When you meet someone who has Asperger's syndrome, you might notice two things right off. They're just as smart as other folks, but they have more trouble with social skills. They also tend 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 its 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 they 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 them.
They may miss social cues that are obvious to other folks, like body language or the expressions on people's faces. For instance, they may not realize that when somebody crosses their arms and scowls, they're angry.
Another sign is that your child may show few emotions. They may not smile when they're happy or laugh at a joke. Or they may speak in a flat, robotic kind of way.
If your child has the condition, they may talk about themselves most of the time and zero in with a lot of intensity on a single subject, like rocks or football stats. And they might repeat themselves a lot, especially on a topic that they're interested in. They might also do the same movements over and over.
They also may dislike change. For instance, they 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. They can refer you to a mental health expert who specializes in ASDs, like one of these:
Psychologist. They diagnose and treat problems with emotions and behavior.
Pediatric neurologist. They treat conditions of the brain.
Developmental pediatrician. They specialize in speech and language issues and other developmental problems.
Psychiatrist. They have 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 do they have, and when did you first notice them?
- When did your child first learn to speak, and how do they communicate?
- Are they focused on any subjects or activities?
- Do they have friends, and how do they interact with others?
Then they'll observe your child in different situations to see firsthand how they communicate and behave.
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, they'll learn how to use a normal up-and-down pattern when they speak rather than a flat tone. They'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 their way of thinking, so they can better control their emotions and repetitive behaviors. They'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 them 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 they face. They can do well in school and go on to succeed in life.