Asperger Syndrome
by Rosalyn Lord, Coordinator of CASSEL, a support group in East Lancashire (UK)
Asperger Syndrome is a developmental disorder falling within the autistic spectrum affecting two-way social interaction, verbal and nonverbal communication and a reluctance to accept change, inflexibility of thought and to have all absorbing narrow areas of interest. Individuals are usually extremely good on rote memory skills (facts, figures, dates, times etc.) many excel in math and science. There is a range of severity of symptoms within the syndrome, the very mildly affected child often goes undiagnosed and may just appear odd or eccentric.
Whilst Asperger Syndrome is much more common than Autism it is still a rare condition and few people, including professionals, will know about it much less have experience of it. It seems to affect more boys than girls. In general terms they find making friends difficult, not understanding the subtle clues needed to do so. They often use language in a slightly odd way and take literal meanings from what is read or heard. They are happiest with routines and a structured environment, finding it difficult to decide what to do they fall back on to their preferred activities. They love praise, winning and being first, but find loosing, imperfection and criticism very difficult to take. Bad behavior often stems from an inability to communicate their frustrations and anxieties. They need love, tenderness, care, patience and understanding. Within this framework they seem to flourish.
Children with Asperger Syndrome are for the most part bright, happy and loving children. If we can help break through to their 'own little world' we can help them to cope a little better in society. They have a need to finish tasks they have started. Strategies can be developed to reduce the stress they experience at such times. Warnings that an activity is to finish in x minutes can help with older children. With younger children attempts to 'save' the task help - videoing a programme, mark in a book etc.
As the children mature some problems will get easier, but like all other children new problems will emerge. Some teenagers can feel the lack of friendships difficult to cope with as they try hard to make friends in their own way but find it hard to keep them. This is not always the case, many have friends who act as 'buddies' for long periods of time. Social skills will have to be taught in an effort for them to find a place in the world ... so take all opportunities to explain situations time and time again ..... and one day.......it may work!
Please bear in mind that booklets such as this do tend to detail all the problems which can be found within a syndrome but that does not mean every child will have all of them. Each child will also have different levels of achievements and difficulties. They are after all just as the others ... individuals!
Is Asperger Syndrome The Same As Autism?
The debate on this question still continues, some experts say that Asperger Syndrome should be classified separately, others argue that the core difficulties are the same, only the degree to which they are seen in the children actually makes the difference. One expert - Uta Frith - has referred to Asperger children as 'Having a dash of Autism'.
Autism is often interpreted as a withdrawal from normal life - to live in the persons own fantasy world. This is no longer the real meaning of Autism. The severity of the impairments is much greater than in Asperger Syndrome, and often the child will have little or no language. Learning problems are more common in classic Autism. In Asperger Syndrome speech is usual and intelligence (cognitive ability) is usually average or even above average.
For the moment it is taken that the similarities are enough for both Autism and Asperger Syndrome to be considered within the same 'spectrum' of developmental disorders. Whilst a clear diagnosis is essential, it can change through life. The autistic traits seen in young children can often seem less severe as the child matures and learns strategies to cope with his/her difficulties.
Key Features
The main areas affected by Asperger Syndrome are:
- Social interaction
- Communication
- Narrow Interests / Preoccupation's
- Repetitive routines / rituals, inflexibility
Social Interaction
Children with Asperger Syndrome have poor social skills. They can not read the social cues and, therefore, they don't give the right social and emotional responses. They can lack the desire to share information and experiences with others. These problems are less noticeable with parents and adults, but it leads to an inability to make age appropriate friends. This in turn can lead to frustration and subsequent behavior problems. They find the world a confusing place. They are often alone, some are happy like this, others are not. They are more noticeably different among peer groups in unstructured settings i.e. playgrounds. Their naivete can cause them to be bullied and teased unless care is taken by assistants or buddies to integrate and help protect them. They can often focus on small details and fail to see the overall picture of what is happening in any situation.
Communication
Both verbal and nonverbal communications pose problems. Spoken language is often not entirely understood, so it should be kept simple, to a level they can understand. Take care to be precise. Metaphor s (non-literal expressions - 'food for thought') and similes (figures of speech - 'as fit as a fiddle') have to be explained as children with Asperger Syndrome tend to make literal and concrete interpretations. Language acquisition - learning to speak - in some cases can be delayed. They make much use of phrases they have memorized, although they may not be used in the right context. A certain amount of translation may be needed in order to understand what they are trying to say.
