Asperger’s syndrome is a developmental disorder that affects a person’s ability to socialize and communicate effectively with others. Children with Asperger’s syndrome typically exhibit social awkwardness and an all-absorbing interest in specific topics.
Doctors group Asperger’s syndrome with other conditions that are called autistic spectrum disorders or pervasive developmental disorders. These disorders all involve problems with social skills and communication. Asperger’s syndrome is generally thought to be at the milder end of this spectrum.
While there’s no cure for Asperger’s syndrome, if your child has the condition treatment can help him or her learn how to interact more successfully in social situations.
Asperger’s syndrome symptoms include:
Unlike children with more-severe forms of autism spectrum disorders, those with Asperger’s syndrome usually don’t have delays in the development of language skills. That means your child will use single words by the age of 2 and phrases by the time he or she is 3 years old. But, children with Asperger’s syndrome may have difficulties holding normal conversations. Conversations may feel awkward and lack the usual give and take of normal social interactions.
Toddlers and school-age children with Asperger’s syndrome may not show an interest in friendships. Youngsters with Asperger’s often have developmental delays in their motor skills, such as walking, catching a ball or playing on playground equipment.
In early childhood, kids with Asperger’s may be quite active. By young adulthood, people with Asperger’s syndrome may experience depression or anxiety.
When to see a doctor
All kids have their quirks, and many toddlers show a sign or symptom of Asperger’s syndrome at some point. It’s natural for small children to be egocentric, and many children show a strong interest in a particular topic, such as dinosaurs or a favorite fictional character. These generally aren’t reasons to be alarmed.
However, if your elementary schoolchild has frequent problems in school or seems unable to make friends, it’s time to talk with your child’s doctor. These difficulties have many possible causes, but developmental disorders such as Asperger’s syndrome need to be considered. Children who have behaviors that interfere with learning and social development should have a comprehensive evaluation.
It’s not clear what causes Asperger’s syndrome, although changes in certain genes may be involved. The disorder also seems to be linked to changes in the structure of the brain.
One factor that isn’t associated with the development of Asperger’s syndrome or other autism spectrum disorders is childhood immunizations.
Boys are far more likely to develop Asperger’s syndrome than are girls.
You’ll probably first see your child’s pediatrician or family doctor, who will likely refer your child to a mental health expert, such as a child psychologist or psychiatrist.
Being well prepared can help you make the most of your appointment. Here’s some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Preparing a list of questions ahead of time will help save time for the things you want to discuss most. List your questions from most important to least important in case time runs out. For Asperger’s syndrome, some basic questions to ask your doctor include:
In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask additional questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
Because Asperger’s syndrome varies widely in severity and signs, making a diagnosis can be difficult. If your child shows some signs of Asperger’s syndrome, your doctor may suggest a comprehensive assessment by a team of professionals.
This evaluation will likely include observing your child and talking to you about your child’s development. You may be asked about your child’s social interaction, communication skills and friendships. Your child may also have a number of tests to determine his or her level of intellect and academic abilities. Tests may examine your child’s abilities in the areas of speech, language and visual-motor problem solving. Tests can also identify other emotional, behavioral and psychological issues.
To be diagnosed with Asperger’s syndrome, your child’s signs and symptoms must match the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a manual published by the American Psychiatric Association and used by mental health providers to diagnose mental conditions.
Some of the DSM criteria for Asperger’s syndrome are:
Unfortunately, some children with Asperger’s syndrome may initially be misdiagnosed with another problem, such as attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder, possibly because the symptoms of some conditions are similar to those of Asperger’s. Additionally, these other conditions may coexist with Asperger’s, which can delay the diagnosis.
The core signs of Asperger’s syndrome can’t be cured. However, many children with Asperger’s syndrome grow into happy and well-adjusted adults.
Most children benefit from early specialized interventions that focus on behavior management and social skills training. Your doctor can help identify resources in your area that may work for your child.
Asperger’s syndrome treatment options may include:
Communication and social skills training
Children with Asperger’s syndrome may be able to learn the unwritten rules of socialization and communication when taught in an explicit and rote fashion, much like the way students learn foreign languages. Children with Asperger’s syndrome may also learn how to speak in a more natural rhythm, as well as how to interpret communication techniques, such as gestures, eye contact, tone of voice, humor and sarcasm.
Cognitive behavioral therapy
This general term encompasses many techniques aimed at curbing problem behaviors, such as interrupting, obsessions, meltdowns or angry outbursts, as well as developing skills such as recognizing feelings and coping with anxiety. Cognitive behavioral therapy usually focuses on training a child to recognize a troublesome situation — such as a new place or an event with lots of social demands — and then select a specific learned strategy to cope with the situation.
There are no medications that specifically treat Asperger’s syndrome. But some medications may improve specific symptoms — such as anxiety, depression or hyperactivity — that can occur in many children with Asperger’s syndrome. Examples include:
Because there are no definitive treatments for Asperger’s syndrome, some parents may turn to complementary or alternative therapies. However, most of these treatments haven’t been adequately studied. It’s possible that by focusing on alternative treatments, you may miss out on behavior therapies that have more evidence to support their use.
Of greater concern, however, is that some treatments may not be safe. The Food and Drug Administration has warned about over-the-counter chelation medications. These drugs have been marketed as a therapy for autism spectrum disorders and other conditions. Chelation is a therapy that removes heavy metals from the body, but there are no over-the-counter chelation therapies that are approved by the Food and Drug Administration (FDA). This type of therapy should only be done under the close supervision of medical professionals. According to the FDA, the risks of chelation include dehydration, kidney failure and even death.
Other examples of alternative therapies that have been used for Asperger’s syndrome include:
Sleep problems are common in children with Asperger’s syndrome, and melatonin supplements may help regulate your child’s sleep-wake cycle. The recommended dose is 3 mg, 30 minutes before bedtime. Possible side effects include excessive sleepiness, dizziness and headache.
Other dietary supplements
Numerous dietary supplements have been tried in people with autism spectrum disorders, including Asperger’s syndrome. Those that may have some evidence to support their use include:
Some parents have turned to gluten-free or casein-free diets to treat autism spectrum disorders. There’s no clear evidence that these diets work, and anyone attempting such a diet for their child needs guidance from a registered dietitian to ensure the child’s nutritional requirements are met.
This gastrointestinal hormone has been tried as a potential treatment. Numerous studies have been conducted on secretin, and none found any evidence that it helps.
Other therapies that have been tried, but lack objective evidence to support their use include hyperbaric oxygen therapy, immune therapies, antibiotics, antifungal drugs, chiropractic manipulations, massage and craniosacral massage, and transcranial magnetic stimulation.
Asperger’s syndrome can be a difficult, lonely disorder — both for affected children and their parents. The disorder brings difficulties socializing and communicating with your child. It may also mean fewer play dates and birthday invitations and more stares at the grocery store from people who don’t understand that a child’s meltdown is part of a disability, not the result of “bad parenting.”
Luckily, as this disorder gains widespread recognition and attention, there are more and more sources of help. Here are a few suggestions: