How to diagnose aspergers in a child
Asperger's Syndrome: Symptoms, Diagnosis and Treatment
Nationwide Children’s Hospital
Overview
Signs & Symptoms
Causes
Diagnosis
Treatment
Seeking Help
What is Asperger’s Syndrome?
Asperger’s Syndrome is a developmental disorder. Young people with Asperger’s Syndrome have a difficult time relating to others socially and their behavior and thinking patterns can be rigid and repetitive.
Generally, children and teens with Asperger’s Syndrome can speak with others and can perform fairly well in their school work. However, they have trouble understanding social situations and subtle forms of communication like body language, humor and sarcasm. They might also think and talk a lot about one topic or interest or only want to do a small range of activities. These interests can become obsessive and interfere with everyday life, rather than giving the child a healthy social or recreational outlet.
Boys are three to four times more likely than girls to have Asperger’s Syndrome. Most cases are diagnosed between the ages of five and nine, with some diagnosed as early as age three.
What Is the Difference Between Asperger’s Syndrome and Autism Spectrum Disorder?
The name for Asperger’s Syndrome has officially changed, but many still use the term Asperger’s Syndrome when talking about their condition. The symptoms of Asperger’s Syndrome are now included in a condition called Autism Spectrum Disorder (ASD). ASD is now the name used for a wide range of autism-like disorders. Some providers may still use the term Asperger’s Syndrome, but others will say “ASD – without intellectual or language impairment.” These two syndromes are, for the most part, the same.
What are the Symptoms of Asperger’s Syndrome?
Children with Asperger’s Syndrome exhibit poor social interactions, obsessions, odd speech patterns, limited facial expressions and other peculiar mannerisms. They might engage in obsessive routines and show an unusual sensitivity to sensory stimuli.
While all children with Asperger’s Syndrome are different, what sets them apart are their unusual social skills and obsessive interests. For a child with Asperger’s Syndrome, you may see one or more of the following symptoms:
- Inappropriate or minimal social interactions
- Conversations that almost always revolve around themselves or a certain topic, rather than others
- Not understanding emotions well or having less facial expression than others
- Speech that sounds unusual, such as flat, high-pitched, quiet, loud, or robotic
- Not using or understanding nonverbal communication, such as gestures, body language and facial expression
- An intense obsession with one or two specific, narrow subjects
- Becoming upset at any small changes in routines
- Memorizing preferred information and facts easily
- Clumsy, uncoordinated movements, including difficulty with handwriting
- Difficulty managing emotions, sometimes leading to verbal or behavioral outbursts, self-injurious behaviors or tantrums
- Not understanding other peoples’ feelings or perspectives
- Hypersensitivity to lights, sounds and textures
Children with Asperger’s Syndrome often show no delays in their language development. They are likely to have good grammar skills and an advanced vocabulary, but they also tend to be very literal. They have trouble using language in a social context.
There may be no obvious delay in their cognitive development. Children with Asperger’s Syndrome can have problems with attention span and organization, but they usually have average intelligence.
What Causes Asperger’s Syndrome?
The causes of Asperger’s Syndrome are unknown. Genetics and brain abnormalities may be involved.
We do know that Asperger’s Syndrome is NOT the result of a child’s upbringing or poor parenting. Asperger’s Syndrome is a neurobiological disorder, meaning it is just a part of the child’s brain development, whose causes are not fully understood.
How is Asperger’s Syndrome Diagnosed?
As mentioned above, Asperger’s Syndrome is no longer diagnosed as a condition in and of itself. It is part of the range of conditions included in Autism Spectrum Disorder.
If a parent is concerned about a child’s social development, unusual language patterns, and odd behaviors, a pediatrician should be consulted. The pediatrician can determine if the child should be seen by a specialist, such as a developmental pediatrician, psychologist, or other clinician who is familiar with ASD.
Testing and assessment usually involve a team of medical and psychological professionals. The specialists will ask the parent many questions about the child’s development and current skills and problems. They will also interact with the child and conduct assessments to evaluate what symptoms the child shows when interacting with others. They may also assess the child’s language and intellectual abilities. A medical doctor might ask questions or order tests to make sure there are no other medical concerns for the child.
Asperger’s Syndrome (also known as “Autism Spectrum Disorder - without intellectual or language impairment”) may be difficult to diagnose. Sometimes this condition can be confused with other conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD) or Oppositional Defiant Disorder (ODD). Making sure to evaluate the child’s social and communication skills, their patterns of behavior and thinking, and how these symptoms have developed over time will help the assessor provide the correct diagnosis.
