Few Key Termsand What They Mean

Pervasive developmental disorders (PDDs) a group of disorders characterized by delayed or abnormal development in many (pervasive) aspects of development social, communication, behavior, cognition, sometimes even motor skills. This term is synonymous with autism spectrum disorders. pervasive developmental disorder not otherwise specified (PDDNOS) The child has some autistic-like behaviors, but does not meet the definition of either high-functioning autism or Asperger syndrome. autism the most...

Comfort and Compatibility with Adults

Children with AS-HFA often have difficulty getting along with their peers, whose behavior they may find unpredictable or capricious. Adults are usually more consistent and more accommodating than peers, so many youngsters with autism spectrum disorders prefer the company of adults. The fact that children with AS-HFA are sophisticated in their language use and interests makes adults enjoy their company as well. Johan fastened his top button and smoothed down his hair. He smiled with excitement...

Your Childs Ability to Handle Emotion

One of the primary tasks of childhood is to learn to regulate emotional responses. For many children with AS-HFA, the process of emotional self-regulation is delayed and they are likely to need extra help learning to deal with strong emotions appropriately. For example, while most toddlers and many preschoolers regularly have tantrums when they are frustrated or don't get their way, by the time they enter elementary school most typically developing children have few or no tantrums. Older...

Problems with Social Interaction Active but

The essence of AS-HFA is difficulty with social interactions, although the striking social impairments of more classic autism, such as extreme remoteness and persistent avoidance of others, rarely appear. Some children, like Lauren, don't go out of their way to start conversations or interact with others but do respond if other people approach them. Other individuals show interest in people and enjoy their company they may even want to join groups and make friends. However, their ability to do...

Maintaining a Healthy Family Attitude Siblings

Working to ensure the psychological well-being of the siblings of children with autism spectrum disorders is one of the most valuable investments parents can make. With a healthy attitude, siblings can be a parent's greatest allies in caring for a child with AS-HFA. They can also be great friends to and serve as role models for children with AS-HFA, particularly for helping them to understand the social world. Finally, of course, when they are happy and feel supported, siblings contribute to...

Learning Disabilities and ASHFA

The fact that there are major distinctions between the cognitive challenges posed by autism spectrum disorders and those posed by learning disabilities does not preclude the possibility that a child will have both. While it is relatively uncommon for children with autism spectrum disorders to have dyslexia too, it does occasionally happen. If your child is experiencing trouble with phonics, by all means have him or her evaluated for dyslexia. Most school psychologists and many clinical...

Sexual Development

Even parents with normal children often find sexuality a difficult subject to discuss, yet it's far too important a topic to avoid. Most adolescents between 13 and 18 report frequently thinking about sex, and 50 say they engaged in sexual intercourse before age 18. Adolescents with AS-HFA may lag in emotional or social development, but for many their biological drives develop on time. Given the reticence about personal matters so typical of those with AS-HFA, it is even more important for you...

What Should I Tell My Child

Parents often ask about sharing the news with their child. The first issue is usually Should we tell him or her The answer to this ques tion depends very much on the child's age, temperament, and other life circumstances, but usually the answer is Yes, at some point. The next question, then, is when The best way to determine if your child is ready to hear about AS-HFA is if he or she is expressing awareness of his or her differences, particularly voicing concerns, as when Joseph says I'm a geek...

Language Communication Therapy

By definition, those with high-functioning autism and Asperger syndrome have relatively well-developed language abilities. They can speak fluently, in full sentences, with few or no grammatical errors. Yet they most likely exhibit some difficulty using language in a social context to exchange ideas and information with others. They usually have trouble with abstract or complex language concepts. When what we say isn't exactly what we mean (such as when we are sarcastic, joking, or using...

Are You and Your Child Alone in This

As you search for answers about how and why your child is so different, you may feel tremendously alone. You may have spent years feeling that no one else has a child just like yours. In fact you may never have heard of high-functioning autism or Asperger syndrome before your doctor or someone else raised it. Actually, you're not nearly as alone as you may now feel. Prevalence estimates vary widely, with numbers as high as 1 of the school-age population occasionally suggested for the whole...