Spoken language can sometimes be odd, perhaps they don't have the local accent or they are too loud for a situation or overly formal or speak in a monotonous tone. If the child with Asperger Syndrome has a good level of spoken language you must not assume their understanding is at the same level . Some talk incessantly (hyperverbal) often on a topic of interest only to themselves without knowing the boredom of the listener.
Difficulties in using the right words or forming conversations is part of semantic-pragmatic difficulties. They appear often to talk 'at' rather than 'to' you, giving information rather that holding proper conversations. Body language and facial expressions of a child with Asperger Syndrome can appear odd (stiff eye gaze rather than eye contact) and find 'reading' these things in others gives rise to further difficulties. Early age is known as Hyperlexia. Some children have remarkable reading abilities although you should check if they also understand the text. The ability to read fluently without understanding the meaning is known as Hyperlexia.
Narrow Interests / Pre-occupations
One of the hallmarks of Asperger Syndrome is the child's preoccupation (or obsession) with certain topics, often on themes of transport - trains in particular-or computers, dinosaurs, maps etc. These pre-occupations, usually in intellectual areas change over time but not in intensity, and maybe pursued to the exclusion of other activities.
Repetitive Routines / Inflexibility
Children often impose rigid routine on themselves and those around them, from how they want things done, to what they will eat etc. It can be very frustrating for all concerned. Routines will change from time to time, as they mature they are perhaps a little easier to reason with. This inflexibility shows itself in other ways too, giving rise to difficulties with imaginative and creative thinking. The child tends to like the same old thing done in the same old way over and over again!. They often can't see the point of a story or the connection between starting a task and what will be the result. They usually excel at rote memory - learning information without understanding, but it can still be an asset. Attempts should always be made to explain everything in a way they can understand. Don't assume because they parrot information back that they know what they are talking about.
Education
If the child with Asperger Syndrome is to be educated in a mainstream school it is important that the correct amount of support is made available. In order to get the correct support a Statement of Special Educational Needs should be drawn up from the various advice's supplied by you and the specialists. This procedure, when it begins, can take 6 months and be a very stressful and confusing time - don't be afraid to contact people who can help, this need not be a professional it may just be someone who has done it all before.
It is beneficial if the school of your choice is willing to learn about the difficulties that they and the child will face, some schools are better than other on this score. Looking at several schools will give a better picture of exactly what is available. The support currently offered in mainstream school is by Special Support Assistants (SSA) for a certain number of hours each week based on the child's needs in order to help the child access the curriculum and develop in a social setting. A support teacher with specialist knowledge of Autism should support the child, SSA, teacher and school in understanding and teaching the child. Other professional input may also be required such as speech and language therapy to help develop skills.
The home/school link is vital, a diary can prove invaluable giving two way communication on achievements and problems on a regular basis.
Helpful Strategies
There are many things you can do to help your child better understand the world and in doing so make everyone's lives a little easier. The ideas below are only suggestions which you may or may not find helpful.
- Keep all your speech simple - to a level they understand.
- Keep instructions simple ... for complicated jobs use lists or pictures.
- Try to get confirmation that they understand what you are talking about/or asking - don't rely on a stock yes or no - that they like to answer with.
- Explain why they should look at you when you speak to them.... encourage them, give lots of praise for any achievement - especially when they use a social skill without prompting.
- In some young children who appear not to listen - the act of 'singing' your words can have a beneficial effect.
- Limit any choices to two or three items.
- Limit their 'special interest' time to set amounts of time each day if you can.
- Use turn taking activities as much as possible, not only in games but at home too.
- Pre-warn them of any changes, and give warning prompts if you want them to finish a task... 'when you have coloured that in we are going shopping'.
- Try to build in some flexibility in their routine, if they learn early that things do change and often without warning - it can help.
- Don't always expect them to 'act their age' they are usually immature and you should make some allowances for this.
- Try to identify stress triggers - avoid them if possible -be ready to distract with some alternative 'come and see this...' etc.
- Find a way of coping with behavior problems - perhaps trying to ignore it if it's not too bad or hugging sometimes can help.
- Promises and threats you make will have to be kept - so try not to make them too lightly.
- Teach them some strategies for coping - telling people who are teasing perhaps to 'go away' or to breathe deeply and count to 20 if they feel the urge to cry in public.
- Begin early to teach the difference between private and public places and actions, so that they can develop ways of coping with more complex social rules later in life.
- Let them know that you love them - wart's an' all' - and that you are proud of them. It can be very easy with a child who rarely speaks not to tell them all the things you feel inside.
Remember, they are children just like the rest, they have their own personalities, abilities, likes and dislikes - they just need extra support, patience and understanding from everyone around them.