How is Asperger’s Syndrome Treated?
Because each case is different, treatment plans must be built according to each child’s needs. They should be adjusted over time as those needs change.
Treatment of Asperger’s Syndrome usually includes:
- Social skills training
- Behavior supports
- Cognitive behavioral therapy
- Parent education and training
- Speech-language therapy
- Occupational therapy
- Special education classes
- Medication
At present, there is no “cure.” By learning to cope with the symptoms and pick up on social cues, a child can learn to overcome some of the challenges he faces. With help, parents can learn how to best support their child. People with Asperger’s Syndrome can do well in school and go on to be contributing members of their community.
When Should I Seek Help?
Treatment should be done while a child's brain is still developing. If you notice signs of Asperger’s Syndrome or any of the symptoms of Autism Spectrum Disorder in your child, see your pediatrician. She or he can refer you to a mental health expert who specializes in diagnosing this type of disorder.
Related Conditions
- Autism Spectrum Disorder
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Asperger Syndrome - Johns Hopkins All Children's Hospital
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- inappropriate or minimal social interactions
- conversations that almost always revolve around self rather than others
- "scripted," "robotic," or repetitive speech
- lack of "common sense"
- problems with reading, math, or writing skills
- obsession with complex topics, such as patterns or music
- average to below-average nonverbal cognitive abilities, though verbal cognitive abilities are usually average to above-average
- awkward movements
- odd behaviors or mannerisms
- parent education and training
- specialized educational interventions
- social skills training
- language therapy
- for younger kids, sensory integration training. This usually involves occupational therapy, in which a child is desensitized to stimuli he or she is overly sensitive to
- psychotherapy or behavioral/cognitive therapy for older kids
- medicines
- Look into educational or training programs for parents. You're your child's first teacher and you'll continue to be the cornerstone in supporting his or her development.
- Teach your child self-help skills. Learning these skills helps kids achieve maximum independence.
- Because it's not always obvious that a child has AS, tell others that your child has special needs. As a parent, you may have to be an educator when dealing with teachers, medical personnel, and other caregivers.
- Find a treatment or intervention program tailored to your child's specific issues or areas of "deficiency." The Autism Society of America (ASA) recommends talking with the program's director to be sure that it can meet your child's needs.
- Choose special programs or treatments that focus on long-term goals and are suited to your child's developmental level.
- Remember that your child is part of a family, and that his or her needs should be balanced with those of other family members.
- Get support for yourself and other family members. You can't help your child if you're not meeting your own emotional and physical needs. Your community may have support groups at a local hospital or mental health center. Government-sponsored services and other programs vary from state to state.
Asperger syndrome (AS) is a type of autism. Autism affects how a person interprets language, communicates, and socializes.
AS used to be considered its own condition, with its own diagnosis, but that changed in 2013. That's when the guidebook that doctors use (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, commonly called DSM-5) changed the classification of AS. Now, kids who show signs of AS are diagnosed with autism and are considered "on the autism spectrum."
"On the Autism Spectrum"
The term "autism spectrum" refers to a wide range of developmental disabilities. These disabilities can appear in different combinations with varying degrees of severity: two children with the same diagnosis, though they may share certain patterns of behavior, can have a wide range of skills and abilities. As a result, general terms such as "low-functioning," "high-functioning," "autistic tendencies," "pervasive developmental disorder," and others are often used to describe children whose behaviors fall on the autism spectrum.
Kids with AS are generally considered to be on the "high-functioning" end of the autism spectrum. Boys are three to four times more likely than girls to have AS. The incidence seems to be increasing, but this might be because milder cases are being identified more frequently.
Although Asperger syndrome is no longer considered to be a diagnosis all on its own, many parents and people in the medical community still use the term.
About Asperger Syndrome
The disorder is named after Hans Asperger, a Viennese pediatrician who, in 1944, first described a set of behavior patterns apparent in some of his patients, mostly males. Asperger noticed that although these boys had normal intelligence and language development, they had severely impaired social skills, couldn't communicate well with others, and had poor coordination.
According to the Asperger Syndrome Coalition of the United States, the onset of AS may be later than what is typical in autism — or at least is recognized later. Many kids are diagnosed after age 3, with most diagnosed between the ages of 5 and 9.
AS is characterized by poor social interactions, obsessions, odd speech patterns, few facial expressions, and other peculiar mannerisms. Often, kids with AS have trouble reading the body language of others. They might engage in obsessive routines and show an unusual sensitivity to sensory stimuli — for example, they may be bothered by a light that no one else notices; they may cover their ears to block out sounds in the environment; or they might prefer to wear clothing made only of a certain material.
