Occupational Therapy: Advice for Adults with Aspergers

Adults with Aspergers (high functioning autism) often face challenges with social interaction, impaired motor skills, sensory processing issues, repetitive patterns of behavior, and intensely focused interests – all of which might interfere with their ability to complete activities of daily living in a manner similar to their peers.

Increased awareness and knowledge about Aspergers has opened many avenues to help adults with Aspergers adjust to life’s demands. One such avenue is Occupational Therapy (OT), which attempts to address the following:

• Age-appropriate interactions

• Behavior modification

• Communication and social skills

• Coping

• Family education

• Imitation skills

• Independent living skills

• Motor skills

• Repetitive behaviors

• Self-care

• Sensory skills

• Social skills

OT is a discipline that utilizes purposeful activity to obtain, regain and/or maintain one’s highest level of daily functioning, work, play and leisure activities:

• Daily functioning skills (e.g., dressing, bathing, grooming, eating, writing, home and money management, etc.) are necessary for all to maintain a healthy lifestyle.
• Work skills are necessary to be a contributing member of society and to earn an income.
• Play for children contribute to a healthy self-esteem and a fulfilling life.
• Leisure activities for adults contribute to overall mental health.

At times, situations or impairments interfere with an Aspergers person’s ability to independently complete or participate in daily functioning skills. These impairments may consist of physical, cognitive and emotional components, or a combination of all three. Once the components have been identified, the type of treatment approach can be determined.

The goal of treatment may be to increase performance levels, to restore functioning to a prior level (or close to it), or to maintain current skills – or prevent regression. For example, restorative therapy can include (a) strengthening of physical skills (e.g., coordination, strength, endurance), (b) improvement of cognitive skills (e.g., memory, following directions, attending to details), and (c) improvement of psychological skills (e.g., self-esteem, self-expression and confidence).

The Occupational Therapist must (a) evaluate which components - physical, cognitive, or emotional - are impairing the individual’s functioning, (b) begin appropriate remediation, and (c) initiate compensation. Here are some examples:

• An example of a physical deficit is difficulty with performing manual tasks. One man had difficulty writing legibly. An evaluation (which included an assessment of abilities, strengths and weaknesses in daily functioning, work, leisure and play) determined that he had decreased hand strength and impaired fine motor control (physical components). The treatment plan was to strengthen his hands, to improve coordination (restore function) and to adapt the pen grip (compensation).

• An example of a cognitive deficit is difficulty with following directions due to decreased attention. The treatment plan might include changing the environment to decrease visual and auditory distractions, or providing compensation techniques (e.g., timers, breaks, guidelines, outlines for assignments, etc.).

• An example of an emotional deficit is difficulty with environmental stimuli. One young woman with Aspergers disliked shopping. She said it was too noisy and busy. An evaluation (which included an assessment of abilities, strengths and weaknesses in performing tasks) determined she had difficulty processing sensory information (i.e., the noises and sights at the store were overwhelming to her). The Occupational Therapist designed a sensory program and compensation techniques that would allow her to successfully complete her shopping trip. The program consisted of exercises that helped her improve her ability to process sensory input from the environment. Compensation techniques included shopping at a smaller store during times that were not as busy/noisy and to practice a “social script.” The social script was a way for her to role-play and practice interaction before it actually occurs. This “rehearsal” helped her to increase her confidence and skills.

The ultimate goal of OT is to help clients have independent, productive, and satisfying lives. Furthermore, Occupational Therapists are becoming increasingly involved in addressing the impact of social, political and environmental factors that contribute to exclusion and occupational deprivation.

OT services typically include:

• a comprehensive evaluation of the client’s home and other environments (e.g., workplace, school)
• an “outcomes evaluation” to ensure that the goals are being met and/or make changes to the intervention plan
• customized intervention to improve the person’s ability to perform daily activities
• environmental adaptation including provision of equipment or designing adaptations to remove obstacles or make them manageable
• guidance and education for family members and caregivers
• how to break down activities into achievable components (e.g., sequencing a complex task like cooking a complex meal)
• performance skills assessments and treatment
• teaching new ways of approaching tasks
• the use of creative media as therapeutic activity

If you are having difficulty with social skills among friends or within the community, an Occupational Therapist can help identify the underlying reason of the difficulty. Once a likely cause or causes have been defined, treatment can begin.

There is a simple way to determine if you, or someone you know, might benefit from OT. Ask yourself the following:

• Has there been difficulty with social interactions at home, work or school?
• Has there been a change in ability to perform any activity of daily living?
• Is there something that is more challenging for you to do than it is for other people to do?

If you answered yes to one or more of these questions, OT might help you become more independent - or regain your independence.

