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Asperger's (how it is diagnosed and treated)

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1 Asperger's (how it is diagnosed and treated) on Tue Jan 13, 2009 9:21 am

csweepigirl

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What are the symptoms?

Children with Asperger's syndrome typically develop a good to excellent vocabulary, but they usually lack the social instincts and practical skills needed for relating to others. This can result in poor communication skills. They may not recognize verbal and nonverbal cues or understand social norms, such as taking turns talking or grasping the concept of personal space. They may have difficulties with accent, tone, and pitch, which can make their speech sometimes odd or difficult to understand. And they may have a hard time expressing their own feelings and perceiving others' feelings. Children with Asperger's typically try to form friendships, but they may have difficulty making friends because of their social awkwardness.

Children with Asperger's syndrome often have limited and very focused interests. They are often most comfortable with fixed routines, and they do not like change. They may lack coordination, exhibit unusual facial expressions, body postures, and gestures, and be somewhat clumsy. Many children with Asperger's syndrome also have trouble with fine motor skills, such as handwriting. They may also have trouble with gross motor skills, such as riding a bike.

Children with Asperger's syndrome will have some of the traits typical of the syndrome. But each child with Asperger's presents a different picture. Some will have less pronounced traits, and others' traits are more noticeable. Each child will have individual interests, likes, and dislikes. All children with Asperger's syndrome have severe trouble in social situations.

How is Asperger’s syndrome diagnosed?

Asperger's syndrome is usually not diagnosed until a child is at least 3 years old, when social problems become apparent, although it may be diagnosed earlier. A diagnosis is based on a careful history of the child’s development, psychological and psychiatric assessments, communication tests, and the parents’ and clinicians’ shared observations.

Asperger's syndrome is diagnosed using specific criteria, published in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

How is it treated?

Treatment for Asperger's syndrome should be tailored to meet individual needs. Communication and social skills training is usually recommended. Behavior management, in which good behavior is rewarded, can help change problem behaviors such as interrupting and dominating conversations.

Medicines for Asperger's syndrome are generally avoided, especially in young children, but may be recommended for specific symptoms, such as depression. Medicine for depression may be recommended for adolescents with Asperger's syndrome.

Federal law requires public schools to provide appropriate educational services for people with Asperger's between the ages of 3 and 21. Contact your local school district to find out which services are available for your child.

How are families affected?

Parents of children with Asperger's syndrome face many challenges in raising children with special needs. They may have difficulty finding doctors who are knowledgeable about this uncommon condition. Additionally, overtaxed teachers may not be able to offer the kind of help parents know that their children need at school. They may view the child’s symptoms as simply bad behavior.

Many children with Asperger's syndrome have other coexisting conditions, such as attention deficit hyperactivity disorder (ADHD), anxiety disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, or depression. These conditions also complicate a parent's job. Many parents find comfort and build acceptance with help from support groups, counseling, and a network of friends, family, and community.

Dr. Ron

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I have spoken to a fellow who does not know anything about Aspergers or Autism. He has viewed each videow email and yet he wants me to explain what Autism is and then explain what Aspergers Syndrome is. I thought people who watched my videos knew about these symptoms...apparently not. Okay I will do a series of videos about Aspergers Syndrome and/or Autism. I am also thinking about doing my videos on you tube instead of Talk Fusion. Any thoughts.??? scratch

KelleyNNelson

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I think having a child with autism, albeit mild, and then finding myself to have aspergers and sharing many of the same symptoms and issues of my son, but slightly more muted as well as being around the school system with my son for 3 years with children carrying a variety of profoundness has sharpened my view of the world. I can tell when a child is being "bad" vs. a child who genuinely has a problem, whether it be autism, aspergers, or any other disorder.