In the Autism Spectrum Disorders

Even after the terribly wrong theories that parents caused autism had been put to rest, most scientists dismissed the idea that genetic factors might play any role in the development of autism. For one thing, it was extremely rare that a child with autism had a parent with autism, a pattern that we usually expect to see in a genetic condition. Occasionally, an autistic child would have a brother or sister who also had autism, but this again was considered too uncommon to support a genetic...

Steps in Finding the Right Program for Your Child

As soon as you receive the diagnosis, contact the principal of your child's school. Ask for a referral to the school personnel who conduct eligibility determinations for special education. 2. After determining if your child is eligible for special education, find out about different classroom options in your district. Visit the different classrooms and interview the teachers. Ask about the availability of certain accommodations or the willingness to provide them. 3. If your child is not...

How Can We Be Sure Our Child Has ASHFA and Not ADHD or OCD or Something Else

Estimates of the prevalence of autism spectrum disorders have soared during the past two decades. Although it is still unclear what has caused this rapid rise, one factor that has certainly contributed is that as professionals and the general public have become more familiar with the autism spectrum disorders, the number of children diagnosed with them has soared. And as their diagnosis has become more prevalent, misdiagnosis is also more likely. Sometimes a proper assessment by a specialist...

Step 6 Be Sure That the Challenging Behavior Is No Longer Effective in Getting Your Childs Needs

Leave your child no alternative for getting his or her needs met besides the new, appropriate method you've taught. Ignore the problem behavior whenever it occurs, but provide a prompt for the new communication. For example, if your child screams whenever she wants to avoid a situation, prompt her to use an appropriate phrase, but do not permit her to leave the situation while she is screaming. Ivana's 11-year-old daughter, Michaela, had a habit of coming up to her siblings and classmates and...

Some Concluding Thoughts

Some of the problems described in this chapter could be eliminated if school personnel were educated regarding the learning style of students with AS-HFA. This education may start when you alert the school about your child's diagnosis. Some parents fear that sharing diagnostic information with educators will negatively label their son or daughter, resulting in substandard education or inappropriate reduction of academic and behavioral expectations. In our experience, this is rarely the case. In...

Depression and Anxiety

During adolescence (and sometimes earlier), many children who were previously oblivious to or even content with their lack of social connections start to experience distress. In childhood, much of friendship consists solely of acting as playmates and engaging in activities, such as sports or video games, together. During adolescence, however, the very nature of friendship changes in several ways that can challenge young people with AS-HFA. Friendships become more sophisticated and complex, with...

Step 5 Reward Your Child for Using the Strategy by Showing That It Gets His or Her Needs

You must make sure that the new communication strategy you've taught your child is as effective as the old one. If screaming or repetitive complaining is more effective than saying I want to finish this video or holding up a break card, your child will have little motivation to use the new strategy. Whenever possible, immediately reward your child for using the appropriate communication, first by praising him or her (I'm glad you're using your new words) and then by honoring the communication...

Observation of Your Child

The professional will also observe your child and interact with her for some period of time, making note of the same types of symptoms he or she asked you about in the interview. The examiner might set up specific situations to make sure that certain symptoms, if present, are evident during the observation period. Eye contact, for example, is often poor in children with autism spectrum conditions. To be certain that your child's eye contact is limited with the examiner because of an autism...

Identifying Your Childs Strengths

The six characteristics listed above are a good place to start in identifying your own child's potential strengths. But keep in mind that it's not always easy or simple to identify strengths. Nor is it easy to determine which behaviors that usually manifest themselves as weaknesses can be redirected to make them strengths. When your child's endless discussion of the detailed features of myriad video game characters is getting in the way of social interactions and family plans, it can be a chal...

What Your Childs Therapist Can Offer

Your family may have adapted to your AS-HFA child's social deficits, and therefore you might not consider the problem an enormous one at home in your daily activities. But social difficulties tend to be more pronounced in groups and with peers. So social problems may in fact be fairly significant for your child at school, at the local playground, or in a scout troop. We know that people with AS-HFA have trouble generalizing from one situation to another, so it's important to teach social skills...