Living With Aspergers: Help for Couples

Cognitive-Behavioral Therapy: Advice for Adults with Aspergers

If you are an older teen or adult with Aspergers or High-Functioning Autism, and are struggling to “make it” (i.e., cope) with real-world circumstances and social situations, then this may be the most important article you’ll ever read:

The ideal treatment for Aspergers coordinates therapies that address core symptoms of the disorder, including poor communication skills and obsessive or repetitive routines. While most therapists agree that the earlier the intervention, the better, there is no single best treatment package.

Aspergers treatment resembles that of other high-functioning Autism Spectrum Disorders except that it takes into account the linguistic capabilities, verbal strengths, and nonverbal vulnerabilities of children with Aspergers. A typical program generally includes:

• Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions, and to cut back on obsessive interests and repetitive routines
• Medication, for coexisting conditions such as major depressive disorder and anxiety disorder
• Occupational or physical therapy to assist with poor sensory integration and motor coordination
• Social communication intervention, which is specialized speech therapy to help with the pragmatics of the give and take of normal conversation
• The training and support of moms and dads, particularly in behavioral techniques to use in the home
• The training of social skills for more effective interpersonal interactions

Of the many studies on behavior-based early intervention programs, most are case studies of up to five participants, and typically examine a few problem behaviors such as self-injury, aggression, noncompliance, stereotypies, or spontaneous language; unintended side effects are largely ignored.

Despite the popularity of social skills training, its effectiveness is not firmly established. A randomized controlled study of a model for training mothers/fathers in problem behaviors in their kids with Aspergers showed that parents attending a one-day workshop or six individual lessons reported fewer behavioral problems, while parents receiving the individual lessons reported less intense behavioral problems in their Aspergers kids.

Vocational training is important to teach job interview etiquette and workplace behavior to older kids and adults with Aspergers , and organization software and personal data assistants can improve the work and life management of people with Aspergers.

For the sake of this article, we will look more deeply into cognitive-behavioral therapy:

Cognitive-Behavioral Therapy (CBT) is a common type of therapy. With CBT, you work with a psychotherapist in a structured way, attending a limited number of sessions. By helping you become aware of inaccurate or negative thinking, CBT allows you to view challenging situations more clearly and respond to them in a more effective way.

CBT can be a very helpful tool in treating certain disorders (e.g., Aspergers, anxiety, depression, etc.). But not everyone who benefits from CBT has a mental health condition. It can be a very effective tool to help anyone learn how to better manage stressful life situations.

CBT is used to treat a wide range of issues. It's often the preferred type of therapy because it can quickly help you identify and cope with specific concerns. It generally requires fewer sessions than other types of therapy and is done in a structured way that deals directly with specific challenges.

CBT is a useful tool to address emotional challenges. For example, it may help you:

• Cope with a medical illness (e.g., chronic fatigue syndrome or cancer)
• Cope with grief (e.g., loss of a loved one)
• Identify ways to manage emotions (e.g., anger)
• Learn techniques for coping with stressful life situations (e.g., problems at work)
• Manage chronic physical symptoms (e.g., pain, insomnia or fatigue)
• Manage symptoms of mental illness, either by itself or with other treatments such as medications
• Overcome emotional trauma related to abuse or violence
• Prevent a relapse of mental illness symptoms
• Resolve relationship conflicts and learn better ways to communicate
• Treat a mental illness when medications aren't a good option (e.g., during pregnancy)

Mental health conditions that may improve with CBT include:

• Anxiety disorders

• Autism spectrum disorders

• Bipolar disorders

• Depression

• Eating disorders

• Personality disorders

• Phobias

• Schizophrenia

• Sexual disorders

• Sleep disorders

• Substance abuse disorders

In some cases, CBT is most effective when it's combined with other treatments, such as antidepressants or other medications.

In general, there's little risk in CBT. Because it can explore painful feelings and experiences, however, you may feel emotionally uncomfortable at times. Because therapy sometimes involves emotional discussions, you may cry, get upset or feel angry during a session. You may also feel physically drained after a challenging session. Your psychotherapist is trained to help you cope with these feelings and emotions.

Some forms of therapy (e.g., exposure therapy) may require you to confront situations you'd rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary stress or anxiety. But the coping skills you learn should help you later on to manage and conquer negative feelings and fears.

You might decide on your own that you want to try CBT. Or a doctor, relative, friend, employer or someone else may suggest therapy to you. Here's how to get started:

• Find a psychotherapist. You can find a psychotherapist on your own — looking through the phone book or on the Internet, for instance. Or you can get a referral from a doctor, health insurance plan, friend or other trusted source. Many employers offer counseling services or referrals through employee assistance programs (EAPs). Before selecting a psychotherapist, check his/her credentials. Your psychotherapist should be a licensed counselor, psychologist or other mental health provider experienced in CBT.

• Review your concerns. Before your first appointment, spend some time thinking about what issues you'd like to work on. While you also can sort this out with your psychotherapist, having some sense in advance may provide a starting point.

• Understand the costs. If you have health insurance, contact your health plan to be sure you understand what coverage it offers for therapy. Some health plans cover only a certain number of therapy sessions a year. Also, talk to your psychotherapist about fees and payment options.

