Asperger Syndrome

What is Asperger syndrome?

Asperger syndrome is a pervasive developmental disorder. Children who have it do not develop normally in several basic areas:

• They behave oddly at times and have trouble with social skills.
• They may not want to interact with others or may have trouble doing so.
• They may not be able to understand body language or use gestures to communicate.
• They are obsessed with specific topics and become like little professors about those topics.

Asperger syndrome is also called an autistic spectrum disorder because it is a mild form of autism. Autism is a disorder in which children have communication and social problems.

How does it occur?

The cause of this disorder is unknown. It may be caused by problems during birth. The fathers of children with this disorder may also have intense and limited interests, a rigid style, and be awkward or timid with other people.

Brain scans show that the structure or shape of certain parts of the brain is different in children with Asperger syndrome. This disorder sometimes run in families. There may be certain genes linked to Asperger syndrome. About 1 in 10,000 children are diagnosed with Asperger syndrome. Boys have it 4 times as often as girls. Most children are diagnosed between the ages of 5 and 9.

What are the symptoms?

The language and self-help skills of children with Asperger syndrome develop normally. They show normal curiosity about their surroundings. Most parents of children with Asperger syndrome notice problems by the child's third birthday. Children with this disorder:

• have a hard time making eye contact and using facial expressions and hand gestures when talking to other people.
• may be clumsy and uncoordinated, or have awkward postures and gestures.
• are very self-focused. They will often have long-winded, one-sided conversations, and not notice if others respond. They may seem uncaring about other people’s feelings.
• may not understand humor and may have a hard time understanding the social cues of others.
• may speak very fast, or in a monotone, “robotic” voice. They often have a very formal way of speaking.
• are obsessed with one or two subjects, such as trains, sports statistics, or spiders. They become experts about their interest and talk all the time about facts related to these subjects.
• may get very upset at the slightest change in routine.
• are very sensitive to certain sounds, textures, tastes, and smells.
• may take longer than most children to learn to walk, catch a ball, or ride a bike.

People with this disorder do not relate well to others in large groups, but they may do fine in smaller groups or one-to-one. They can be very attached to friends and family.

How is it diagnosed?

Not all children with Asperger syndrome have the same symptoms. The healthcare provider will examine and observe your child and ask about symptoms, medical history, and the family history of any medical and mental problems. A psychologist can test your child's intelligence, social, and communication skills. A psychiatrist may evaluate your child to see if medicine might help his or her symptoms.

How is it treated?

There is no one best treatment for all children with Asperger syndrome. Before you decide on your child's treatment, find out what your options are. Learn as much as you can and make your choice for your child's treatment based on your child's needs. A good treatment program will:

• build on the child's interests
• offer a predictable schedule
• teach tasks as a series of simple steps
• actively hold the child's attention in highly structured activities
• provide regular evaluation of educational and behavioral goals

Usually children are placed in public schools and the school district pays for all needed services. These will include working with a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide. You may want to visit public schools in your area to see the type of program they offer to special needs children.

By law, public schools must prepare and carry out a teaching plan. This plan is designed to help children in a special education program to learn specific skills. The list of skills is known as the child's Individualized Education Program (IEP). The IEP is an agreement between the school and the family about the child's goals. Parents play an important part in creating the program, as they know their child and his or her needs best. If your child is under 3 years of age and has special needs, check into early intervention programs.

A cognitive behavioral therapist can help your child learn to manage stress, and cut back on obsessive interests and repetitive routines.

Treatment includes doing activities at home as well as at school. Behavioral therapy can also be done in the home by parents. The first step is to choose a skill to work on. You need to make sure the child can succeed. When your child succeeds, reward the behavior. When they are rewarded, they start to understand what you want them to do. A reward follows a behavior and increases the chances that the behavior will be repeated. Be sure that the reward you use is something your child wants, and that it works for the behavior you are trying to change. Some things that have been found to work well for children with Asperger syndrome are food, hugs, massage, being lifted or swung in the air, TV, videos, music, and reading books.

It is important to show your child that interacting with people is fun and that communicating with people leads to good things (rewards). Give your child lots of supervised opportunities to practice communication and social skills.

Sometimes medicine can help. Mood- or behavior-altering drugs can improve behaviors that may cause self-injury or greatly interfere with school or social ability. These medicines must be prescribed by a doctor experienced with their use in children with this disorder. There is no medicine that will take away the symptoms of Asperger syndrome.

Parents often learn of new or alternative treatments through friends or the media. Your provider can help you decide if these treatments could help or harm your child.

How long will the effects last?

Asperger syndrome is a lifelong condition. Treatment helps. People with this disorder can have good relationships, hold jobs, and lead happy and productive lives.