Kim, I definitely have the ADHD thing going for me... my parents said if I was born 5 years later I would have been medicated, and they actually considered it at one point, but they didn't want me to think there was something "wrong" with me. Also, my brother has severe ADHD and OCD, and my stepmother and I both agree that he exhibits asperger traits, but she seems content with the treatment they have... but then, they have no insurance, so I can't force them to get him diagnosed with anything because they can't afford the medications (much less their mortgage) I believe now that both my stepmother and my dad (especially) exhibit traits of aspergers. My dad is more like me, laid back, fears contact with new people, severely afraid of the phone and OCD about his work. My stepmom is severely OCD about the way every single thing is done, and she's got a completely rational reason for everything, but it usually makes every task take 3 times longer than it should. She barely sleeps, has revolving thoughts in her head, swings from a great mood to a deep depression pretty rapidly. But she blames a lot of that on their bad luck recently and also her fibromyalgia.

My brother though (now 16), is OCD to the point of washing his hands until they are raw or gets up all hours of the night to double check that the front door is locked. I remember when he was very little... maybe from the ages of 1-3, he'd gnaw his fingernails off until his fingers bled. My parents tried lemon juice (he actually rather enjoyed that taste. Razz He'll actually eat an entire lemon for you, or eat a grapefruit raw, like an orange. *shudders*) Finally they just put gloves on him. He still chews today, but only now and then does he chew until he bleeds. He was diagnosed as ADHD at 5, but my parents refused to put him on medication for the same reason they didn't give me anything. But when he continued to do poorly in school and when kids continued to pick on him, say around 3rd grade, he asked my parents "What's wrong with me??" and that's when they put him on ADHD medication. A year or so later on that same dosage, he began having symptoms of tourettes...ticks of the head, random guttural grunts and coughs. It ended up being because of the medication, so they lowered his dose significantly, but the tourettes symptoms remained. Some got less noticeable, but even today he has the cough and he blinks hard or jerks his head. I keep trying to get him to come to these meetings, but basically he's home-bound. He tells me that "my family understands me, that's good enough for me." He never goes out unless I get a hold of him and that's rare. My parents have home schooled him since after 5th grade because the school system just passed him every year instead of helping him. At 16, he still has to count on his fingers, he still writes letters backwards, mainly the capital D and is at about a 3rd grade spelling/grammar level. And that's not the shortfall of my parents teaching either, it's just things he's never been able to comprehend (These are things he inherited from my step mom). He excels in reading and writing, he's in between writing a few "novels" that he's gotten ideas for, and he writes lovely, just like a professional author (that can't spell or do any kind of grammar) and also excels at sciences of all kinds, he knew all of the dinosaurs by age 2 (kind of like my kid and cars), and now pretty much can tell you anything you wanted to know about bugs, or outer space, or what have you. If it has to do with science, he's read it. He's also current on social studies, my stepmother is sure that all of her kids know what's going on in the world, past and present and he's always drawing, always as far back as I can recall, he's always had a pencil or crayon drawing something. He's just never been keen on grammar, spelling or math of any kind.

Wow, what a ramble. Now, Dr. Ron... Perhaps this fellow who wants to know so much about these symptoms, instead of showing him videos, you can give "confidential" patient reports. My son, for instance... If he is not minding, and/or driving me insane while he is not in "autistic mode." I will unplug the TV's until the next day or until he is rational as a punishment, and I always warn him before I do it, to give him pause so he has the chance to while still rational.

Unfortunately, he usually decides to defy me... because I think that mixed in with his autism is ADHD and ODD. But I can see the switch go off in his eyes and it's like watching my son leave his body and only rage is left. This is when I get scared, because he is now over half my height and weight (at barely 6), and when in this particular mode, he is way stronger than me because he's working on pure adrenaline and rage. First he'll try to break things, usually that he knows are our "good" things, so I have to intervene. Occasionally, he'll start breaking his own toys... which at first, I think, well... It's his, he'll have to deal with it, but then I think, well I paid for the damn thing... So I end up intervening again. But usually what it boils down to is he's tall enough to just raise up his hands and scratch my face and neck. So, I hold his hands. So he starts kicking at me. And then basically it becomes a wrestling match. I try to take him down to the ground in a fetal position and leglock him with my legs and hold onto his hands... but with his growing strength, this usually gets reversed back on me, only he fights dirty. He'll grab my hair and shove my head to the ground so I'm basically defenseless until I can get my head up or his hands out of my hair. Anyway, we can go back and forth forever, the "meltdowns" can last 10 minutes or they can last an hour.

