Asperger’s Cliff Notes

Last week, Colin was officially diagnosed with Asperger’s Disorder (AS). We felt it coming and honestly it’s nice to have that label because now we can get the right therapies in place. I wanted to just sit and write out a synopsis of what people with Asperger’s deal with in their world so that as I continue to blog about our lives, this post can be a reference tool.

You can also refer back to my May blogging to get a little window into some of our daily stuff here: http://divinegraffiti.com/2009/05/

In order to diagnose AS or any disorder on the Autism spectrum, a thorough evaluation takes place. Colin spent three hours in the company of two wonderful neuropsychologists playing games, taking tests, coloring, doing mazes, and working computer games. Mom, Dad and teacher got to fill out little score sheets asking about certain behaviors. Those things all put together helped the neuropsychologist to determine whether or not Colin has ADHD, Autism, PDD (pervasive developmental disorder) or Asperger’s Syndrome.

Many clinicians will consider AS to be the same as High Functioning Autism. However, one of the diagnostic criteria for AS is that a child will not score high on the Autism scale. In fact, Colin was shown on that scale to be Not Autistic. But, on the AS scales and in his behavior evaluations, he scored very high. That is not to say that a child with AS is not on the autism spectrum, but AS has very specific differences from HFA and they are hard to pinpoint at times.

Our wonderful neuropsychologist explained it to us like this:
A child with AS has an intense need for relationships and intimacy with others just like we all do.  However, they do not know how to go about forming relationships or making friends using appropriate social skills and this becomes a source of real worry and sadness for them. They care very much that someone is unhappy with them or that they don’t have friends.  They will overshoot (by being too aggressive with physical touch) or undershoot (by shutting down, freezing or hiding). There are studies to show that there is a physical change in the cerebellum of AS kids that functions like someone with Parkinson’s Disease or injury to that area. They know what they want, but the tremor doesn’t let them pick it up. Children with PDD or HFA often use the same behaviors to try to make friends, but they are not all that concerned if the friendships don’t materialize. They aren’t really bothered if they are alone. That is one of the slight nuanced differences between HFA and AS. And one of the behaviors used to diagnosis AS apart from any other disorder.

Typically children with AS have no language or speech delay, in fact often develop language skills early and are quite sophisticated in their use of words, pronunciation and grammar. Almost pedantic in their speech. (Come over sometime and just listen to the conversations we have!!!) 

AS kid often have no fine motor problems, or only slight fine motor deficits. Colin struggles with buttons, zippers and snaps but has no other problems in that area. He’ll have a tough time learning to tie shoes. He won’t qualify for OT services because of this.

Within the first week of school, Colin had memorized the locations of all the red fire alarms in the building so he could keep an eye on them in case they should sound off.  He has to have at least two days warning if there will be a substitute teacher, or his behaviors in school that day will be difficult. Super sensitivity to any external stimuli can result in hyperactivity. Many kids with AS also have ADHD and are treated with medications effectively. Colin’s hyperactivity is very situational and only rears its head when he’s reacting to external stimuli that makes him uncomfortable. That could be crowded places, loud noises or even excitement. He will not need medications for ADHD, at least for now.

Routine is very important. AS kids can not switch gears without ample warning, or there will be trouble. We must give Colin time warnings constantly when something is going to happen. “Ten minutes til dinner,” “Five minutes til bath time,” “Three minutes til we leave.”  He also needs to know each day what we will be doing. If the schedule is changed he may cry, bang his head on the couch, hide under a table or generally act out.  As he gets older, his emotional maturity will probably lag behind that of his peers to a degree.

Eye contact is like nails on a chalkboard to him. Force him to look at you and he’ll do so, but giggle the whole time to make himself feel better. He can’t understand the nuances in facial expressions or tone of voice that infants and toddlers learn instinctively. He’ll need to be taught all of those things. He’ll interpret mild irritation with real anger directed at him. He has difficulty answering questions that ask him to describe a feeling…”Do you like school?”…for example. But, “What’s your teacher’s name?” will get a response. Just the facts please, not the feelings. He has the feelings we all do, but has difficulty describing which one is which.

Sarcasm goes nowhere. AS is a literal world, so the jokes and nuanced speech that we all use doesn’t compute in his brain. His soccer coach made cookies for the team and said “I put my blood, sweat and tears into these cookies.”  Colin was very confused and somewhat alarmed by that and unsure if the cookie was good to eat!

Colin is an extremely bright and fun kid! He’s silly, goofy and full of life. He loves to wrestle and play. Colin is constantly giving out hugs and kisses to those he loves (sometimes to the point of overkill) and we wouldn’t have him any other way.

Our challenge will be parenting this child and preparing him for a world that functions on social norms which he doesn’t instinctively understand. He’ll be very successful in whatever he decides to do, but it’ll be a different road that gets him there.

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1 Comment (+add yours?)

  1. Shivon
    Dec 02, 2009 @ 16:24:34

    This is THE BEST description of Asperger’s for the average person I have read tuhs far. Thank you!!

    Reply

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