It's likely that you'll go to a psychotherapist's office for CBT sessions. A psychotherapist may have an office in a medical clinic, an office building or a home office. Therapy can also take place in a hospital if you've been admitted for treatment. You'll probably meet weekly with your psychotherapist for one-on-one sessions that last 45 to 60 minutes. CBT may also be done in groups — either with family members or with individuals who have similar issues.

Your first session is usually a time for the psychotherapist to gather information about you and to determine what concerns you'd like to work on. The psychotherapist may ask you to fill out forms about your current and past physical and emotional health. This information helps the psychotherapist gain a deeper understanding of your situation. Your psychotherapist will also want to know whether you might benefit from other or additional treatment (e.g., medications). It might take a few sessions for your psychotherapist to fully understand your situation and concerns, and to determine the best approach or course of action.

The first session is also an opportunity for you to interview your psychotherapist to see if his or her approach and personality are going to work for you. Make sure you understand:

• His/her approach

• How many therapy sessions you may need

• The goals of your treatment

• The length of each session

• What type of therapy is appropriate for you

If you don't feel comfortable with the first psychotherapist you see, try someone else. Having a good "fit" with your psychotherapist can help you get the most benefit from CBT.

In general, conversations with your psychotherapist are confidential. However, in certain situations a psychotherapist may be required by law to report serious concerns to authorities — such as threatening to commit suicide, threatening to harm another person or admitting to abusing a child. Talk to your psychotherapist about any worries you might have regarding confidentiality.

For CBT, you and your psychotherapist will most likely sit facing each other during sessions. Your psychotherapist will encourage you to talk about your thoughts and feelings and what's troubling you. Don't worry if you find it hard to open up about your feelings. Your psychotherapist can help you gain more confidence and comfort.

CBT is generally focused on specific problems, using a goal-oriented approach. Each session may have a specific agenda to guide discussion. As you go through the CBT process, your psychotherapist may ask you to do "homework" — activities, reading or practices that build on what you learn during your regular therapy sessions. Along with homework, your psychotherapist will likely encourage you to apply what you're learning in your daily life.

Although there are different ways to do CBT, it typically includes these steps:

• Become aware of your thoughts, emotions and beliefs about these situations or conditions. Once you've identified the problems you want to work on, your psychotherapist will encourage you to share your thoughts about them. This may include observing what you tell yourself about an experience (i.e., your "self-talk"), your interpretation of the meaning of a situation, and your beliefs about yourself, other individuals and events. Your psychotherapist may suggest that you keep a journal of your thoughts.

• Challenge negative or inaccurate thinking. As you continue to examine your thought patterns, your psychotherapist may encourage you to test the validity of your thoughts and beliefs. This may include asking yourself whether your view of a situation is based on fact or based on an inaccurate perception of what's going on. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. Many thought patterns are first developed in childhood. Thoughts and beliefs that you've held for a long time feel normal and correct, so it can be a challenge to recognize inaccuracies or negative tendencies in your thinking. With practice, helpful thinking and behavior patterns will become a habit, and won't take as much effort.

• Identify negative or inaccurate thinking. To help you recognize patterns of thinking and behavior that may be contributing to your problem, your psychotherapist may ask you to pay attention to your physical, emotional and behavioral responses in different situations.

• Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger or symptoms of a specific mental illness. You and your psychotherapist may have to spend some time deciding what problems and goals you want to focus on.

Your psychotherapist's approach will depend on your particular situation and preferences. Your psychotherapist may combine CBT with another therapeutic approach — for example, interpersonal therapy, which focuses on your relationships with other individuals.

CBT is generally considered short-term therapy — about 10 to 20 sessions. You and your psychotherapist can discuss how many sessions may be right for you. Factors to consider include:

• How long you have had your symptoms or have been dealing with your situation
• How much stress you're experiencing
• How much support you receive from family members and other individuals
• How quickly you make progress
• The severity of your symptoms
• The type of disorder or situation

CBT may not cure your condition or make an unpleasant situation go away. But overall, it's an effective treatment. It can give you the power to cope with your situation in a healthy way and to feel better about yourself and your life.

CBT isn't effective for everyone. But you can take steps to get the most out of your therapy and help make it a success, including:

• Approach therapy as a partnership. Therapy is most effective when you're an active participant and share in decision making. Make sure you and your psychotherapist agree about the major issues and how to tackle them. Together, you can set goals and gauge progress over time.

• Be open and honest. Success with therapy depends on your willingness to share your thoughts, feelings and experiences, and on being open to new insights and ways of doing things. If you're reluctant to talk about certain things because of painful emotions, embarrassment or fears about your psychotherapist's reaction, let your psychotherapist know about your reservations.

• Do your homework between sessions. If your psychotherapist asks you to read, journal or do other activities outside of your regular therapy sessions, follow through. Doing these homework assignments is important because they help you apply what you've learned in the therapy sessions.