Dietary Treatments

Some professionals have advocated the use of special diets, vitamin supplements, or both to manage some symptoms associated with autism spectrum disorders. In recent years, a theory has been formed that some cases of autism are caused by food allergies, specifically severe allergic reactions to gluten, a protein found in flour, and casein, a protein found in milk products, that irritate or damage the brain and lead to the unusual behaviors associated with the autism spectrum disorders. So far...

Autopsy Studies

Only a few investigations of this type have been done, since they are so difficult to perform and since it is uncommon both for individuals with autism spectrum disorders to die prematurely (thankfully) and for their survivors to donate their brains to science. The few studies that have been done have found two types of brain abnormalities. First, they have found that there are too many brain cells (neurons) in a region known as the limbic system, which lies deep in the center of the brain and...

Distinguishing High Functioning Autism from Asperger Syndrome Is There a Difference

The characteristics that may differentiate autism from Asperger syndrome are so tentative that they have not been included in the DSM-IV. There is, for example, no requirement in the DSM-IV that children with Asperger syndrome must be clumsy to meet criteria for the diagnosis. Likewise, there is nothing that says that everyone with autism must be good at puzzles (or that those with Asperger syndrome must be poor at puzzles). So how do we distinguish between the two Unfortunately, it's a very...

Support Groups

AAA Autistic Adolescents and Adults klbuckle email.msn.com Autinet Forum http www.autinet.org The Autism Channel http autfriends.autistics.org Bay Area Asperger's Syndrome Information and Support http www.php.com baasis.htm Independent Living Forums (INLV) http www.inlv.demon.nl Mothers United for Moral Support (MUMS) www.netnet.net mums National Parent Network on Disabilities (NPND) www.npnd.org The Sibling Support Project www.chmc.org departmt sibsupp The UK Autism Electronic mailing List

What Lies Ahead

The combination of challenges and talents seen in children with AS-HFA strikes fear in the hearts of many parents. Which will prevail, the child's deficiencies or the child's strengths What can you do to make sure that your child doesn't slip through the cracks because his or her needs are not as extreme as those of children with more severe autism What are your child's chances of going to college, getting a good job, and marrying When a child displays such a mixture of challenges and...

Dealing with Teasing and Bullying

Many children and teens with AS-HFA are teased, belittled, or bullied in school. The peer mediation approaches described above appear to foster greater peer acceptance, which may reduce the frequency of victimization by peers that can be a common part of the life of a child with AS-HFA. Peer buddies are especially useful to the child with high-functioning autism or Asperger syndrome during unstructured times of the school day, such as lunch or recess. It is well established that bul lies rarely...

After the Diagnosis

When they first receive a diagnosis of high-functioning autism or Asperger syndrome, parents experience a wide range of reactions, from one extreme of shock, grief, or denial to another extreme of relief and even happiness. More commonly, there is a mixture of negative and positive feelings. Many parents have known for a long time that there was something different about their child and have actively sought an explanation, but still hope that nothing is really wrong and their fears will prove...

Resources

Books on Asperger Syndrome and High-Functioning Autism General Information on Asperger Syndrome Attwood, Tony. (1998). Asperger's syndrome A guide for parents and professionals. London Kingsley. Baron-Cohen, Simon, & Bolton, Patrick. (1994). Autism The facts. Oxford, UK Oxford University Press. Bashe, Patricia Romanowski, & Kirby, Barbara. (2001). The OASIS guide to Asperger syndrome Advice, support, insights, and inspiration. New York Crown. Frith, Uta (Ed.). (1992). Autism and Asperger...

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC Author. Asperger, H. (1944 1991). Autistic psychopathy in childhood. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 37-92). New York Cambridge University Press. Bachevalier, J. (1994). Medial temporal lobe structures and autism A review of clinical and experimental findings. Neuropsychologia, 32, 627-648. Bailey, A., Le Couteur, A., Gottesman, I., Bolton, P., Simonoff,...

