Q: My 6-year-old-grandson has been diagnosed with Asperger's. He is very bright (he loves marine life), but he must be helped in many ways. He is hyperactive and blurts out inappropriate remarks. I understand that adolescence can be particularly challenging. Can anything be done to help?
A: Asperger's syndrome is a form of autism that afflicts smart, verbal children.
But the distinction between the two disorders is complicated. Both autism and Asperger's syndrome are classified as pervasive developmental disorders. This term encompass abnormalities in three areas — social skills, communication and behavior — involving both a restricted range of activities and interests, and unusual actions, such as repetitive motions. Both autism and Asperger's have a wide range of severity.
Autism is characterized by impaired social interaction, severe language difficulties, and restricted and repetitive patterns of behavior, as well as serious learning disabilities — although some autistic people may be quite bright.
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Children with Asperger's syndrome (boys are afflicted more often than girls) have no significant delay in cognitive development and have average to above-average IQs. These children are usually bright and do well in school.
Unfortunately, the part of the brain that deals with social skills and empathy does not work well in people with Asperger's syndrome, leading to severe developmental delay in this area. Normally developing young children quickly learn how to interpret and use body language, such as facial expressions and eye contact.
Children who have a pervasive developmental disorder have difficulty interacting with others. They avoid eye contact, laugh inappropriately and often have a standoffish or defiant attitude. Although autistic children have little interest in interacting with others, those with Asperger's syndrome both want and like to interact, but the way they interact can be very inappropriate.
For example, they may hug a child who is trying to squirm away. Or gather all the toys in a heap so the other children can't play with them. Or spin around or rock constantly.
Children with Asperger's generally learn to speak on schedule, and they may even have an impressive vocabulary, but it takes them extra time to interpret and understand what they have heard.
They tend to interpret what is said very literally, often talk incessantly even when others are trying to get a word in edgewise, and talk about themselves a lot. They may laugh or giggle inappropriately.
Asperger's syndrome probably is genetic, and it's not "curable." But there are ways to improve functioning and help families cope. Early diagnosis, behavioral-training programs and careful educational management can help the children reach their maximum potential. Some people with Asperger's learn how to cope well enough with their disability to lead productive lives.
Parents of any child with a disability that affects every aspect of the child's life and will not go away need two things: knowledge and support. Family members must truly understand that this is a developmental disorder, not a behavioral one. Yes, there is "weird behavior," but that results from a problem in the child's brain, not because the child is "bad" or the parenting was "bad."
Resources include the child's pediatrician, the library and the Internet (www.asperger.org will provide much valuable information, including how to find support groups). Parents should work closely with schools to foster leaning, encourage the child to do his or her best, and minimize any reluctance to go to school because of social problems.
The best way to deal with the challenges of adolescence is to make an early diagnosis and start interventions early. As a grandmother, the best thing you can do is be supportive to the parents.