• Don't expect instant results. Working on emotional issues can be painful and often requires hard work. It's not uncommon to feel worse during the initial part of therapy as you begin to confront past and current conflicts. You may need several sessions before you begin to see improvement.

• If therapy isn't helping, talk to your psychotherapist. If you don't feel that you're benefiting from therapy after several sessions, talk to your psychotherapist about it. You and your psychotherapist may decide to make some changes or try a different approach.

• Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip therapy sessions. Doing so can disrupt your progress. Attend all sessions and give some thought to what you want to discuss.

If you are struggling with life – now you know what you can do about it! Good Luck!!!

Living With Aspergers: Help for Couples

Children on the Autism Spectrum and Video Game Addiction

According to a study conducted by researchers at the University of Bolton, video game addicts show the same personality traits as kids who are suffering from Aspergers (AS) and High-Functioning Autism (HFA). These young people find social situations stressful. The study has fueled concerns that video gaming may lead to a rise in mental health problems like depression.

During the study, researchers examined nearly 400 gamers (most of whom were male). The subjects were questioned about how much they played video games (researchers did not specifically test participants with AS or HFA during the study). The research revealed that the higher the time the participants spent playing video games, the more likely they were to show 3 specific traits usually associated with an autism spectrum disorder: (1) neuroticism, (2) lack of extraversion, and (3) lack of agreeableness.

This outcome suggests that children on the autism spectrum may have a higher likelihood of becoming video game addicts, because it allows them to escape into a world where they can avoid face-to-face interactions. In addition, these kids may be prone to addiction to MMORPGs (massive multi-player online role playing games).

Children and teens on the autism spectrum often can’t make eye contact and fail to pick up social cues (e.g., boredom in others). The researchers say that tends to isolate them and can trigger depression, which video games may encourage.

Treatment for AS and HFA usually consists of improving social skills and breaking repetitive behavior, the very things video games discourage. Video games don’t prepare these young people for interacting with real people. Also, as an older teen or young adult, video game addiction is known to cause problems with motivation, going to college, and finding employment (you can’t walk into a college or job interview and say that you are really good at playing Xbox).

While most people associate addiction with substances (e.g., drugs or alcohol) therapists recognize addictive behaviors as well:

1. If the person does not get more of the substance or behavior, he becomes irritable and miserable.
2. The person needs more and more of a substance or behavior to keep him going.

Compulsive gaming meets these criteria, and many therapists have reported seeing severe withdrawal symptoms in game addicts. They become angry, violent, or depressed. If moms and dads take away the computer, their "special needs" youngster may sit in the corner and pout, refuse to eat, sleep, or do anything else.

Unlike substance abuse, the biological aspect of video game addiction is uncertain. Research suggests gambling elevates dopamine, and gaming is in the same category. But there's more to addiction than brain chemistry. Even with alcohol, it's not just physical. There's a psychological component to the addiction (e.g., knowing you can escape or feel good about your life). The addict is trying to change the way he feels by taking something outside of himself. The cocaine addict, for example, learns, I don't like the way I feel, I take a line of cocaine. For gamers, it's the fantasy world that makes them feel better.

The lure of a fantasy world is especially pertinent to online role-playing games. These are games in which a player assumes the role of a fictional character and interacts with other players in a virtual world. An intelligent youngster who is unpopular at school can become dominant in the game. The virtual life becomes more appealing than real life.

Too much gaming may seem relatively harmless compared with the dangers of a drug overdose, but video game addiction can ruin lives. Kids who play 4 - 5 hours per day have no time for socializing, doing homework, or playing sports. That takes away from normal social development (e.g., you can have a 20-year-old adult child still living at home with the emotional intelligence of a 12-year-old … he's never learned to talk to girls …never learned to play a sport ...never learned to hold down a job).

Spending a lot of time gaming doesn't necessarily qualify as an addiction. Most people play games safely. The question is: Can you always control your gaming activity? According to the Center for On-Line Addiction, warning signs for video game addiction include:

• Feeling irritable when trying to cut down on gaming
• Gaming to escape from real-life problems, anxiety, or depression
• Lying to friends and family to conceal gaming
• Playing for increasing amounts of time
• Thinking about gaming during other activities

In addition, video game addicts tend to become isolated, dropping out of their social networks and giving up other hobbies. It's about somebody who has completely withdrawn from other activities.

The overwhelming majority of video game addicts are males under 30. It's usually kids with poor self-esteem and social problems. They're intelligent and imaginative, but don't have many friends at school. A family history of addiction may also be a factor.

Unfortunately, many - if not most - parents of kids on the spectrum view their child's constant game playing as self-soothing behavior with few - if any - negative consequences (e.g., "he's entertaining himself ...he's not hurting or bothering anyone ...he's happy"). But what parents fail to realize is that, as the clock tics and the years pass, their child is losing opportunity after opportunity to develop emotional muscles (a big problem with the disorder anyway - but exacerbated by years of gaming).