But once he's worked it out of his system, I can see my son snap back into himself, just as I saw him snap out of himself before. Once he's there, he's telling me how much he loves me and how he's sorry I'm hurt, and he's crying and hugging me and then this is the moment where things return relatively back to normal. Even though I've shut the TV's off, he's still mad about it but he gets why and moves on.

Aside from that, he speaks about 25% echolalia, however the percentages rise dramatically when he's in "rage" mode. Everyone I've ever talked to at his school always raves about his good behavior and how he has such excellent manners, which leaves me jaw-dropped since he is so different at home. His eye contact has gotten better, but you can tell it's difficult sometimes to look people in the eye. He still has some issues with fine motor skills, but it's getting better every day. He can print legibly, but large, and he can do arts and crafts with little help. His "coach" at school thinks his gross motor is behind too, but I think that's because they do P.E. with all 6 KG classes at one time and Richard likely feels out of place with that many children and won't perform. I've seen him on a playground, his gross motor skills are above normal, trust me. His speaking continues to get better, If you didn't know him, you would think he was a normal kid. Only my husband and I can pick out the echolalia, since it's usually from movies and video games. It usually seems appropriate for the moment, but sometimes strange to the person he's talking to and we have to explain. We're used to deciphering his language. He has great emotion and empathy (unless in rage mode...)

His obsession is cars, he knows nearly all makes and models of cars, from a Mustang to a Buggati Veyron. He owns over a thousand or more of different makes, models, toy (piggy bank cars) that we've collected over the years, either things we bought or gifts people have given him since everyone knows that's his #1 obsession. I once gathered them all up in his room to find that they took up his entire room's walking space. I didn't count them, just re-organized them and put 75% of them up in his closet and off the floor where we step on them daily in every room of the house. He likes any movie with cars... The entire Back to the Future series, Thelma and Louise, The Muppet Movie (the original, you know... the one with the rainbow colored Studebaker?) etc. Of course some are above his head and are violent (like Thelma and Louise at times), so we have to watch what we show him. He mostly just wants to see the cars moving.

I think you could probably say about the same for both autistic and aspergers, only on a smaller scale for aspergers. Again, a "confidential" patient, me... As a child, I always knew I was different, but didn't know why. I always got picked on, but rarely said or did anything about it, maybe cried at home, but to the person? No. However, if someone pressed my buttons enough, it would be almost like what I described with my son. I would "leave" my body and not have any control of what came out of my mouth or if I got violent or not. I could try to take it back, but I had absolutely no control over it. I remember in middle school, some kid pushing me down and I jumped right back up, in that "rage mode" and punched him in the face. Luckily, I was in good graces with the teachers, they gave me the option to go to the office or not, since they saw it wasn't me who started it. Of course I said no... because I'd be in trouble too since I hit him back and we were both bloody.

I remember my sister always picked on me (my step mom said she would actually watch my sister set me up for something and then run and tell on me. This would have been when I was maybe 4 or 5, she's 2¼ years older than me). She was always so much bigger than me (she grew tall fast, and I stayed short until high school, when I outgrew her), and she had arthritis so I didn't ever want to hurt her so I never fought back. Until I snapped. Again, middle school time-ish). She deliberately walked in my room and stole the thing either I prized the most or was using at the time, just to irritate me like she always had done. Literally I snapped, all I felt was revenge and rage. I wasn't thinking, I wasn't there. I went into the kitchen, grabbed two butcher knives and went after her, chasing her around the house until she gave me back my things. I remember her standing on my bed, unknowingly giving her my now patented "Evil Look©" while holding two butcher knives at her, and seeing her with absolute terror in her eyes, and that's when I came back to myself, I just walked back to the kitchen and back into my room without much emotion. My sister, however, had fled back to her own room and locked the door. Would I have hurt her? I doubt it. I think I was just trying to scare her, I don't really know because I wasn't really there, you know? Needless to say, she never bothered me again... not that that was my intention, I simply just snapped. If I give the Evil Look around her even now, she shies or turns away from me because it still scares/reminds her of that day. That really embarrasses me, although sometimes I do it on purpose to get a laugh out of the group we're in, and she's a good sport about it. This part of me is better with the medication.

