Monday, November 17, 2014

A little bit about Asperger Syndrome Disorder

     Last post I talked about Marc being diagnosed Asperger syndrome disorder (ASD) and today I want to talk more in depth about what exactly it is. As I said before it is on the autism spectrum. It is considered to be the highest functioning kind.  Most children that have this type either get diagnosed at about the age of 5 or 6 (when the child enter kindergarten) or it goes undiagnosed until teenage or even adulthood. The reasoning for the under diagnosis is in this type of autism the language developmental is normal. These children are often very bright and learn at a very fast rate and ahead of their peers. However the two core features that are present are social and communication deficits and fixed interests and repetitive behaviors.

     The social communication deficits seen in ASD are a lack of eye contact, lack of normal back and forth conversation, trouble reading facial expressions and body language, and trouble maintaining relationships. Fixed interest and repetitive behaviors can include repetitive use of objects or phrases. Such as they always have to use a certain plate to eat breakfast, one for lunch and another for dinner. Or the child loves to line up his cars; he has to keep his room tidy. An example of the repetitive phrases could be off their favorite cartoons “ Hey Squidward” or my sons favorite right now “Twerk this and twerk that”. These children are also highly addicted to schedules and routines. They like to know when they are going to be doing something and get highly stressed if an activity occurs outside of its scheduled time. And will often have meltdowns when changes to their routines occur.  Persons with ASD also tend to higher sensory processing, which can cause either an indifference or excessive interest to their environments.

     Children with ASD sometimes have speech that lacks rhythm has a weird inflection, lack of rhythm, or have a monotone pitch. They often have an absence of skill to control the volume of their voice to match their environments. Often times their parents remind them to lower their voices because they don’t realize how loud they are talking. This is usually a problem at a library or at church.

     Unlike other forms of autism where the child seems to withdraw from the rest of the world children with Asperger do want to be included but are isolated because of poor social skills and their narrow interest. As I have discussed above these children then to have fixed interests and amass extreme knowledge on these subjects. They become mini professors and then become your teachers to the point where they don’t let you get in a word edgewise.  A lot of times these children will tell you that they don’t have anything in common with kids there age because they are not on “their level” but have “lots in common with adults because mentally they are their equals.” Well excuse me!

Some children with ASD are very active as kids.  They have lots of energy but may not meet all the motor skills milestones as early as other kids.  These normal motor skills are peddling a bike, catching a ball, or climbing playground equipment. Sometimes they can have an awkward walk or run. Marc still has trouble walking and is quite clumsy. We joke about his two left feet.

     A lot of times children with ASD will develop problems with anxiety or depression. This can come from the break from their routines. A challenging time for them such puberty, a parental divorce, a pet dying or any other traumatic event to the child. Other common co-occurring diagnoses are attention deficit disorder (ADHD), and obsessive-compulsive disorder (OCD).  Treatment for this co-occurring diagnose is the same. Your physician should still approach the child with therapy and medication if necessary. Please see your doctor if your child is exhibiting symptoms of these other disorders.

     This is a little bit about what ASD is about and if you suspect your child may have the first step is making an appointment with your pediatrician.  After that initial step they should then refer you for a comprehensive evaluation. The team will consist of a psychiatrist, psychologist, neurologist, speech therapist, and occupational therapist, and any additional professionals who would be helpful in diagnosis your child. The testing process is lengthy. The younger your child is the longer the process will be. But basically they test your child neurologic, cognitive, language, IQ, psychomotor function, verbal and nonverbal strengths and weakness, styles of learning and independent living skills. After they gather all the data the team meets and decides what diagnosis best fits your child.

     Asperger disorder or autism does not have a cure. However there are various treatments out there that work for these unique children. As I continue to preach children are uniquely made and these therapies should be tailored to them.  An therapeutic treatment plan should build on the child’s interest, should stick to a expected schedule, teach good social skills, use simple steps, absorb the child’s attention in organized activities and provided reinforcement of wanted behavior. I am a firm believer in therapy, therapy for the child, for the parents and for the family.

     Since my son’s Marc’s diagnosis I have been hitting the books and the Internet. What I didn’t see before now I see. I have been a little more forgiving when it comes to his interest.  For him he is hyper focused on vine videos, and SIMS. He has a photographic memory and can recite to me almost textbook like the ins and outs of the cardiovascular system. He is in 7th grade but doing 11th grade math. Talk about a brainiac! But he relates poorly to kids his age and has a hard time telling when people are joking with him. He tends to reveal, to openly, personal information about me that I normally wouldn’t want people to know. We live on an island with some of the most beautiful beaches but he refuses to go because he hates the feeling of being dirty. We are working through all of this. The diagnosis, the treatment and the therapy, but just like everything else we will get through this like we do everything else like a family.


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