If you're concerned your youngster may be addicted to video games, don't dismiss it as a phase. Keep good documents of the youngster's gaming behavior, including:

• How the youngster reacts to time limits
• Logs of when the youngster plays and for how long
• Problems resulting from gaming

You need to document the severity of the problem. Don't delay seeking professional help. If there is a problem, it will only get worse. Treatment for video game addiction is similar to detox for other addictions, with one important difference. Computers have become an important part of everyday life, as well as many jobs, so compulsive gamers can't just look the other way when they see a PC. It's like a food addiction. You have to learn to live with food. Because video game addicts can't avoid computers, they have to learn to use them responsibly. That means no gaming. As for limiting game time to an hour a day, I compare that to an alcoholic saying he's only going to drink beer.

The toughest part of treating video game addicts is that it's a little bit more difficult to show somebody they're in trouble. Nobody's ever been put in jail for being under the influence of a game. The key is to show gamers they are powerless over their addiction, and then teach them real-life excitement as opposed to online excitement.

(It should be noted that we are only recommending "abstinence" for the child who is truly an "addict" -- and it will be up to parents to make that determination.)

==> Preventing Meltdowns and Tantrums in Kids on the Autism Spectrum

Testing a Child for Aspergers

How do they test a child for Aspergers?

There are several tests. We will look at the two prominent ones:

1. The ASDS—

The Asperger Syndrome Diagnostic Scale (ASDS) offers a viable way of measuring whether or not a youngster has Aspergers. This exam is easy to administer and it yields reliable results.

The ASDS was developed to help determine if a youngster is likely to have the disorder. This developmental exam consists of fifty yes/no questions that take about fifteen minutes to complete.

• The Asperger test scores are evaluated and rated on an Aspergers scale.
• The results are compared between the subject and other kids with Aspergers.
• These results reveal whether or not the youngster is likely to have the disorder.

While the ASDS score is not a formal diagnosis, it helps to determine if the youngster should have further evaluation. The results are quite reliable, and the process helps to move the youngster along quicker when it comes to attaining a proper diagnosis of Aspergers.

Administering the ASDS exam is a relatively uncomplicated process. The rating scale is simple to use and merely consists of carefully chosen inquiries. Ironically, the youngster does not take the exam. Just about anyone who knows the youngster well answers the fifty questions.

People who qualify to take the ASDS for a youngster include his mother/father, brothers/sisters, educators, or a therapist who works directly with the youngster. The questions can be completed in about fifteen minutes. This test is designed to assess kids ages five through eighteen.

There are 50 questions on the ASDS. These inquiries cover five different aspects of behavior:

1. cognition
2. language skills
3. maladaptive behavior
4. sensorimotor
5. social interactions

The exam questions cover each of these areas:

• Social interaction skills vary from one-on-one to being in a group as well as family interactions.
• Sensorimotor questions would include inquires about reactions to sensory input and questions about gross motor skills.
• Maladaptive behavior concerns stereotyped repetitive movements, inflexibility, and tantrums.
• Language skills measures the youngster’s ability to manage spoken and written communication.
• Cognitive questions concern how the youngster processes information.

The ASDS is a valuable tool for you to gain insight to a possible developmental delay. Aspergers is difficult to detect in many cases because the kids are typically high functioning and quite intelligent.

2. The CAST—

Another well-known Aspergers test is the Childhood Asperger Syndrome Test (CAST), which is a valuable tool for evaluating kids who might have the disorder. It's easy to administer and well organized.

Exams like this have been developed to help families with high-functioning kids receive the necessary screening. The CAST is also used for epidemiological research.

The inspiration for the CAST is twofold:

1. Sensory overload is a noteworthy problem that can lead to negative behavior and tantrums. Social interaction proves to be a great hurdle, and many kids are overwhelmed in unusual situations.

2. High-functioning kids who have this disorder are faced with many significant challenges. They might struggle through many common day-to-day activities and often feel great anxiety.

Unfortunately, very high-functioning kids who have Aspergers are not understood by others. This is often due to the simple fact that the condition has not been discovered. Many of these kids grow up without a diagnosis and without any treatment interventions.

Epidemological research seeks to make connections between certain conditions and possible contributing factors. The CAST collects data about a certain population (those who have Aspergers) and works to make associations.

In a nutshell, the CAST is looking for a possible cause of Aspergers through studying its population for clues. This is crucial in the advancement of the public’s understanding of pervasive developmental disorders.

The CAST is a questionnaire that is completed independently by school-aged kids. There are 37 questions that touch upon social, physical, cognitive, coping, and communication skills.

• High-scoring tests are followed by CAST-2, which is completed by parents.
• The exam is typically administered to kids who are in a mainstream classroom and who do not have an autism spectrum disorder diagnosis.
• The scores are compared, and further evaluation could be necessary.

