Guidelines for the Treatment of Asperger’s

A thorough assessment along with specific interventions lead to success for children with Asperger's

A thorough assessment along with specific interventions lead to success for children with Asperger’s

Asperger’s Syndrome is a disorder in which a person has difficulty communicating with others; developing, maintaining, and understanding relationships; and engaging in flexible, lively, and wide ranging interests and activities.

Asperger’s has many similarities with autism. Recently, in fact, Asperger’s and Autism were merged in the official classification of disorders into one category, Autism Spectrum Disorders. Since the merger, we no longer speak of Asperger’s as a separate condition. For the purpose of this article, however, I will continue to use the word “Asperger’s.”

Assessment

Treating Asperger’s requires one initial and essential step, a thorough assessment of the child or adult. Someone, preferably an Asperger’s psychologist, should find out all that is possible to know about the person’s social, behavioral, and emotional background, from birth to the present. It is especially important to know how the person communicated as a child, including how language was used in interacting with others, how the child shared interests, emotions and feelings with others, the use of body language, facial expression and other ways of communicating nonverbally.

This assessment also includes gathering information about narrow, repetitive patterns of behavior, interests and activities, examples being fascination with World War II airplanes, train schedules, or spiders.

An assessment of the child’s sensitivity to sensory input, lights, sounds and touch, is also important as is an understanding of routines or lack thereof, as a child and in the present. Children with Asperger’s tend to become distressed at small changes in their surroundings. They have difficulty with transitions and often are rigid about what should or should not be happening around them. These needed to be assessed to determine if Asperger’s is a dominant part of the person’s condition.

General Intervention Strategies

The following is list of interventions that can be used to build competence and success in children once a diagnosis of Asperger’s has been reached:

1.    Explicitly instructing the child on how to interpret other people’s social behavior. The meaning of eye contact, tone of voice, facial and hand gestures, and non-literal communication such as humor, figures of speech, irony and metaphors can all be taught, much like the teaching of foreign language.

2.    Monitoring the child’s own speech should be taught, focusing on volume, rhythm, context and social situation.

3.    Drawing up a list of problematic, disruptive behaviors, such as interrupting, throwing tantrums, yelling, raging, and disobeying, along with a list of the consequences both for engaging in those behaviors and acting in a different, more positive way.

4.    Encouraging an active social life with other children, particularly around mutually enjoyable activities or shared interests.

5.    Linking specific frustrating or anxiety-provoking experiences and difficult feelings like anger and fear, so that the child is able to gradually understand how feelings come about.

6.    Showing how the child’s actions impact other people, both those who are familiar and unfamiliar to the child. Having the child practice engaging with others is often necessary, as simply explaining how to act is not usually effective.

7.    Teaching the child how to infer and to predict what is likely in social situations, to understand why people do what they do and anticipate the outcome of social interactions. This helps the child be more flexible in thinking about why other people are doing what they do and in responding to them.

  1.    Considering psychotherapy. This can be very useful for children with Asperger’s who struggle with anxiety, sadness, low self-esteem and feelings of rejection.

9.    Incorporating medication. Children with Asperger’s who suffer from depression, anxiety, obsessions and compulsions or other psychological and emotional difficulties can often benefit from medication.

10.  Using vocational training, focusing on job interview etiquette and workplace behavior, can help considerably in achieving self-sufficiency for the older teen or adult. Also, fostering the development of talents and special interests, whether they translate into marketable skills or not, encourages self-esteem and self-reliance, both of which are foundations for success in life.

Dr. Kenneth Roberson is an Asperger’s psychologist in San Francisco with over 30 years of experience. To ask a question, or schedule an appointment,
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