Overall, kids and teens with AS can function in everyday life, but tend to be somewhat socially immature, relate better to adults than peers, and may be seen by others as odd or eccentric.
Other characteristics of AS can include motor delays, clumsiness, limited interests, and peculiar preoccupations. Adults with AS have trouble showing empathy for others, and social interactions continue to be difficult.
Experts say that AS follows a continuous course and usually lasts a lifetime. However, symptoms can increase and decrease over time, and early intervention services can be helpful.
Signs and Symptoms
Because the signs of AS can be similar to those of other behavioral problems, it's best to let a doctor or other health professional evaluate a child's symptoms. Many kids are diagnosed with attention deficit hyperactivity disorder (ADHD) before a diagnosis of AS is made later.
A child with AS might have these signs and symptoms:
It's important to note that, unlike kids with autism, those with AS might show no delays in language development; they usually have good grammar skills and an advanced vocabulary at an early age. However, many do have a language disorder — for instance, a child might be very literal and have trouble using language in a social context.
Often there are no obvious delays in cognitive development. Kids with AS can have problems with attention span and organization, or skills that seem well developed in some areas and lacking in others, but they usually have average and sometimes above-average intelligence.
What Causes Asperger Syndrome?
Researchers and mental health experts are still investigating the causes of autism and AS. Brain abnormalities are thought to be one possible cause of AS, because structural and functional differences have been seen with advanced brain imaging.
Genetics might play a role, and research indicates that some cases of AS may be associated with other mental health problems such as depression and bipolar disorder.
AS is not caused by emotional deprivation or the way a child was brought up. Because some behaviors seen in AS may be thought of as intentionally rude by others, many people wrongly assume that AS is the result of bad parenting — it isn't. It's a neurobiological disorder whose causes are not yet fully understood.
Currently, there is no cure for the disorder — kids with AS become adults with AS. But many lead full and happy lives, and their chances of doing so are helped by appropriate education, support, and resources.
Diagnosing Asperger Syndrome
Asperger syndrome can be very difficult to diagnose. Children with AS function well in most aspects of life, so it can be easy to attribute their strange behaviors to just being "different."
Experts say that early intervention involving educational and social training, done while a child's brain is still developing, is very important for kids with AS.
If your child shows some of the symptoms and behaviors that are typical of AS, it's critical to seek help from your doctor. He or she can refer you to a mental health professional or other specialist for further evaluation.
A specialist will do a thorough "psychosocial" evaluation of your child. This includes a careful history of when symptoms were first noticed, the development of motor skills and language patterns, and other aspects of personality and behavior (including favorite activities, unusual habits, preoccupations, etc.).
Particular focus is placed on social development, including past and present problems in social interaction and development of friendships. A psychological evaluation and assessment of communication skills usually are done to see which might be lacking.
Treating Asperger Syndrome
AS behaviors and problems can differ widely from child to child, so there isn't a "typical" or prescribed treatment. But, depending on what their strengths and weaknesses are (or what their development history is), kids may benefit from:
Many people can help your child, so it's important to involve all caregivers. For instance, every health professional caring for your child should know what the others are doing. And teachers, babysitters, other family members, close friends, and anyone else who cares for your child should be involved.
Finding the right program is key, as is getting help for your child early. Kids with AS can and do have great gains with the proper treatment and education.
Helping Your Child
AS brings challenges for kids and their parents, but you can help your child adjust and offer support in many ways:
Your Child's Future
Few facilities are dedicated to providing for the needs of kids with AS. Some children attend mainstream schools where their progress depends on the support and encouragement of parents, caregivers, teachers, and classmates. Others go to special schools for kids with autism or learning disabilities.
Many people with AS manage well in most aspects of life, so the condition does not have to prevent your child from succeeding academically and socially.
You may feel overwhelmed and discouraged if your child is diagnosed with AS. Remember that the treatment team can provide enormous support and encouragement for your child — and your family.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Asperger's Syndrome | Autism FRC
Asperger's syndrome-, like Kanner's syndrome, belongs to non-procedural, dysontogenetic forms of RDA. Recently, it has been referred to as a constitutional pathology of the autistic type.
1) As with other types of autism, the condition in Asperger's syndrome is determined by communication disorders, underestimation of reality, a limited and peculiar, stereotypical circle of interests, which distinguishes such children from their peers.
