Having just reviewed the clinical criteria for the diagnosis of Asperger's Syndrome, you may be filled with many questions and concerns. Some of what was described may match what you know to be true of your child.
But you might be surprised to see that other areas weren't included. What about the child who screams and covers her ears when an ambulance goes by, blaring its siren? Or the child who cannot tolerate the taste of Jell-O or pudding in her mouth? These are called sensory sensitivities, a commonality shared with people with autism but not defined by the DSM as clinical criteria.
Your child may vibrate at a different “frequency” than most others. That is, she may be described as “exquisitely sensitive.” Because of this, her entire nervous system — her senses and emotions — may be routinely affected by stimulation others filter out naturally.
Many children with Asperger's share some common sensitivities with people with autism. The most common sensory sensitivities are:
Auditory (including intolerable noise or frequency levels)
Smell and taste
The child with exquisitely sensitive hearing may cry and recoil from a variety of sounds. She reacts in this way because in a very real sense, she is physically hurting from the intensity of the noise. The most offensive sounds are those that are not only very loud and startling but also unpredictable, meaning there's no telling when or where they will occur with any certainty.
The most commonly hurtful, unpredictable sounds for someone with especially sensitive hearing include (in no particular order): dogs barking; babies crying; crowd noises; vacuum cleaners; police, ambulance, and fire engine sirens, or cars backfiring; loud music or television programs not of the child's choosing; public announcement systems and intercoms; people tapping, clicking, or snapping fingers or objects (such as a pencil); and people laughing, talking, or sneezing loudly.
Taste and Smell
Certain smells (especially food scents and perfumes or toiletries) and tastes may also be overwhelming. On occasion, a child may gag and vomit in reaction to the sensation of the smell or texture of foods. Unable to explain herself in the moment, the child may bolt from the environment if the smells or tastes become too much for her to handle.
Because many people with Asperger's are very visual in how they absorb and process information, they may also become readily overwhelmed by too many visual details in a single environment (think Walmart on a Saturday afternoon). The number of moving, flapping, or spinning objects paired with the vivid mix of colors and combined with too many people crammed together in a single location can push the child with Asperger's into sensory overload.
Light that is too intense can also cause pain and discomfort. Overhead fluorescent lighting is a harsh, abrasive, and unnatural illumination that is especially troublesome for many people with both Asperger's and autism. In addition to its intensity, fluorescent lighting may flicker and buzz. The flickering and buzzing may go completely unnoticed by others but will become unbearable for the child with heightened sensitivities.
Finally, the sensation of touch may be equally overwhelming for the child with Asperger's. Being hugged, patted on the head or back, or picked up — especially unpredictably and without warning or permission — may cause the child to cry, bite, or even hit. The challenge is that children, particularly small children, often tend to be hugged, patted, and picked up simply because they're adorable. The people doing the touching are well-intentioned but don't understand that the concept of respecting someone's personal space also applies to children.
The texture of certain clothing fabrics worn against one's skin may create extreme discomfort and physical irritation as well. This unpleasant sensation has been likened to one's flesh being rubbed raw with sandpaper. For some, cotton and natural fiber clothes are a must to ward against the manifestation of skin welts and rashes.
Conversely, other children with Asperger's may welcome (and seek out) the sensory input provided by the deep-pressured touch offered by bear hugs and massage, or burrowing under sofa cushions and mattresses, or self-swaddling in comforters and sleeping bags. The difference here is that these activities occur on the child's terms and at his specifications of endurance.
Another commonality children with Asperger's Syndrome may have with those with autism is “flat affect” expressions and some-what different speech patterns. A flat affect refers to facial expressions that are fixed or “artificial” in appearance instead of naturally animated. The child may not laugh or smile unless cued to do so in an appropriate situation, or the child may appear to have a collection of rehearsed or “canned” reactions to match certain circumstances. (This is actually a real strength.) The child's way of talking may also seem “flat” and monotone.
The child's words may sound robotic and carefully measured. Or there may be a lilting tone to her voice, described by some as “sing-song,” in which her speech sounds as if it's bouncing up and down when she talks.
Often, the child with Asperger's may find it challenging to demonstrate or understand what others take for granted as a commonsense manner of thought. The child may have a logic all her own that perplexes or exasperates others because it is not representative of the norm. She may not grasp certain social rules or ways of doing things, explained away by others with the phrase “just because.”
It is also not uncommon for many children with Asperger's Syndrome to have a desire to maintain order, peace, and tranquility. Your child may (from her logic and perspective) initiate great and creative measures to make others happy and content to maintain the status quo, even if it means making decisions that adults may judge as unwise or unacceptable. It may have more to do with desiring to please in order to keep the peace than with being intuitive to others' needs.
It is important to appreciate that none of these reactions are typically “attention-seeking” or deliberately “bad” or noncompliant behaviors. They are a genuine reaction to extreme, hurtful disturbances in the child's immediate environment.
For example, one mother assumed her son was engaging her in a power struggle when he refused to wear the new blue jeans he had picked out in the store and that she purchased for him. He complained that they scratched when he wore them. He was speaking truthfully, but his mom wasn't listening carefully enough to his words. Washing the new jeans several times to soften them made them physically tolerable, and the conflict was resolved without further incident. This concept of distinguishing an “Asperger's moment” from typical kid behavior will make more sense as you continue reading. Helping the child with Asperger's to cope with sensory sensitivities will be explored in more detail later in this book.
Your child may have Asperger's Syndrome if he or she finds it difficult to make friends; doesn't seem to understand nonverbal communications, like body language or facial expressions; doesn't understand or appears insensitive to others' feelings; is deeply passionate about one or more subject areas; is not physically graceful; has great difficulty accepting change in routine or schedule; or has different or mechanical-sounding speech patterns.
The Diagnostic and Statistical Manual does not currently include any of the previous autistic-like commonalities as clinical criteria for autism or Asperger's Syndrome. These attributes, while valid in many children, have become stereotypes when some doctors, journalists, and others generically describe those with Asperger's Syndrome.
Asperger's is as unique and individual an experience as each individual is unique. You may find that some, all, or none of these nonclinical, autistic-like commonalities make sense when you think about your child's way of being in the world.
Friday, October 5, 2012
Asperger's and Autistic-Like Commonalities - Parenting Children with Asperger's Syndrome