Are there medications that can treat or cure Asperger's?
Aspergers & Associated Conditions
“Our son is diagnosed with AS. He has stomach problems, difficulty sleeping, and can’t stand loud noises of any kind. Is this part of AS, or are these totally separate issues?”
It’s very likely that these issues are part of the Aspergers (AS) condition. There are a number of concerns that often accompany a child with Aspergers and High-Functioning Autism. Here are the primary ones:
1. Fragile X syndrome is a genetic disorder and is the most common form of inherited intellectual disability, causing symptoms similar to Aspergers. The name refers to one part of the X chromosome that has a defective piece that appears pinched and fragile when viewed with a microscope. Fragile X syndrome results from a change, called a mutation, on a single gene. This mutation, in effect, turns off the gene. Some people may have only a small mutation and not show any symptoms, while others have a larger mutation and more severe symptoms. Around 1 in 3 kids who have Fragile X syndrome also meet the diagnostic criteria for Aspergers, and about 1 in 25 kids diagnosed with Aspergers have the mutation that causes Fragile X syndrome. Because this disorder is inherited, kids with Aspergers should be checked for Fragile X, especially if the mom or dad wants to have more kids. Other family members who are planning to have kids may also want to be checked for Fragile X syndrome.
2. Some moms and dads of kids with Aspergers report that their youngster has frequent gastrointestinal (GI) or digestion problems (e.g., stomach pain, diarrhea, constipation, acid reflux, vomiting, bloating, etc.). Food allergies may also cause problems for kids with Aspergers. It's unclear whether kids with Aspergers are more likely to have GI problems than typically developing kids. If your youngster has GI problems, a doctor who specializes in GI problems, called a gastroenterologist, can help find the cause and suggest appropriate treatment. Some studies have reported that kids with Aspergers seem to have more GI symptoms, but these findings may not apply to all kids with Aspergers. For example, a recent study found that kids with Aspergers in Minnesota were more likely to have physical and behavioral difficulties related to diet (e.g., lactose intolerance or insisting on certain foods), as well as constipation, than kids without Aspergers. The researchers suggested that kids with Aspergers may not have underlying GI problems, but that their behavior may create GI symptoms (e.g., a youngster who insists on eating only certain foods may not get enough fiber or fluids in his or her diet, which leads to constipation). Some moms and dads may try to put their youngster on a special diet to control Aspergers or GI symptoms. While some kids may benefit from limiting certain foods, there is no strong evidence that these special diets reduce Aspergers symptoms. If you want to try a special diet, first talk with a doctor or a nutrition expert to make sure your youngster's nutritional needs are being met.
3. Some kids with Aspergers have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak (e.g., a youngster with Aspergers may do well on tasks related to sight such as putting a puzzle together, but may not do as well on language-based problem-solving tasks). However, most kids with Aspergers often have average or above-average language skills and do not show delays in cognitive ability or speech.
4. One in four kids with Aspergers has seizures, often starting either in early childhood or during the teen years. Seizures, caused by abnormal electrical activity in the brain, can result in: (a) staring spells; (b) convulsions, which are uncontrollable shaking of the whole body, or unusual movements; (c) a short-term loss of consciousness, or a blackout. Sometimes lack of sleep or a high fever can trigger a seizure. An electroencephalogram (EEG), a nonsurgical test that records electrical activity in the brain, can help confirm whether a youngster is having seizures. However, some kids with Aspergers have abnormal EEGs even if they are not having seizures. Seizures can be treated with medicines called anticonvulsants. Some seizure medicines affect behavior; changes in behavior should be closely watched in kids with Aspergers. In most cases, a doctor will use the lowest dose of medicine that works for the youngster. Anticonvulsants usually reduce the number of seizures but may not prevent all of them.
5. Many kids with Aspergers either over-react or under-react to certain sights, sounds, smells, textures, and tastes. For example, some may: (a) have no reaction to intense cold or pain; (b) experience pain from certain sounds (e.g., a vacuum cleaner, ringing telephone, sudden storm, etc.) and cover their ears and scream; (c) dislike or show discomfort from a light touch or the feel of clothes on their skin. Researchers are trying to determine if these unusual reactions are related to differences in integrating multiple types of information from the senses.