2) Violation of social interaction can manifest itself in the following forms:
- extreme egocentrism - the inability to interact with peers;
- peer interaction is possible but not attractive, meaningful or highly valued;
- social and emotional inadequacy of communication.
3) The child gives the impression of being old-fashioned, a “little old man”, perceived by other children as an eccentric professor. Lives in his own world with narrow, unusual interests. Demonstrates unusual tendencies (collecting). Collects facts related to certain events, but does not always understand the meaning (reads encyclopedias about dinosaurs - remembers everything (they often have a good mechanical memory), but they may not understand what an era is).
4) Some children show an early ability for an unusual, non-standard understanding of themselves and others. Logical thinking is preserved or even well developed, but knowledge is difficult to reproduce and extremely uneven.
5) A child can be surprisingly successful at one thing and unsuccessful at another. For example, he is fluent in the language, but finds it difficult to adapt to the social context and various hearings (it is difficult for him to conduct a dialogue). There are difficulties in understanding the figurative meaning of metaphors (which is not related to the level of intelligence).
6). Active and passive attention are unstable, but individual autistic goals are achieved with great energy.
7) There is a deviant, unusual style of communication:
- the communicative function of speech is weakened. Speech - formal, pedantic, boring, poor intonation, unusually modulated, peculiar in melody, rhythm and tempo (robot-like, slightly modulated language, the child speaks as if in different voices), the voice sounds either quiet or cuts the ear and in general speech is often similar to recitation.
There is a tendency to word creation, which sometimes persists after puberty. The child often involuntarily makes various sounds “clears his throat”, laughs;
- problems of non-verbal communication are revealed: inability to use gestures, clumsiness, limited mimic expression,
- an unusual style of eye contact (very gazing or gaze avoidance) is noted.
8) Children with Asperger's syndrome have reduced empathy (reduced ability to understand the feelings of other people and adapt to them). Attachment to the house, and not to relatives, is characteristic.
9) They have no close friends. They are often offended. At the same time, the child wants to communicate, to be socialized, but it is extremely difficult for him to do this. He can be with other children, but only if these children adjust to him. There is an attraction to autistic games. Team games are difficult because the autistic child is only interested in his own score, not the score of the team.
10) In appearance, the detached expression of the face attracts attention, which gives it “prettyness”, the facial expressions are frozen, the gaze is turned into emptiness, the fixation on the faces is fleeting. There are few expressive facial movements (minimal expression), gesticulation is depleted. Sometimes the facial expression is concentrated and self-deep, the gaze is directed “inward”.
11) Behavior is determined by impulsiveness, contrasting affects, desires, ideas (often behavior lacks internal logic).
12) Motor sphere is poorly developed:
- there is clumsiness, awkwardness;
- motility is angular, movements are irregular with a tendency to stereotypes.
13) Intelligence Unlike other cases of autism, there is no significant delay in speech and cognitive development in Asperger's syndrome. Intelligence is often normal (overall IQ of at least 70, while verbal intelligence is better developed, and non-verbal intelligence is worse) or above normal.
Written N.V.
The following literature was used: Bashina V.M. Autism in childhood. - Moscow. - "Medicine". - 1999; Kovalev V.V. Psychiatry of childhood. - Moscow. - "Medicine". - 1995; Nikolskaya O.S., Baenskaya E.R., Liebling M.M. Autistic child. Help paths. - Moscow. - “Terevinf”. – 1997
How to Diagnose Asperger's Syndrome - Psychotherapist Services
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How to Diagnose Asperger's Syndrome : Asperger's Syndrome is a general developmental disorder characterized by severe difficulties in social interaction and a restricted, stereotyped, repetitive repertoire of interests and activities. The initial diagnosis of Asperger's syndrome will require a consultation with a psychotherapist. As an additional examination, the doctor may prescribe:
- Brain MRI
- electroencephalography (EEG).
Which doctor treats Asperger's syndrome: If you have symptoms of Asperger's syndrome, you should first consult a neurologist or psychologist.
Although Asperger's syndrome is no longer an official diagnosis, it belongs to a group of neurodevelopmental disorders known as autism spectrum disorder. The main features of Asperger's syndrome include:
- difficulties with social interaction
- repetitive behavior
- abnormal stubbornness in opinions and beliefs
- focus on rules and routine.
Some autistic patients develop a condition called high-functioning autism. They need less support than other people with autism. This category usually includes patients with Asperger's syndrome. Asperger's syndrome is not associated with a delay in language skills or cognitive development, so patients can usually manage daily activities on their own. In other words, their needs usually do not prevent them from getting an education in the regular classroom or getting a job.
