What is it?
- Asperger's syndrome is a developmental disorder that affects a child'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.
Signs and symptoms of Asperger's syndrome include:
- Engaging in one-sided, long-winded conversations, without noticing if the listener is listening or trying to change the subject
- Displaying unusual nonverbal communication, such as lack of eye contact, few facial expressions, or awkward body postures and gestures
- Showing an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes
- Appearing not to understand, empathize with or be sensitive to others' feelings
- Having a hard time "reading" other people or understanding humor
- Speaking in a voice that is monotonous, rigid or unusually fast
- Moving clumsily, with poor coordination
- Having an odd posture or a rigid gait
Doctors and researchers don't understand what causes Asperger's syndrome, although there seems to be a strong genetic component. The disorder also seems to be linked to structural abnormalities in several regions of the brain.
- 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 undergo a number of tests to determine his or her level of intellect and academic abilities. Tests may assess 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.
- Unfortunately, some kids with Asperger's syndrome are first 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, other conditions may coexist with Asperger's, and this may delay the diagnosis.
Treatments and drugs
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:
- Aripiprazole (Abilify). This drug may be effective for treating irritability related to Asperger's syndrome. Side effects may include weight gain and an increase in blood sugar levels.
- Guanfacine. This medication may be helpful for the problems of hyperactivity and inattention in children with Asperger's syndrome. Side effects may include drowsiness, irritability, headache, constipation and bedwetting.
- Selective serotonin reuptake inhibitors (SSRIs). Drugs such as fluvoxamine may be used to treat depression or to help control repetitive behaviors. Possible side effects include restlessness and agitation.
- Risperidone (Risperdal). This medication may be prescribed for agitation and irritability. It may cause trouble sleeping, a runny nose and an increased appetite. This drug has also been associated with an increase in cholesterol and blood sugar levels.
- Olanzapine (Zyprexa). Olanzapine is sometimes prescribed to reduce repetitive behaviors. Possible side effects include increased appetite, drowsiness, weight gain, and increased blood sugar and cholesterol levels.
- Naltrexone. This medication, which is sometimes used to help alcoholics stop drinking, may help reduce some of the repetitive behaviors associated with Asperger's syndrome. However, the use of low-dose naltrexone — in doses as low as two to four mg a day — has been gaining favor recently. But, there's no good evidence that such low doses have any effect on Asperger's syndrome.
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:
- Vitamin B-6 and magnesium
- Vitamin C (usually in combination with other vitamins)
- Omega-3 fatty acids
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.
Coping and support
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:
- Maintain a consistent schedule whenever possible. If you have to introduce change, try to do so gradually.
- Learn about the disorder. There are numerous books and websites dedicated to the disorder. Do some research so that you better understand your child's challenges and the range of services in your school district and state that may help.
- Learn about your child. The signs and symptoms of Asperger's syndrome vary for each child, and young children have a hard time explaining their behaviors and challenges. But, with time and patience, you'll learn which situations and environments may cause problems for your child and which coping strategies work. Keeping a diary and looking for patterns may help.
- Find a team of trusted professionals. You'll need to make important decisions about your child's education and treatment. Find a team of teachers and therapists who can help evaluate the options in your area and explain the federal regulations regarding children with disabilities.
- Help others help your child. Most children with Asperger's syndrome have no visible sign of disability, so you may need to alert coaches, relatives and other adults to your child's special needs. Otherwise, a well-meaning coach may spend time lecturing your child on "looking at me while I'm talking" — something that can be very difficult for a child with Asperger's syndrome.
- Help your child turn his or her obsession into a passion. The tendency to fixate on a particular narrow topic is one of the hallmarks of Asperger's syndrome, and it can be annoying to those who must listen to incessant talk about the topic every day. But a consuming interest can also connect a child with Asperger's syndrome to schoolwork and social activities. In some cases, kids with Asperger's syndrome can even turn their childhood fascination into a career or profession.
- Find support. Lean on family and friends when you can. Ask someone who understands your child's needs to babysit sometimes so that you can get an occasional break. You may also find a support group for parents of children with Asperger's syndrome helpful.