6. Kids with Aspergers tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behavior. In addition, moms and dads of kids with Aspergers and sleep problems tend to report greater family stress and poorer overall health among themselves. Fortunately, sleep problems can often be treated with changes in behavior (e.g., following a sleep schedule or creating a bedtime routine). Some kids may sleep better using medications such as melatonin, which is a hormone that helps regulate the body's sleep-wake cycle. Like any medication, melatonin can have unwanted side effects. Talk to your youngster's doctor about possible risks and benefits before giving your youngster melatonin. Treating sleep problems in kids with Aspergers may improve the youngster's overall behavior and functioning, as well as relieve family stress.
7. Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumors to grow in the brain and other vital organs. Tuberous sclerosis occurs in 1 to 4 percent of people with Aspergers. A genetic mutation causes the disorder, which has also been linked to mental retardation, epilepsy, and many other physical and mental health problems. There is no cure for tuberous sclerosis, but many symptoms can be treated.
8. The particularly high comorbidity with anxiety often requires special attention. One study reported that about 84 percent of Aspergers kids also met the criteria to be diagnosed with an anxiety disorder. Because of the social differences experienced by those with Aspergers (e.g., trouble initiating or maintaining a conversation, adherence to strict rituals or schedules), additional stress to any of these activities may result in feelings of anxiety, which can negatively affect multiple areas of one’s life, including school, family, and work.
It’s very likely that these issues are part of the Aspergers (AS) condition. There are a number of concerns that often accompany a child with Aspergers and High-Functioning Autism. Here are the primary ones:
1. Fragile X syndrome is a genetic disorder and is the most common form of inherited intellectual disability, causing symptoms similar to Aspergers. The name refers to one part of the X chromosome that has a defective piece that appears pinched and fragile when viewed with a microscope. Fragile X syndrome results from a change, called a mutation, on a single gene. This mutation, in effect, turns off the gene. Some people may have only a small mutation and not show any symptoms, while others have a larger mutation and more severe symptoms. Around 1 in 3 kids who have Fragile X syndrome also meet the diagnostic criteria for Aspergers, and about 1 in 25 kids diagnosed with Aspergers have the mutation that causes Fragile X syndrome. Because this disorder is inherited, kids with Aspergers should be checked for Fragile X, especially if the mom or dad wants to have more kids. Other family members who are planning to have kids may also want to be checked for Fragile X syndrome. 2. Some moms and dads of kids with Aspergers report that their youngster has frequent gastrointestinal (GI) or digestion problems (e.g., stomach pain, diarrhea, constipation, acid reflux, vomiting, bloating, etc.). Food allergies may also cause problems for kids with Aspergers. It's unclear whether kids with Aspergers are more likely to have GI problems than typically developing kids. If your youngster has GI problems, a doctor who specializes in GI problems, called a gastroenterologist, can help find the cause and suggest appropriate treatment. Some studies have reported that kids with Aspergers seem to have more GI symptoms, but these findings may not apply to all kids with Aspergers. For example, a recent study found that kids with Aspergers in Minnesota were more likely to have physical and behavioral difficulties related to diet (e.g., lactose intolerance or insisting on certain foods), as well as constipation, than kids without Aspergers. The researchers suggested that kids with Aspergers may not have underlying GI problems, but that their behavior may create GI symptoms (e.g., a youngster who insists on eating only certain foods may not get enough fiber or fluids in his or her diet, which leads to constipation). Some moms and dads may try to put their youngster on a special diet to control Aspergers or GI symptoms. While some kids may benefit from limiting certain foods, there is no strong evidence that these special diets reduce Aspergers symptoms. If you want to try a special diet, first talk with a doctor or a nutrition expert to make sure your youngster's nutritional needs are being met.
3. Some kids with Aspergers have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak (e.g., a youngster with Aspergers may do well on tasks related to sight such as putting a puzzle together, but may not do as well on language-based problem-solving tasks). However, most kids with Aspergers often have average or above-average language skills and do not show delays in cognitive ability or speech.
