Does your teen seem to cry easily?
7. Does your teen seem like he is filled with guilt and remorse?
8. Has your teen been denying food saying he is not hungry?
9. Has your teen been easily agitated?
10. Has your teen been having a difficult time making decisions?
11. Has your teen seemed to have lost his energy?
12. Has your teen withdrawn from you or other family members?
13. Has your teen had recurrent thoughts of death or suicide?
14. Has your teen been falling asleep in class?
15. Has your teen felt hopeless?
16. Has your teen had problems sleeping at night?
17. Has your teen not been focused on what is going on in front of him, and is he often lost in his own thoughts?
18. Has your teen had a dramatic change in personality such as extreme irritability or sadness?
19. Has your teen had a hard time focusing on homework or reading?
20. Has your teen had an overwhelming feeling of sadness for no known reason?
21. Has your teen often feel fatigued, even when he has gotten enough rest?
22. Has your teen spent too much time in his room alone?
23. Has your teen withdrawn from his friends?
24. Has your teenager been over-eating?
25. Have you heard your teen put himself down, making derogatory comments and being overly critical?
If you answered yes to 5 or more of these, then your teen is likely suffering with depression.
AS and HFA teenagers have a difficult time relating their true feelings to others. The world is quite different today, and these young people face so many obstacles. If your teenager becomes withdrawn and disinterested, it is critical that you intervene in an attempt to see what the trouble may be. Many times a teen will open up to a close friend or family member that they are able to trust. Once a teen gains a comfort level, they will pretty much open up about anything.
Recognizing teen depression can be difficult at times, but it is important to intervene in an attempt to save a life. Teen suicide among teens wth an autism spectrum disorder is nothing new. Sometimes just talking things out will help the teenager immensely. However, sometimes it may take more than just a one on one conversation. In severe cases, the teen may benefit from psychological counseling with a professional.
Young Aspergers (high functioning autistic) teens entering high school look forward to having more choices and making new and more friends; however, they also are concerned about being picked on and teased by older students, having harder work, making lower grades, and getting lost in a larger, unfamiliar school.
As Aspergers teens make the transition into high school, many experience a decline in grades and attendance. They view themselves more negatively and experience an increased need for friendships. By the end of the 10th grade as many as 6% drop out of school. For middle school students, including those who have been labeled "gifted" or "high-achieving," the transition into high school can be an especially unpleasant experience.