High-functioning kids usually develop many coping skills on their own. However, uncovering a possible pervasive developmental disorder, no matter how mild, is crucial to helping the youngster thrive in different environments.

Here's the CAST:

Child's name_______________________________

Age______ Sex: M / F

Birth Order: Twin or single birth______________

Parent / Guardian______________________________

Parent(s) occupation___________________________

Address______________________________________

_______________________________________

Phone#______________________________________

School_______________________________________

Please read the following questions carefully, and circle the appropriate answer.

1. Does child join in playing games with others easily?

Yes

No

2. Does child come up to you spontaneously for a chat?

Yes

No

3. Was child speaking by 2 years old?

Yes

No

4. Does child enjoy sports?

Yes

No

5. Is it important for him/her to fit in with a peer group?

Yes

No

6. Does child appear to notice unusual details that others miss?

Yes

No

7. Does child tend to take things literally?

Yes

No 

8. When child was 3 years old, did child spend a lot of time pretending (e.g., play-acting being a super-hero, or holding teddy's tea parties)?

Yes

No 

9. Does child like to do the same things over and over again, in the same way all the time?

Yes

No

10. Does child find it easy to interact with other children?

Yes

No

11. Can child keep a two-way conversation going?

Yes

No

12. Can child read appropriately for his/her age?

Yes

No

13. Does child mostly have the same interests as his/her peers?

Yes

No

14. Does child have an interest that which takes up so much time that he/she does little else?

Yes

No

15. Does child have friends, rather than just acquaintances?

Yes

No

16. Does child often bring things to show you that interest him/her?

Yes

No

17. Does child enjoy joking around?

Yes

No

18. Does child have difficulty understanding the rules for polite behavior?

Yes

No 

19. Does child have an unusual memory for details?

Yes

No

20. Is his/her voice unusual (e.g., overly adult, flat, or very monotonous)?

Yes

No

21. Are people important to him/her?

Yes

No

22. Can child dress him/herself?

Yes

No

23. Is child good at turn-taking in conversation?

Yes

No

24. Does child play imaginatively with other children, and engage in role-play?

Yes

No

25. Does child do or say things that are tactless or socially inappropriate?

Yes

No

26. Can child count to 50 without leaving out any numbers?

Yes

No

27. Does child make normal eye-contact?

Yes

No 

28. Does child have any unusual and repetitive movements?

Yes

No

29. Is his/her social behavior very one-sided and always on his or her terms?

Yes

No

30. Does your child sometimes say "you" when child means to say "I"?

Yes

No

31. Does child prefer imaginative activities such as play-acting or story-telling, rather than numbers or a list of facts?

Yes

No

32. Does child sometimes lose the listener because of not explaining what he/she is talking about?

Yes

No

33. Can child ride a bicycle (even if with stabilizers)?

Yes

No

34. Does child try to impose routines on himself/herself, or on others, in such a way that it causes problems?

Yes

No

35. Does child care about how he/she is perceived by the rest of the group?

Yes

No

36. Does child often turn conversations to his/her favorite subject rather than following what the other person wants to talk about?

Yes

No

37. Does child have odd or unusual phrases?

Yes

No

SPECIAL NEEDS SECTION-

• Have teachers ever expressed any concerns about his/her development?

Yes

No

If yes, please specify___________________________________

• Has child ever been diagnosed with the following?

-Language delay

Yes

No 

-Hyperactivity/Attention Deficit Disorder (ADHD)

Yes

No

-Hearing or visual difficulties

Yes

No

-Autism Spectrum Condition, including Asperger syndrome

Yes

No

-A physical disability

Yes

No

-Other (please specify)

Yes

No

If yes, please specify___________________________________

The Aspergers Comprehensive Handbook

Aspergers versus Autism: What’s the Difference?

Question

I'm not sure I understand the difference between Aspergers and Autism. What exactly is the difference?

Answer

The lines are sometimes blurred when it comes to the similarities and differences between Aspergers and autism. While both are Autism Spectrum Disorders (ASDs), and while there are similarities that can be noted in autism and Aspergers, there are some significant differences too.

Similarities between Autism and Aspergers—

• both have trouble maintaining age appropriate relationships

• both suffer from poor communication skills

• children with autism and Aspergers alike may develop obsessions to a specific subject of interest

• hyper or hyposensitivity to pain and touch is common in both disorders

• poor eye contact is exhibited by both populations

• problems with gross and fine motor skills can be noted in both groups

• resistance to a change in routine is commonly found in both Aspergers and autism

Differences between Autism and Aspergers—

• Aspergers is usually detected later in a child’s life than autism

• autistic people typically are to some degree oblivious to the need for social interactions

• children with Aspergers express a desire to fit in socially, whereas autistic kids gravitate toward complete exclusion and seclusion

• in autism, the person’s IQ is usually below average, and communication delays are always present

• many autistic children are very late at developing verbal language (some are nonverbal)