4. One in four kids with Aspergers has seizures, often starting either in early childhood or during the teen years. Seizures, caused by abnormal electrical activity in the brain, can result in: (a) staring spells; (b) convulsions, which are uncontrollable shaking of the whole body, or unusual movements; (c) a short-term loss of consciousness, or a blackout. Sometimes lack of sleep or a high fever can trigger a seizure. An electroencephalogram (EEG), a nonsurgical test that records electrical activity in the brain, can help confirm whether a youngster is having seizures. However, some kids with Aspergers have abnormal EEGs even if they are not having seizures. Seizures can be treated with medicines called anticonvulsants. Some seizure medicines affect behavior; changes in behavior should be closely watched in kids with Aspergers. In most cases, a doctor will use the lowest dose of medicine that works for the youngster. Anticonvulsants usually reduce the number of seizures but may not prevent all of them.
5. Many kids with Aspergers either over-react or under-react to certain sights, sounds, smells, textures, and tastes. For example, some may: (a) have no reaction to intense cold or pain; (b) experience pain from certain sounds (e.g., a vacuum cleaner, ringing telephone, sudden storm, etc.) and cover their ears and scream; (c) dislike or show discomfort from a light touch or the feel of clothes on their skin. Researchers are trying to determine if these unusual reactions are related to differences in integrating multiple types of information from the senses.
6. Kids with Aspergers tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behavior. In addition, moms and dads of kids with Aspergers and sleep problems tend to report greater family stress and poorer overall health among themselves. Fortunately, sleep problems can often be treated with changes in behavior (e.g., following a sleep schedule or creating a bedtime routine). Some kids may sleep better using medications such as melatonin, which is a hormone that helps regulate the body's sleep-wake cycle. Like any medication, melatonin can have unwanted side effects. Talk to your youngster's doctor about possible risks and benefits before giving your youngster melatonin. Treating sleep problems in kids with Aspergers may improve the youngster's overall behavior and functioning, as well as relieve family stress.
7. Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumors to grow in the brain and other vital organs. Tuberous sclerosis occurs in 1 to 4 percent of people with Aspergers. A genetic mutation causes the disorder, which has also been linked to mental retardation, epilepsy, and many other physical and mental health problems. There is no cure for tuberous sclerosis, but many symptoms can be treated.
8. The particularly high comorbidity with anxiety often requires special attention. One study reported that about 84 percent of Aspergers kids also met the criteria to be diagnosed with an anxiety disorder. Because of the social differences experienced by those with Aspergers (e.g., trouble initiating or maintaining a conversation, adherence to strict rituals or schedules), additional stress to any of these activities may result in feelings of anxiety, which can negatively affect multiple areas of one’s life, including school, family, and work.
Children with Aspergers may also be diagnosed with:
- ADHD
- Bipolar disorder
- Obsessive compulsive disorder
- Tourette syndrome
- Clinical depression
- Visual problems
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism
==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance
==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism
==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook
==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism
How Asperger's [High-Functioning Autism] Is Diagnosed
“My husband and I suspect our 7-year-old boy has Asperger’s, but admittedly, we have procrastinated having him diagnosed for fear of labeling him with something that will follow him the rest of his life. Should we pursue a formal diagnosis simply based on our suspicions? And how do children get diagnosed with Asperger’s?”
It’s better to know than not to know. If your child has Aspergers and nobody knows it, the disorder affects him anyway. If parents and teachers do know, they can help minimize the negative impact and leverage the positive. Without the knowledge that you have Aspergers, you tend to come to some negative, misguided conclusions (e.g., “I’m a failure” or “I’m strange” or “I’m a disappointment” etc.).
Aspergers and High-Functioning Autism diagnosis is often a two-stage process:
1. The first stage involves general developmental screening during well-child checkups with a doctor or an early childhood healthcare provider. Kids who show some developmental problems are referred for additional evaluation.
2. The second stage involves a thorough evaluation by a team of doctors and other health professionals with a wide range of expertise. At this stage, a youngster may be diagnosed as having Aspergers or another developmental disorder. Kids with Aspergers can usually be reliably diagnosed by age 2, though research suggests that some screening tests can be helpful at 18 months or even younger.
Many moms and dads minimize the signs of Aspergers at first, believing that their son or daughter will "catch up" with his/her peers. While parents may be concerned about labeling their youngster with Aspergers, the earlier the disorder is diagnosed, the sooner specific interventions may begin. Early intervention can reduce or prevent the more severe disabilities associated with Aspergers. Early intervention may also improve the youngster's IQ, language, and everyday functional skills (also called adaptive behavior).
A well-child checkup should include a developmental screening test, with specific “Autism Spectrum Disorder (ASD) screening” at 18 and 24 months. Screening for Aspergers is not the same as diagnosing Aspergers. Screening instruments are used as a first step to tell the doctor whether a youngster needs more testing. If your youngster's doctor does not routinely screen for ASDs, ask that it be done.
For moms and dads, your own experiences and concerns about your youngster's development will be very important in the screening process. Keep your own notes about your youngster's development and look through family videos, photos, and baby albums to help you remember when you first noticed each behavior and when your youngster reached certain developmental milestones.
Sometimes the doctor will ask the mother or father some questions about the youngster's symptoms to screen for Aspergers. Other screening instruments combine information from caregivers with the doctor's own observations of the youngster. Examples of screening instruments for toddlers and preschoolers include:
- Social Communication Questionnaire (SCQ)
- Screening Tool for Autism in Two-Year-Olds (STAT)
- Modified Checklist for Autism in Toddlers (M-CHAT)
- Communication and Symbolic Behavior Scales (CSBS)
- Checklist of Autism in Toddlers (CHAT)
To screen for Aspergers in older kids, the doctor may rely on different screening instruments, such as:
- Autism Spectrum Screening Questionnaire (ASSQ)
- Australian Scale for Asperger's Syndrome (ASAS)
- Childhood Asperger Syndrome Test (CAST)
The second stage of diagnosis must be thorough in order to find whether other conditions may be causing your youngster's symptoms. A team that includes a psychologist, a neurologist, a psychiatrist, a speech therapist, or other professionals experienced in diagnosing Aspergers may do this evaluation. The evaluation may assess the youngster's cognitive level (i.e., thinking skills), language level, and adaptive behavior (i.e., age-appropriate skills needed to complete daily activities independently, for example eating, dressing, and toileting).
Because Aspergers is a complex disorder that sometimes occurs along with other illnesses or learning disorders, the comprehensive evaluation may include brain imaging and gene tests, along with in-depth memory, problem-solving, and language testing. Kids with any delayed development should also get a hearing test and be screened for lead poisoning as part of the comprehensive evaluation.
Although kids can lose their hearing along with developing Aspergers, common Aspergers symptoms (e.g., not turning to face a person calling their name) can also make it seem that kids cannot hear when in fact they can. If a youngster is not responding to speech, especially to his or her name, it's important for the doctor to test whether a youngster has hearing loss.
The evaluation process is a good time for moms and dads to ask questions and get advice from the whole evaluation team. The outcome of the evaluation will help plan for treatment and interventions to help your youngster. Be sure to ask who you can contact with follow-up questions.
More resources for parents of children and teens with Asperger's and High-Functioning Autism:
COMMENTS
• Anonymous said… Different diagnosis but I always had BPD and ADHD since a child and found it very hard in school and growing up because my parents refused me to be diagnosed and didn't agree with medication, which meant I always got in trouble at school and never got the support I needed, I was just seen as a problem child. I think life would have been a lot easier for me if I just got the support and diagnosis when I was a child. I always knew I was different from the other children and didn't know who I was which lead to depression, once I was diagnosed I felt a relief and got the support I needed. To this day I still don't forgive my parents for their decision.
