WHAT IS ASPERGER’S SYNDROME?
Asperger Syndrome (AS) is a disorder of development and is considered to be one of Autism Spectrum Disorders. All Autism spectrum disorders include developmental problems in broadly three areas: social relatedness and social skills, the use of language for communicative purposes, and repetitive behaviours and a limited but intense range of interests. The presence of abnormalities in these three areas defines all disorders on the spectrum, including AS.
AS, however, is considered the mildest end of the spectrum. Asperger syndrome represents that portion of the spectrum which is characterized at least normal IQ by definition, and sometimes ranging up into the very superior range, and by more normal language function compared to other disorders along the spectrum. In fact, the presence of normal basic language skills is now felt to be one of the criteria for the diagnosis of AS.
Individuals with AS can exhibit a variety of characteristics and the disorder can range from mild to severe.
WHAT CAUSES AS?
There is no single identifiable cause in most cases of AS; studies show that several factors, including genetic ones, can cause AS.
HOW DO I KNOW THAT A CHILD HAS AS?
Children with AS typically show a number of the following characteristics:
Social impairment with extreme egocentricity, which may include:
o Inability and lack of desire to interact with peers
o Poor appreciation of social cues and non-verbal cues (like body-language)
o Socially and emotionally inappropriate responses
• Limited interests and preoccupations, including:
o More rote than meaning
o Relatively exclusive of other interests
o Repetitive adherence
o May be preoccupied with a particular subject of interest (eg. maps, trains, snakes)
• Repetitive routines or rituals. Prefer sameness (routines and structure); and has difficuties with transitions and changes.
• Speech and language peculiarities, such as:
o Delayed early development possible but not always seen – Superficially perfect expressive language
o Odd prosody, peculiar voice characteristics
o Impaired comprehension including misinterpretation of literal and implied meanings.
• Nonverbal communication problems, such as:
o Limited use of gesture
o Clumsy body language
o Limited or inappropriate facial expression
o Peculiar “stiff” gaze
o Difficulty adjusting physical proximity
• Motor clumsiness
o may not be necessary part of the picture in all cases
• Often very sensitive to sound, light, taste, smell.
These behaviors must be sufficient to interfere significantly with social or other areas of functioning. There are other factors as well, and a diagnosis has to made after investigations by a developmental pediatrician. Also note that from May 2013, Asperger Syndrome will no longer be considered as a separate diagnosis and will now be called Autism spectrum Disorder (ASD). This is because, across the world, people acknowledge that while individuals with Asperger syndrome may appear to be functioning fairly well, their challenges in social communication and behaviours are common to others who get a diagnosis of Autism or Autism Spectrum Disorder (ASD).
HOW DO I GET A CHILD EVALUATED FOR AS?
If you are worried that your child exhibits some or all of the above concerns, you should get him evaluated by a professional who has expertise in this area. It could be a developmental pediatrician, a child psychiatrist or a child psychologist.
You might be advised to get your child undergo a test called the ADOS (Autism Diagnostic Observation Schedule) and/or a detailed observation and interaction with your child.
HOW CAN I HELP A CHILD WITH AS IN SCHOOL AND IN GENERAL SOCIAL SITUATIONS?
• A child with AS may have a great deal of difficulty with transitions. Having a picture or word schedule may be helpful.
• Try to give as much advance notice as possible if there is going to be a change or disruption in the schedule. (E.g. Before going on a field trip.)
• Giving one or two warnings before a change of activity or schedule may be helpful. (“Tomorrow we will be going to the museum, no math, no English, no PT period”)
Sensory Motor Skills/Auditory Processing
• Breaking directions down into simple steps is quite helpful (“first read pg. 40, then answer questions on pg. 42”)
• Using picture cures or directions may also help.
• Speaking slower and in smaller phrases can help.
• Children with AS may get overstimulated by loud noises, lights, strong tastes or textures, because of the greater sensitivity to these things.
• With lots of other kids, chaos and noise, please try to help a child with AS find a quiet spot to which he/she can go for some “comfort“. (You can ask to the child to have 5 min in that comfort zone when things get difficult.)
• Unstructured times (such as lunch, break and PE) may prove to be the most difficult for these children. Please try to help provide some guidance and extra adults help during these more difficult times.
• Allow the child to “move about” as sitting still for long periods of time can be very difficult (even a 5 minute walk around, with a friend or aide can help a lot).
• Some children with AS learn best with visual aids, such as picture schedules, written directions or drawings (other children may do better with verbal instruction.)
• Hand signals may be helpful, especially to reinforce certain messages, such as “wait your turn“, “stop talking” (out of turn), or “speak more slowly or softly“.
• At times, it may take more than few seconds for a child with AS to respond to questions. He/she needs to stop what they’re thinking, put that somewhere, formulate an answer and then respond. Please wait patiently for the answer and encourage others to do the same. Otherwise, they will have to start over again.
• When someone tries to help by finishing his/her sentences or interrupting, he/she often has to go back and start over to get the chain of thought back.
• At times, it looks as if a child with AS is not listening to you when he/she really is. Don’t assume that because he/she is not looking at you that he/she is not hearing you.
• Unlike most of us, sometimes forcing eye contact BREAKS concentration.
• The child may actually hear and understand you better if not forced to look directly at your eyes.
Social Skills and Friendships
• Here lays one of the biggest challenges for children with AS. They may want to make friends very badly, yet not have a clue as to how to go about it.
• Identifying 1 or 2 empathetic students who can serve as “buddies” will help the child feel as though the world is a friendlier place.
• Talking with the other members of the class may help, if done in a positive way and with the permission of the family. For example, talking about the fact that many or most of us have challenges and that the AS child’s challenge is that he cannot read social situations well, just as others may need glasses or hearing aids.
• This is very important to most children with AS, but can be very difficult to attain on a regular basis in our world.
• Please let the child know of any anticipated changes as soon as you know them, especially with picture or word schedules.
• Let them know, if possible, when there will be a substitute teacher or a field trip occurring during regular school hours.
• Although his vocabulary and use of language may seem high, children with AS may not know the meaning of what they are saying even though the words sound correct.
• Sarcasm and some forums of humour are often not understood.
• Children with AS lack the ability of remember a lot of information or how to retrieve that information for its use.
• It may be helpful to develop schedules (picture or written) for him.
• Posting schedules and homework assignments on the board and make a copy for him. Put the assignment into his backpack because he can’t always be counted on to get everything home without some help.
• If necessary allow to copy the notes of other children or you provide a copy. Many AS children are also dysgraphic and they are unable to listen to you talk, read the board and take notes at the same time.