• normal to above average intelligence and language development is common in children with Aspergers

• problems with depression are much more common with people who have Aspergers than in those with autism

• the average age for the diagnosis of Aspergers is 6 to 11, while Autism is usually diagnosed around or before the age of 3

• those with Aspergers tend to know that they have social challenges and sometimes suffer anxiety and depression related to these problems

• verbal IQ is higher than the performance IQ in Aspergers

• with Aspergers, even though speech is sometimes repetitive, the grammar is usually very good

• young children with Aspergers reach most developmental milestones within a typical time frame

The Aspergers Comprehensive Handbook

What To Do When Your Aspergers Child Doesn't Have Any Friends

Question

My little guy does not have any friends. J___ will be 9 in Aug. He doesn't like sports, he's had a few rough experiences trying to fit in and play ball with his peers. He is not very coordinated i.e., he cannot ride a bike yet. He would be content riding a bike with training wheels - he is not AWARE that the other kids would make fun of him. He doesn't intuitively know what may trigger other children’s ridicule. My heart breaks for him. We went to the park the other day and he tried to play with 2 other boy's his age, one of them immediately told him to “shut up”. Kids are so cruel and notice “different” immediately. I have thought about home schooling him but I just don't think I have the patience (J___ is adopted …he is my stepdaughter’s biological child). My husband and I have raised him since he was 5 months old and for J___'s protection adopted him at age 3. At his request, after starting school, he calls us Mom and Dad. He loves to watch TV - could do it all day if allowed. He used to be into video games but seems to be bored with them right now. He enjoys reading but doesn't do it???? He is constantly asking to eat! Not sure if it's boredom or what. Thankfully he has skinny genes or he'd be in trouble. I don't know what I am asking; it feels like I could type for hours.

Answer

When an Aspergers (high functioning autistic) youngster doesn’t get acceptance from his peer group, parents have to find an organized way to work with him step by step to show him how to manage his daily life.

One thing to consider is that many Aspergers traits often don’t reveal themselves fully until the youngster starts school, although the issues have been there since birth. So when the youngster gets to kindergarten or first grade, parents might see that he has trouble reading, doing math or processing social situations. In reality, Aspergers has been there all along—it’s just surfacing in a different, more concrete way. By the time that youngster has been diagnosed, he’s probably already developed a very cautious way of looking at the world; he may already feel different and be working hard to hide it.

If you tell an Aspergers youngster, “C’mon, you’re just like the other children - don’t let it bother you,” that may make a bad problem worse because it sends a message to your youngster that he has control over whether or not he has a disorder, or the power to decide how it affects him. He’s going to walk away feeling like there’s something wrong with him, and he’s going to say to himself, “Nobody understands me, I really am different.” While Aspergers children may often learn how to manage the effects their Aspergers traits have on them, it usually takes a lot of work and effort on everybody's part—moms and dads, educators, and the children themselves—to make that happen.

What is your role as a parent in this situation? One job is to balance reassurance with coaching. When talking to your youngster, remind him that a lot of other Aspergers children have gone through the same thing and made it through okay. Give him some perspective on the issue – the knowledge that this is not the end of the world. Also, in your own mind, don’t let it be the end of the world.

This is the time to be a coach to your youngster. A coach reinforces and reminds children of skills that they have already acquired. A coach helps children to identify and develop the skills they need to solve a specific problem. Being a coach is one of the most precious things parents are to children. It’s a powerful thing to be able to help your youngster identify and solve his problems, because you’re giving him a tool that will aid him the rest of his life.

Also, continue setting limits even if your youngster is feeling bad or down. Let him know you still expect him to carry out his responsibilities and complete his tasks. If he is upset after school, say, “Well, take a few minutes and then let’s get started with homework.” He can feel bad for a certain amount of time, but then he has to start his homework or clean his room. Don’t let him be crippled by feeling bad – and don’t treat him like he is a cripple.

Limit-setting is very important during these times. You can be a loving and concerned parent, but it’s up to you to keep this problem in perspective. Your youngster may make the problem huge, so you have to be the one to say, “Yeah, that’s tough,” and then bring it down to its proper size (e.g., “It really hurts when this happens, but it happens. And even when we’re feeling this way, we still have to do our homework. We still have to talk nicely to our little brother. We still have to clean our room. We still have to eat dinner”). That way, your youngster is still being responsible and still keeping up with the tasks in his life.

Affirm what’s going on in your Aspergers youngster’s life and acknowledge that it’s hard for him. You can say things like, “It must be really tough to feel like you don’t get acceptance.” And then you can move to the offer of help: “I’m going to get us some help with that. I bet you’re not the only child that doesn’t feel like he fits in. I bet there are books out there and stuff we can find online that will help us.” You’re showing positive regard to your youngster, being comforting and being helpful.