• Anonymous said… My son was first diagnosed with SPD and was seeing an occupational therapist. I asked her one day about having him tested for aspergers( as his teachers were concerned it was more than SPD...he had ALOT of problems at school..especially with authority, changes in routine, even hitting teachers when upset).. Her response to me was" why do you want him to have a label?" MY response was " he already has a label..he's the bad kid that no teacher wants in his/ her class" I'll NEVER forget that and AM so glad he was diagnosed so that he has advocates and teachers can learn more about autism and aspergers and help these kids become better students! All of the help he's received has made a tremendous difference in his behaviors!
• Anonymous said… Diagnosis = Support. Teachers: if they are aware and have information of your child's needs they can take a different approach if necessary. Community: a little bit of awareness and acceptance go a long way in helping your child feel part of their community. People that work in our local shop are aware of our child's diagnosis and are wonderful in supporting him and me by helping him to to shop and keep their eye out if he wonders off etc. Government funding for therapy: therapy is necessary and expensive! You owe it to your child to have an assessment. He deserves the chance to be the best he can be and you need and deserve the support to help him do that. It hurts to be told there is something wrong with your child that you love so much and it will be a process to accept it, but a year down the track when you see how far he's grown and improved you will know you've made the right decision. And they might just say " No, we don't believe he's on the spectrum. ". You need to know! Good luck. And remember there is lots of support here for you and your family x
• Anonymous said… Get the diagnoses.
• Anonymous said… He is who he is a label doesn't change him it just makes its a lot easier with everything to help him helps you
• Anonymous said… I agree. When you have a diagnoses the Government pays the school your child attends for extra help in the classroom. You don't have to tell anyone else about your son's "label" if you wish not to. Depending where you live (I'm in Australia) may depend on how the process begins. With us my doctor started the process writing a referral to a Paediatrician. After assessing, he said aspergers & referred us onto a psychologist. After assessing, he said aspergers. Then back to Paediatrician again for all outcomes. We then got documentation & this helped with the cost for therapist. Good luck.
• Anonymous said… I am raising a 10 year grandson. He started reading at 4,he always did not like socializing with others and never liked loud noises. He was held back in second grade his teacher labeled him lazy and told me to get him to bed earlier.We changed schools and they said the same. I it turns out he has hashitothyroiditis and low vitamine d so with synthyroid and vitamine d every day.The his adnoids and tonsils were removed
• Anonymous said… I don't understand your concern about a "label"? Don't you want the best for your child? If so, wouldn't you want to understand how his mind and body function so that you and all around him can support him appropriately? If he is struggling at school, then your school (if public) should have the resources to start the evaluation process. Talk to his teacher or the school's social worker as a starting point. You can also pursue a diagnosis privately, look for neurobehavior therapists in your area.
• Anonymous said… I hate it when people say label.. Its not a label, its an insight how to treat/help someone who has different ways/needs/understandings to others...
• Anonymous said… I haven't labelled my child......I have helped him understand why he is struggling. I have given him a ticket to the best life he can achieve.
• Anonymous said… I suffered mental illness from the age of twelve. I wasn't diagnosed and "labeled" with bipolar disorder until my mid twenties. After that, my doctors knew how to treat me and my quality of life improved significantly. When my son showed signs of a problem, I didn't wait. I was eager to know the problem so I could help him find solutions. I think we would all benefit if people would be more open and less judgemental. My two cents.
• Anonymous said… I too was scared at having my little guy labelled (being in a private school, what would they say!?!).....it was the best thing I could have done! His school has been fantastic and the support/help is incredible!
Originally the mums thought he was just a naughty child, now they understand and accept him!.....People in general need to be more accepting of our special, gifted children. They are not naughty, should not be subjected to different behaviour, but given the correct respect/understanding that they deserve/need! It's a long process being diagnosed but it's well worth it and you are doing the best for your child!
