When you meet someone who has Asperger's syndrome, you might notice two things right off. He's just as smart as other folks, but he has more trouble with social skills. He also tends to have an obsessive focus on one topic or perform the same behaviors again and again.
Doctors used to think of Asperger's as a separate condition. But in 2013, the newest edition of the standard book that mental health experts use, called The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), changed how it's classified.
Today, Asperger's syndrome is technically no longer a diagnosis on it's own. It is now part of a broader category called autism spectrum disorder (ASD). This group of related mental health issues shares some symptoms. Even so, lots of people still use the term Asperger's.
The condition is what doctors call a "high-functioning" type of ASD. This means the symptoms are less severe than other kinds of autism spectrum disorders.
The DSM-5 also includes a new diagnosis, called social pragmatic communication disorder, which has some symptoms that overlap with Asperger's. Doctors use it to describe people who have trouble talking and writing, but have normal intelligence.
They start early in life. If you're a mom or dad of a kid who has it, you may notice that he can't make eye contact. You may also find that your child seems awkward in social situations and doesn't know what to say or how to respond when someone talks to him.
He may miss social cues that are obvious to other folks, like body language or the expressions on people's faces. For instance, he may not realize that when somebody crosses his arms and scowls, he's angry.
Another sign is that your child may show few emotions. He may not smile when he's happy or laugh at a joke. Or he may speak in a flat, robotic kind of way.
If your child has the condition, he may talk about himself most of the time and zero in with a lot of intensity on a single subject, like rocks or football stats. And he might repeat himself a lot, especially on a topic that he's interested in. He might also do the same movements over and over.
He also may dislike change. For instance, he may eat the same food for breakfast every day or have trouble moving from one class to another during the school day.
How You Get a Diagnosis
If you notice signs in your child, see your pediatrician. He can refer you to a mental health expert who specializes in ASDs, like one of these:
Psychologist. He diagnoses and treats problems with emotions and behavior.
Pediatric neurologist. He treats conditions of the brain.
Developmental pediatrician. He specializes in speech and language issues and other developmental problems.
Psychiatrist. He has expertise in mental health conditions and can prescribe medicine to treat them.
The condition is often treated with a team approach. That means you might see more than one doctor for your child's care.
The doctor will ask questions about your child's behavior, including:
- What symptoms does he have, and when did you first notice them?
- When did your child first learn to speak, and how does he communicate?
- Is he focused on any subjects or activities?
- Does he have friends, and how does he interact with others?
Then he'll observe your child in different situations to see firsthand how he communicates and behaves.
Every child is different, so there isn't a one-size-fits-all approach. Your doctor might need to try a few therapies to find one that works.
Treatments can include:
Social skills training. In groups or one-on-one sessions, therapists teach your child how to interact with others and express themselves in more appropriate ways. Social skills are often best learned by modeling after typical behavior.
Speech-language therapy. This helps improve your kid's communication skills. For example, he'll learn how to use a normal up-and-down pattern when he speaks rather than a flat tone. He'll also get lessons on how to keep up a two-way conversation and understand social cues like hand gestures and eye contact.
Cognitive behavioral therapy (CBT). It helps your child change his way of thinking, so he can better control his emotions and repetitive behaviors. He'll be able to get a handle on things like outbursts, meltdowns, and obsessions.
Parent education and training. You'll learn many of the same techniques your child is taught so you can work on social skills with him at home. Some families also see a counselor to help them deal with the challenges of living with someone with Asperger's.
Applied behavior analysis. It's a technique that encourages positive social and communication skills in your child -- and discourages behavior you'd rather not see. The therapist will use praise or other "positive reinforcement" to get results.
Medicine. There aren't any drugs approved by the FDA that specifically treat Asperger's or Autism Spectrum Disorders. Some medications, though, can help with related symptoms like depression and anxiety. Your doctor may prescribe some of these:
- Selective serotonin reuptake inhibitors (SSRIs)
- Antipsychotic drugs
- Stimulant medicines
With the right treatment, your child can learn to control some of the social and communication challenges he faces. He can do well in school and go on to succeed in life.