Differences between Asperger's syndrome and autism
The main difference between Asperger's syndrome and autism is that patients with the syndrome tend to:
- experience milder symptoms of autism
- have normal language skills.
Symptoms of Asperger's Syndrome
Some of the symptoms of Asperger's Syndrome include:
- hyperfocus. Many patients develop excessive focus on a narrow topic of interest. For children, it can be an all-consuming interest in things like train schedules or dinosaurs. This interest can fuel one-sided conversations with peers and adults
- problems with recognition of social signals. People with Asperger's Syndrome may not recognize intonations and hints, and for this reason they have difficulty with social interaction. They may also find it difficult to know when to lower their voice in certain places
- difficulty in recognizing someone else's facial expressions. Many autistic people have difficulty recognizing and understanding other people's feelings. They may have difficulty interpreting body language, avoid eye contact, speak in a monotone, and show little facial expressions
- problems with motor skills and coordination.
Some children with Asperger's syndrome may find basic motor skills such as running or walking difficult. They may lack coordination.
Causes of Asperger's Syndrome
Changes in the brain occur in the entire spectrum of autistic disorders. Experts have identified several potential factors that may contribute to the development of autism, including genetics and exposure to environmental toxins such as chemicals or viruses. Boys are more likely to be diagnosed with autism.
How Asperger's is diagnosed
A mental health professional can help identify a patient's support needs by assessing key areas, including:
- language skills
- social interaction
- facial expression when talking
- interest in socializing with others
- motor coordination and motor skills.
Some patients on the autism spectrum may initially be diagnosed with attention deficit hyperactivity disorder or other neurodevelopmental disorders.
Treatment of Asperger's Syndrome
Many autistic patients, including those with Asperger's syndrome, do not consider their condition to be a disability or a serious illness. In other words, Asperger's Syndrome, like autism, is not a disease requiring treatment. Early diagnosis can make it easier to get the support you need to improve social interaction and daily activities. Patients with Asperger's syndrome, of course, may have mental disorders such as anxiety or depression. Treating these mental health symptoms can go a long way towards improving your overall well-being.
Medication
There is no cure for Asperger's Syndrome, but some patients may use medication to treat symptoms of common conditions that occur together, namely depression and anxiety. The patient may be prescribed:
- antidepressants. Antidepressants can relieve symptoms of depression. Selective serotonin reuptake inhibitors, a common type of antidepressant, may also be helpful for symptoms of anxiety disorders and obsessive-compulsive disorder
- anti-anxiety drugs.
Anti-anxiety drugs may reduce anxiety symptoms
- antipsychotic drugs. Some doctors may prescribe them for irritability and agitation.
Therapy
Various therapeutic approaches improve communication skills, emotional regulation and social interaction:
Cognitive behavioral therapy. A type of psychotherapy that allows you to identify and change negative and useless patterns of thought and behavior. This therapy can help manage anxiety, depression, and other personal or day-to-day problems
speech therapy. A speech therapist examines and solves language and communication problems. For patients with Asperger's Syndrome, a speech pathologist can help with voice control
social skills training. Social skills programs address issues that hinder social interaction
physical and occupational therapy. Improve fine motor skills and coordination. Physical therapy can also help children with Asperger's syndrome cope with sensory issues.
Other potentially helpful strategies include:
melatonin. Sleep disturbances, which are common in children with Asperger's syndrome, can increase anxiety, depression, and irritability. Preparations containing melatonin allow removing negative conditions
music and art therapy. Music therapy (also called sound therapy) and art therapy can help with communication, emotional, and social problems associated with Asperger's syndrome.
massage. Massage therapy may provide short-term relief from anxiety or sensory symptoms in some autistic patients if they feel comfortable being touched.
Long-term treatment options for a child with Asperger's Syndrome
Early diagnosis can help identify key support needs and learn skills to manage social interactions and other aspects of everyday life. Most adults with Asperger's Syndrome work and live independently.
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Literature
- Antsiferova L.I. E.Erikson's epigenetic concept of personality development//Priitsnp of development in psychology. M., 1978. - S.212-242.
- Balp N. Mathematics in biology and medicine. M., 1970.
- Bodalev L.L., Stolits V.V. General psychodiagnostics. SPb., 2000.
- Deglin B.L. Lectures on the functional asymmetry of the human brain. Amsterdam, Kyiv, 1996.
- Kuznetsova I.K. Psychological features of self-awareness as a person of a certain gender in adolescence: Abstract of the thesis. cand. psychol. Nauk M.