Good luck hon X
• Anonymous said… I was skeptical to have my son diagnosed as well. Not because of the label, I just felt we didn't need it-I had the mindset of: this is the way he is, and we love him knowing all of his quirks, and anyone who doesn't understand doesn't have to. BUT we have recently gone through the process, and the amount of resources that are available to help him is incredible! From help and understanding with the school, to learning knew tricks on parenting, to social skills classes-it's made a big difference. We've also seen a lot more acceptance from people (which in a way makes me upset, because some of these people should have been accepting before-but it's better for him now, and ill deal with my issue separately), we feel more comfortable with how we parent, and advocating is easier because now we have a whole team to help us through everything. I can very honestly say that I wish we had done it sooner.
• Anonymous said… I'm glad my son has his label. It means he gets the help and assistance he needs and people understand better.
• Anonymous said… It is a double edge sword. We are in the process. My son is 6. Two independent child psychologists have said ASD but now the school's educational psychologist is trying to label him as severe ODD. I haven't found this process helpful at all.
• Anonymous said… It will be easier to know now, so you can learn how to better help him then fight until he is a teenager.
• Anonymous said… 'Labels' open doors! The longer you leave 'starting the process' towards a diagnosis, the longer you put off vital early intervention. It's NOT for you, but your child! Parents don't realize just how lengthy the process is.
• Anonymous said… My son is 6 and was just diagnosed. We had to have a psychologist and pedestrian sign off on it. They worked together with his school for 6 months to see whether it would effect his day today life to much. If it wasn't going to they weren't good to label him.
• Anonymous said… Nobody what's to label their child. I was one of those parents who was afraid to get the "label" as we call it. But getting over that fear and understanding what the positive are. You move on from it. My son needed a "label" because it open so many doors for him. My health insurance covered more and there were services, I never knew was out there. Taking that step is a parents fear not the child's fear. Do what going to help you son not hurt him.
• Anonymous said… Outside of the teachers and staff who you tell is up to you.
• Anonymous said… sleep apnea showed he only sleep 3 hours a night.Got to say he is doing better,grades are three A and 3 b, but I ask the teacher about Asperger if see thought he had it. She has taught kids 16 years and has a son with asperger, her answer was yes.She advised me not to have him tested he will be labeled.This eats at me because for years this child has been misunderstood and as parents and myself I am his mom and granny I feel if I do not ask a doctor I will be letting him down. He needs to understand it as much as I do.So I will have him tested.I only hope you will also.
• Anonymous said… This is how I see a Dx. My son's Dx is that he is Jaxon, but a Jaxon with quirks and challenges I need to understand. I didn't want to push or discipline him for things he wasn't capable of doing. The Dx isn't your child just a better begining to work with them. Best of luck
• Anonymous said… Unfortunately to get help in uk education system having a "label" is the way forward. Don't be afraid of it... If it helps then it can only be good. "Labels " are easily got rid of as child gets older.
• Anonymous said… We all have challenges! If your child has autism chances are the children around him already have some idea that something is off. The social help for kids with ASD is crucial.
• Anonymous said… Yes you should because if you don't there is not a school or a medical system out there that will help your child with out that label for extra support, unless your willing to pay $$$ a week going private.
• Anonymous said… Yes, most definitely yes get a diagnosis. It can be tough to accept; but the best thing to do is that if your child is determined to fall within the ASD; don't allow your child to use it as an excuse. Your child is not Autism; your child is Billy, or Sally or whomever they may be. She/she may have some limitations; but their abilities are incredible. It's okay to say "Billy, you do have Aspergers syndrome; and some things may be harder for you to understand; but you're smart and able and we'll figure it out together"; or something along those lines to encourage your child they are not broken. Some things may be harder to grasp; but it can be done and it will be done with proper therapies.
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Does My Child Have Asperger's or Childhood Disintegrative Disorder?
“We believe our son has Asperger’s Syndrome and we want to have him tested. What are the symptoms we should be looking for and who should we go to for testing? Also, is it possible that his current symptoms may be reflective of something other than Asperger's, like CDD?"
Ideally, you would take your son to a child and adolescent psychiatrist who specializes in autism spectrum disorders. But these doctors are hard to find. Alternatively, you can have your son’s pediatrician make a referral to a specialist.