Aside from all that, more specific symptoms for me would be like I said above, I likely have ADHD on top of the aspergers. I have insomnia mostly because of cycling thoughts, I can't speak to people without reaching for words in my brain - it's like my brain hides all of the words I know and I have to fight to find them, and especially if I attempt to make eye contact, I lose all train of thought, so usually I'll be looking at the person's mouth or nose or slightly to the left or right of them while I speak. But when I type, as you can see I write freely and at great length. I'm terrified of the phone and calling people (although I've had a cellphone for over a decade now). I won't answer unless I know the person or if I'm willing to talk at all. I'm majorly OCD with any type of work I do, however in the last 16 years since my first "real" job at 15 years old, I've had 17 (maybe more?) different jobs, ranging from fast food to factory line work to finally finding my love in photography and developing - in which I had at least 5 different jobs in alone... sometimes 2 at one time. Before all of that, I started babysitting almost every day at age 12 and helped my parents with their business before that, nothing too major, but I've always had a decent work ethic.

Problem is, I get bored, so I leave in search of something new and different. Supposedly, that's a symptom of ADHD, switching between jobs rapidly out of boredom, etc. I've been unemployed (laid off from my last job) for over a year, although I've been looking here and there, but with little interest anymore. I feel better, safer at home. I feel secure on my computer.... listening to my music, and after school, chasing after Richard as best as I can. Of course, after tomorrow there is no school, so it'll be just he and I to play.

I'm going to work harder on his behavior this summer, because he thinks he's alpha1 in this house and we are at his demand. He's already lost his video games permanently, because when he had them, he'd never stop playing them and it was a fight, sometimes a meltdown to get him to stop just to eat or even to go to the bathroom... god forbid bedtime. So we'd take them away temporarily and things would be fine for a little while, but then we'd cycle back and forth. So we took those away permanently, as a first step and he's a little better, but he still thinks no means absolutely yes and vice versa.

Anyway.... I'm rambling now and Sir Dr. Ron, you will see me tonight at the meeting, if you are coming... if not, I have an appointment with you tomorrow evening. Smile I better stop typing, or I'll never stop. heh. Smile

csweepigirl

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I know what you mean about the snapping, and feeling like captain asshole afterwards. I was worse in my teen years, and I swear I was so close to my mother giving up and calling the cops. She was my safe person, so I don' t know why I lashed out on her. I would lose it, than my apologies were not taken seriously. It was hell for both of us. If she didn't stay seated, and was being unpredictable in my eyes, I would get worked up. I would get punished during my rages, and it just made me so sad because I knew she did not know my brain. She didn't believe I was sorry, she didn't understand how much I did not mean anything I did or said. Pretty intense stuff. I was trying to control my environment by any means necessary, and my poor mom was the target. I think the phone thing should be on the Aspergers checklist for adults lol. I don't even know where the thing is, I hate the phone. When it rings, my pulse goes up to 120 at the least. The sleep thing seems to get worse with age, it's 3:30 am now, but I did sleep for an hour, but damned if I didn't have a twilight dream, a scary one, Edward and Bella were in my house, and it was haunted. Everything they looked at transformed, all the food was rotten. Hard to explain, guess you would have to be in that dream lol. I don't know where I was going with this, hmm... I like the idea of patient reports.

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