Autism in general and Asperger’s Disorder in particular have received a great deal of media attention over the past decade, in part due to the sudden recent increase in diagnosis of this disorder. While debate rages about whether or not certain vaccinations have caused this increase in occurrences, the increase has led to a heightened awareness among parents, teachers and school administrators, and the medical community. Just what is Asperger’s Disorder, how is it different from autism, and how can a parent raise a healthy, happy child diagnosed with either of these conditions?
Autism is a much more severe condition, in which verbal and nonverbal communication are both qualitatively and quantitatively constricted. It is common for individuals with autism to be mute and isolative, with very limited interest or enjoyment in social interactions. To meet diagnostic criteria for autism, an individual must show impairment in social interaction, impairment in communication, and a narrow range of focus on interest, usually on parts of things versus whole things (e.g. memorizing an entire train schedule, but not having any interest in trains or traveling). Some individuals with autism struggle with rigid schedules or rituals, and become upset or disregulated if their pattern of behavior is disrupted. In addition, autistic individuals often have odd movements or mannerisms, such as flapping their hands or arms.
Asperger’s disorder is a less severe but similar condition, affecting boys with greater frequency than girls. Diagnostic criteria are similar to autism but with an important difference: in order to diagnose autism, communication/language delays must be present, while Asperger’s disorder cannot be diagnosed if such delays exist. Further, to be diagnosed with Asperger’s disorder, the child must be “functionally normal” – that is, not showing any delays in cognitive or intellectual functioning, nor any delays in self help skills, or other normative childhood developmental tasks. Thus children with Aspberger’s disorder are of normal intelligence, curious about their world in an age appropriate way, and able to communicate verbally and nonverbally.
However, they must show real disturbances in the area of social interaction: they are often described as having poor social skills, meaning that they lack appropriate emotional responses to situations (e.g. they may laugh when a classmate is sad or upset “because his face looked funny”), or appear cold because they are disinterested in other people’s happiness or pleasure. The classic Asperger’s disorder symptom is their inability to read, respond appropriately to, and use nonverbal communication. Eye contact, gestures, facial expressions and the like are “Greek” to children with this diagnosis.
How Does a Parent Cope Following Diagnosis?
Once diagnosed, what’s a parent to do? The news is at once good and bad: your child is normal in many ways, and capable of functioning well in certain environments, but is deeply impaired in the area of making and enjoying relationships with others, including you. Many parents find this painful and difficult, and support for you as you help your child is key. Consider a short-term course of therapy to work through any issues or concerns of your own as you move forward with helping your child.
As communication and social interaction are the major areas of impaired functioning, school is going to be a key player in helping you help your child. Discuss your child’s needs and challenges openly with his or her teacher, and explore informal and formal options as needed. Informal options include teacher-directed classroom supports and interventions, such as pairing your child up at a desk or table with an appropriate peer, or using “circle time” or other entire class activities to practice social skills in a supportive and structured way.
Formal options may include seeking a 504 accommodation plan or having the school conduct a functional behavioral assessment so that a behavioral intervention plan might be created. If your child is really struggling in a regular classroom, a smaller room with less noise, stimulation, or social challenges might be appropriate and initiating a referral to the committee of special education may be your best bet.
At home: patience, patience, patience! Your child may fall apart or become combative over the smallest changes in routines, or beg you to be allowed to take electronic devices apart, or cut their sibling’s hair “because it was bothering me.” Their logic works for them, and they experience their needs as being more important than any other household concern. Structure and routines (e.g. bedtime routines, and morning routines for getting ready for school) can really help. Come up with simple but fun catchy phrases to help your child remember and attach to the routine and enjoy it. Set clear limits and give short, simple, clear reasons why those are the rules. Children with Asperger’s disorder have trouble with subtlety, nuance, and “gray areas.” Make things as clear as you can, especially when your children are young. As they approach teenage years, you can talk with them about how challenging certain aspects of human interaction may be. Their insights may well surprise and impress you!