Symptoms of Asperger’s and High-Functioning Autism vary from one youngster to the next, but in general, they fall into three areas:
- Communication difficulties
- Repetitive and stereotyped behaviors
- Social impairment
Kids with Asperger’s do not follow typical patterns when developing social and communication skills. Moms and dads are usually the first to notice unusual behaviors in their youngster. Often, certain behaviors become more noticeable when comparing kids of the same age.
In some cases, toddlers with Asperger’s may seem different very early in their development. Even before their first birthday, some babies become overly-focused on certain objects, rarely make eye contact, and fail to engage in typical back-and-forth play and babbling with their mom or dad. Other kids may develop normally until the second or even third year of life, but then start to lose interest in others and become silent, withdrawn, or indifferent to social signals. Loss or reversal of normal development is called regression and occurs in some kids with Asperger’s.
1. Communication Issues—
By the first birthday, typical toddlers can say one or two words, turn when they hear their name, and point when they want a toy. When offered something they do not want, toddlers make it clear with words, gestures, or facial expressions that the answer is "no." For kids with Asperger’s, reaching such milestones may not be so straightforward. For example, some kids with Asperger’s and High-Functioning Autism may:
- Coo and babble in the first year of life, but then stop doing so
- Develop language at a delayed pace
- Fail or be slow to develop gestures (e.g., pointing and showing things to others)
- Fail or be slow to respond to their name or other verbal attempts to gain their attention
- Learn to communicate using pictures or their own sign language
- Repeat words or phrases that they hear, a condition called echolalia
- Speak only in single words or repeat certain phrases over and over, seeming unable to combine words into meaningful sentences
- Use words that seem odd, out of place, or have a special meaning known only to those familiar with the youngster's way of communicating
Even kids with Asperger’s who have relatively good language skills often have difficulties with the back and forth of conversations (e.g., because they find it difficult to understand and react to social cues, kids with Asperger’s often talk at length about a favorite subject, but they won't allow anyone else a chance to respond or notice when others react indifferently).
Kids with Asperger’s who have not yet developed meaningful gestures or language may simply scream or grab or otherwise act-out until they are taught better ways to express their needs. As these kids grow up, they can become aware of their difficulty in understanding others and in being understood. This awareness may cause them to become anxious or depressed.
2. Repetitive and Stereotyped Behaviors—
Kids with Asperger’s often have repetitive motions or unusual behaviors. These behaviors may be extreme and very noticeable, or they can be mild and discreet (e.g., some kids may repeatedly flap their arms or walk in specific patterns, while others may subtly move their fingers by their eyes in what looks to be a gesture). These repetitive actions are sometimes called "stereotypy" or "stereotyped behaviors."
Kids with Asperger’s also tend to have overly focused interests. They may become fascinated with moving objects or parts of objects (e.g., wheels on a moving car). They might spend a long time lining up toys in a certain way, rather than playing with them. They may also become very upset if someone accidentally moves one of the toys. Repetitive behavior can also take the form of a persistent, intense preoccupation (e.g., they might be obsessed with learning all about vacuum cleaners, train schedules, or lighthouses). Kids with Asperger’s often have great interest in numbers, symbols, or science topics.
While kids with Asperger’s often do best with routine in their daily activities and surroundings, inflexibility may often be extreme and cause serious difficulties. They may insist on eating the same exact meals every day or taking the same exact route to school. A slight change in a specific routine can be extremely upsetting. Some kids may even have emotional outbursts, especially when feeling angry or frustrated or when placed in a new or stimulating environment.
No two kids express exactly the same types and severity of symptoms. In fact, many typically developing kids occasionally display some of the behaviors common to kids with Asperger’s. However, if you notice your youngster has several Asperger’s-related symptoms, have your youngster screened and evaluated by a health professional experienced with this disorder.