Treatments for Asperger Syndrome and High Functioning Autism

As Seth's parents heard the psychologist say autism, they were engulfed in despair. But, the psychologist continued, there are some very good programs that have been developed to treat the exact kinds of problems Seth has. She handed them a slip of paper with a phone number written on it and encouraged them to call that very afternoon, saying, They will take care of you and Seth. Seth enrolled in this special education preschool just for children with autism that fall. He stayed in this program...

Sensory Integration Therapy

Some children with high-functioning autism and Asperger syndrome are overly sensitive to and easily overwhelmed by everyday sensations, such as certain sounds, tastes, textures, or smells, or by being touched. Their distress when encountering these sensations can be very intense. Parents sometimes describe the phenomenon as sensory overload. One young woman said that when she was bombarded by unwanted sounds, smells, and sights, her body would shut down. She described feeling completely...

Disclosure

If your child's symptoms lessen with age, as often happens, and if he or she branches out into new settings, the question of disclosure of your child's disorder will come up more and more often. At first you'll participate in the decision of whether or not to tell others that your child has AS-HFA. For example, it will be your call to determine whether or not to let the camp counselor, sports coach, or neighborhood parents know that your son or daughter has Asperger syndrome or high-functioning...

Strategies for Teaching Social Skills Outside the Clinic

Earlier we stressed the importance of addressing social issues in a group setting, since this is where social problems usually arise, and thus this is where your child needs to practice social behavior. We also emphasized that you should practice and support your child's emerging social abilities at home whenever possible and that social skills training in a clinic alone would not do much good. In the following sections, we describe a variety of resources and techniques for working on social...

Unusual Interests and Behaviors

The third area in which people with high-functioning autism spectrum disorders differ is behavior. You will probably have noticed that your child's range of activities is relatively focused and that he or she can do the same thing over and over again without getting bored. Among those with Asperger syndrome and high-functioning autism, these traits usually show up as very specific interests that verge on obsessions. These kids have the favorite pastimes that many children have computers, video...

Superior Academic Skills

Besides having strong memories for facts and other information, many children with AS-HFA have stronger than average academic abilities, typically in one or two specific domains. Advanced vocabulary is one example. Learning and using new or sophisticated words comes easily to some children with AS-HFA, as we've seen in many examples throughout this book. Spelling is another common strength. And many children with AS-HFA can sound out or sight-read words far beyond their own grade level...

Who Is Qualified to Diagnose Autism Spectrum Conditions

The types of professionals most often making such diagnoses are psychologists and psychiatrists, particularly those trained in childhood disorders. Other types of doctors, such as neurologists, pediatricians, and general practitioners (sometimes called family practice doctors), may also see your child for a diagnostic evaluation. Additionally, social workers are trained in the diagnostic process and how to use the DSM-IV, so they are qualified to make diagnoses. Other professionals, such as...

Strategies for Positive Discipline

As you may have experienced with your own child, many standard disciplinary methods don't work well with children who have autism spectrum disorders. Children with Asperger syndrome or high-functioning autism may not have good self-monitoring skills and may lack the ability to judge whether their behavior is appropriate. They may not pick up on cues that normally would signal that their behavior does not fit in, and they may not feel the embarrassment or shame that many children experience when...

Medical Centers UniversitiesClinics

Autism Asperger Resource Center 4001 HC Miller Building 3901 Rainbow Boulevard Kansas City, KS 66160 Phone (913) 588-5988 Fax (913) 588-5942 Bradley Hospital Developmental Disabilities Program 1011 Veterans Memorial Parkway East Providence, RI 02915 Phone (401) 434-3400 The Center for Asperger's Assessment and Intervention The Center for Children with Special Needs 384-2 Merrow Road Tolland, CT 06084 Phone (860) 870-5313 Child Evaluation and Treatment Program The Connections Center 4120...

What about [Fill in the Blank Other Possible Causes

Over the years, a number of other causes of autism have been suggested. There is some evidence, although it is controversial, that infections during pregnancy or in the first years of life may contribute to the development of autism in a very small number of children. For example, studies in the 1960s and '70s found that approximately 10 of children exposed to the rubella virus in utero developed autism. Other studies found that infections with the herpes simplex virus, which can cause brain...