Know that it’s a lot easier to start a relationship with one person than trying to get acceptance from a large group. When you talk with your youngster, tell him to deal with other children one at a time. You can say, “How about if you start with trying to find one friend first? Is there anyone at school who you might like to hang out with?” Suggest peers he might not have thought about before.

Teach your child to use positive self-talk. Positive self-talk is reasoning, soothing self-talk that helps you stay calm and keep your perspective. Children get anxious when they’re feeling left out or being picked on. Their adrenaline starts to pump, they think less clearly, and they panic. Positive, soothing self-talk is meant to bring them back down. In other words, it calms down their internal physical system, and accordingly, their thoughts.

Let your youngster know that help is out there, and that he doesn’t have to go it alone. If you freak out and start to panic about your youngster not “fitting in,” he’s going to think you think he’s a freak, too. So, it’s very important when children share their feelings of being different for you to remain calm. Often it’s very comforting for children to hear things like, “That happened to me when I was a child, and I know how much it hurts.” They feel comforted when you identify with their problem and empathize with them. Another way of doing that is to say, “That must feel awful for you.” That’s framing it for them and empathizing with them at the same time.

Remember, one of the best things you can ever ask your youngster is, “What would be helpful for you right now?” And then respect his need for space.

See if your youngster can find friends outside of school, in other circles, or places where they might meet other children with the same interests. Your youngster can join things like the Boy Scouts, where the uniform basically levels the playing field (everybody in the room has the same shirt on, so children stand out less in that crowd).

Teach children how to ask for help. Here’s a scenario: your youngster comes home upset because some children were laughing at him again at school. So you say, “Well, maybe you could ask your teacher to move you.” And if the next day your youngster says, “I did ask her, and she wouldn’t.” Say, “All right then, you did exactly the right thing. Now, let me talk to the teacher, I’ll see if I can be helpful.”

Teach children how to read social situations. So if there’s a group of children that doesn’t like your youngster or picks on him, your youngster needs to learn how to stay away from them and find other children who he gets along with. Maybe there are some shy children he can befriend or other children having a hard time. For some kids, reading social situations is more difficult than for others. But there are tools that can help moms and dads work with their children that will teach them how to read expressions and pick up on social cues.

Let your youngster “talk it out” — don’t try to make the problem seem like it’s not important, because in your youngster’s life, it’s huge. Yes, all children go through this. But maybe all children don’t go through what your child is going through.

When your youngster goes to school and gets picked on, you feel powerless as a parent. It frightens you and makes you angry, but really it’s a sense of powerlessness that you’re experiencing. You do everything you can to protect yourself in life, but when your youngster goes to school and gets hurt, you’re vulnerable too. The feeling of powerlessness is a personal feeling – and it’s a devastating one. Many moms and dads lose their objectivity when their youngster talks to them about being excluded, picked on or bullied. The technique for the parent here is to go take five minutes and calm down, talk it through with others if you can, work it out, but don’t overreact in front of your youngster. Sure, it’s very normal for moms and dads to feel powerless, and it’s very difficult for them not to overreact to that feeling. But know that when you feel powerless, your first response is not always the best response. In fact, there are generally two kinds of reactions when people feel powerless: (1) they stick their head in the sand, or (2) they strike out. Remember that neither one is helpful to a child!

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

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

==> Discipline for Defiant Asperger's Teens

==> Teaching Social Skills and Emotion Management

==> Launching Adult Children with Asperger's: 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

 

 COMMENTS:

•    Anonymous said... As a parent of an ASD son I can relate. Sports (team related do not usually work) for individual participation do seem to work. My son liked golf he did learn to ride a bun early due to his obsession with wheels. Don't give up finding the activities that he can learn to excel in, they are out there. The social interaction is the hardest, the ideals listed above are excellent.
•    Anonymous said... As the years go on my son started with one friend, then in high school he gained a few more. You just have to let him find the people he clicks with on his own.
•    Anonymous said... Great article and very helpful thank you
•    Anonymous said... I can relate with so much of this article and comments from others. My son is 11 and has not been officially diagnosed but I see so much of all the comments others shared in my son... He has only been riding a bike for about a year and a half, not real coordinated, but the social area is where I really see his differences even though he don't seem to notice it. Great article.
•    Anonymous said... I purposely seek out friends for my son (usually younger siblings of his sister's friends) who are at least 2-3 years younger than he is. They are nicer, more accepting, and don't seem to mind quirks as much.
•    Anonymous said... My son has made friends with the other ASD kids that we have meet in social groups, speech, ot and special needs activities. He has more friends than his NT brother and I have made some wonderful friends with the moms.
•    Anonymous said... Really great insight. We use a lot of these suggestions & it does help. Go with his interests. Sports are really difficult for most kids with Aspergers. Follow their interest....for our son it's art, and they'll have a better chance at finding a more like minded kid that is accepting of & "gets" them. It is so hard to see their pain & feel powerless to help at times.
•    Anonymous said... We have put our son in Cub Scouts, karate, and swimming. All individual activities but still has a social piece.

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