3. Social Impairment—
Most kids with Asperger’s have trouble engaging in everyday social interactions. Some kids with Asperger’s may:
- Do not readily seek to share their enjoyment of toys or activities by pointing or showing things to others
- Make little eye contact
- Respond unusually when others show anger, distress, or affection
- Tend to look and listen less to people in their environment or fail to respond to other people
Recent research suggests that kids with Asperger’s do not respond to emotional cues in human social interactions because they may not pay attention to the social cues that others typically notice. One study found that kids with Asperger’s focus on the mouth of the person speaking to them instead of on the eyes, which is where kids with typical development tend to focus. A related study showed that kids with Asperger’s appear to be drawn to repetitive movements linked to a sound, such as hand-clapping during a game of pat-a-cake. More research is needed to confirm these findings, but such studies suggest that kids with Asperger’s may misread or not notice subtle social cues (e.g., a smile, a wink, a grimace, etc.) that could help them understand social relationships and interactions. For these kids, a question such as, "Can you hold on for just a minute?" always means the same thing, whether the speaker is joking, asking a real question, or issuing a firm request. Without the ability to interpret another person's tone of voice as well as gestures, facial expressions, and other nonverbal communications, kids with Asperger’s may not properly respond.
Likewise, it can be hard for others to understand the body language of kids with Asperger’s. Their facial expressions, movements, and gestures are often vague or do not match what they are saying. Their tone of voice may not reflect their actual feelings either. Many older kids with Asperger’s speak with an unusual tone of voice and may sound sing-song or flat and robot like.
Kids with Asperger’s also may have trouble understanding another person's point of view. For example, by school age, most kids understand that other people have different information, feelings, and goals than they have. Kids with Asperger’s may lack this understanding, leaving them unable to predict or understand other people's actions.
Related Disorders—
Rett syndrome and childhood disintegrative disorder (CDD) are two very rare forms of Autism that include a regression in development. Only 1 of every 10,000 to 22,000 girls has Rett syndrome. Even rarer, only 1 or 2 out of 100,000 kids with Asperger’s have childhood disintegrative disorder.
Unlike other forms of Autism, Rett syndrome mostly affects girls. In general, kids with Rett syndrome develop normally for 6–18 months before regression and Asperger’s-like symptoms begin to appear. Kids with Rett syndrome may also have difficulties with coordination, movement, and speech. Physical, occupational, and speech therapy can help, but no specific treatment for Rett syndrome is available yet.
Scientists have discovered that a mutation in the sequence of a single gene is linked to most cases of Rett syndrome. This discovery may help scientists find ways to slow or stop the progress of the disorder. It may also improve doctors' ability to diagnose and treat kids with Rett syndrome earlier, improving their overall quality of life.
Childhood disintegrative disorder affects very few kids, which makes it hard for researchers to learn about the disease. Symptoms of childhood disintegrative disorder may appear by age 2, but the average age of onset is between age 3 and 4. Until this time, kids with childhood disintegrative disorder usually have age-appropriate communication and social skills. The long period of normal development before regression helps to set childhood disintegrative disorder apart from Rett syndrome. Childhood disintegrative disorder may affect boys more often than girls.
Childhood disintegrative disorder is a condition in which kids develop normally until ages 2 to 4, but then demonstrate a severe loss of social, communication and other skills. Childhood disintegrative disorder is very much like Autism. Both are among the group of disorders known as pervasive developmental disorders (or autism spectrum disorders), and both involve normal development followed by significant loss of language, social, play and motor skills. However, childhood disintegrative disorder typically occurs later than Autism and involves a more dramatic loss of skills. In addition, childhood disintegrative disorder is far less common than Autism.
Kids with childhood disintegrative disorder typically show a dramatic loss of previously acquired skills in two or more of the following areas:
Loss of developmental milestones may occur abruptly over the course of days to weeks or gradually over an extended period of time.
Kids with childhood disintegrative disorder typically show a dramatic loss of previously acquired skills in two or more of the following areas:
- Bowel or bladder control, including frequent accidents in a child who was previously toilet-trained
- Language, including a severe decline in the ability to speak and have a conversation
- Motor skills, including a dramatic decline in the ability to walk, climb, grasp objects and other movements
- Play, including a loss of interest in imaginary play and in a variety of games and activities
- Social skills, including significant difficulty relating to and interacting with others
Loss of developmental milestones may occur abruptly over the course of days to weeks or gradually over an extended period of time.
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