Individual Psychotherapy

Traditional psychotherapy can help some, but in our opinion a limited number of, individuals with AS-HFA. Generally, individual psychotherapy involves discussion of emotions and gaining insight into behavior patterns or interpersonal issues. Since most AS-HFA children, adolescents, and even adults have limited self-awareness, do not naturally make social comparisons, and often show little insight into the nature and reasons for their difficulties, this form of psychotherapy is often not very...

Communication Eloquent but Inarticulate

In addition to social difficulties, autism spectrum disorders usually involve communication problems. In fact, the most prominent feature of classic autism, at least in the minds of most people, is the inability to speak. What is less well understood is that even those with Asperger syndrome and high-functioning autism experience some difficulties with communication. This, it turns out, is one of the most confusing parts of the diagnostic puzzle and often leads to misdiagnoses when the child is...

The Strengths That Accompany the Challenges

Having Asperger syndrome or high-functioning autism is not all bad. There are special gifts, talents, and inclinations that come along with the challenges and make your child a very special, unique, and interesting person. Many children and teens with these conditions have excellent memories. They remember details of family trips, routes around their city, or spelling lists effortlessly. Many also excel in reading. Like Joseph, they may teach themselves to read at an early age and later be able...

Self Awareness Self Esteem and Identity Development

Adolescence may be the first time that children with AS-HFA begin to form an identity by pondering questions like Who am I and Where do I fit in and What will I become These aspects of adolescent development pose a significant set of challenges for young people with AS-HFA. One such area is definition of self-concept. Research suggests that boys and girls use different strategies to determine their own self-concept. For girls, self-concept often relates to perceptions of physical...

Recognizing Order and Following Rules

People with AS-HFA often navigate the world by forming explicit rules or recognizing patterns about how things work, the ways people interact, and how events typically unfold. Parents are often amazed by their child's ability to analyze information and extract a set of patterns or rules by which something operates. One adolescent girl with AS-HFA commented that she noticed that one of the authors (G.D.) preferred clothing with horizontal stripes, whereas a coworker preferred clothing with...

Psychological Tests

Just as there are medical tests that are not diagnostic, but that are informative, so also there are behavioral or psychological tests that are not needed for the diagnosis but nevertheless can be very helpful in painting a complete picture of your child's strengths, weaknesses, treatment needs, and so forth. Probably the most common additional psychological testing that will be done during a diagnostic evaluation is an intelligence (or IQ) test. For verbal children over age 5, the test that is...

Visual Thinkng

Many people with AS-HFA are what we call visual thinkers, which gives them advanced skills in things like completing puzzles, reading maps, or quickly learning the layout of a building. In her book Thinking in Pictures, Dr. Temple Grandin describes translating words automatically into pictures. When someone speaks to her, their words are instantly transformed into a series of images that tell a visual story. She describes her thoughts as visual representations, rather than as the stream of...

Classroom Accommodationsand What Is a 504 Plan

As mentioned above, all is not lost if your child does not qualify for special education and an IEP. The Federal Rehabilitation Act of 1973 is a law that protects the civil and constitutional rights of people with disabilities. Section 504 of this law (since renamed the Americans with Disabilities Act, or ADA) mandates access to a free and appropriate public education for all people with disabilities. Disabilities are broadly defined in this legislation (more broadly than in IDEA, the special...

Chores and Household Responsibilities

Encouraging children to help around the home is a challenge for every parent, including those parenting children with AS-HFA. It is typical for children to dislike chores and to try their best to shirk these responsibilities in lieu of something more fun. To make chores more tolerable for a child with an autism spectrum disorder, embed them in a daily or weekly routine. This consistency will help your child know what needs to be done and prevent a chore from being an unwelcome surprise....

Hello Friend Now Go Away

Everyone diagnosed with an autism spectrum disorder has trouble with social interchange, specifically with what we call reciprocity, the back-and-forth interactions that make up all social encounters. In the very remote, nonverbal children who have classic autism, reciprocity difficulties are obvious. In high-functioning children and adolescents with AS-HFA, however, reciprocity problems may be more subtle. Parents often describe a feeling of one-sidedness in interactions with their child....