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Instant Help for
Children and Teens with Asperger Syndrome
This Instant Help Chart was written by
Corinna Fales
Published by
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Woodbury, NY 11797
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Instant Help for
Children and Teens with Asperger Syndrome
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Medication and Asperger Syndrome
Keep In Mind
Through everyday conversations you
can help individuals with AS to:
See that there are difference choices
they can make and different
consequences to their choices.
Recognize that there are different
ways to interact with people,
including negotiating, persuading,
discussing, and disagreeing.
Understand that different people
have different ways of expressing
themselves.
See that they can predict how others
will react to them, by understanding
the underlying rules of both verbal
and nonverbal communication.
There is no approved
medication for the
symptoms of AS.
However, medications do exist that
may help with
some of the coexisting conditions. These
include those
used for attention deficit disorders
(such as psychostimulants), for
anxiety (anti-anxiety medications),
and for severe obsessive behavior and depression (antidepres-
sants). The complex nature of this
disorder, along with the desperation of parents, leads some medical professionals to experiment
with different combinations of
drugs to handle different symptoms and behavioral problems.
While this type of experimentation
is understandable, there is a
danger that the interactions of
some medications can lead to a
worsening of symptoms. The
objective monitoring of a child’s
behavior should always accompany
treatment with medication.
The Brain and Asperger Syndrome
Some research suggests that people with AS have neuronal abnormalities in the prefrontal lobe and
that these abnormalities are related to the clinical severity of their symptoms. It is not known
how these prefrontal neurons are abnormal or how the abnormalities relate to the severity of
such symptoms as obsessive behaviors and social difficulties. One study showed reduced
activation in the fusiform gyrus, the area of the cerebral cortex where recognition of faces
takes place, which may account for the interpersonal problems experienced by people with
AS. Other studies suggest that a deficit in sensorimotor gating may make it hard for persons
with AS to inhibit repetitive thoughts, speech and actions. Continued research in the brain differences associated with Asperger syndrome should make it easier to diagnose and treat this disorder.
Resources for Helping Children and Teens with Asperger Syndrome
Books for Parents
Parenting Your Asperger Child:
Individualized Solutions for Teaching Your
Child Practical Skills. Alan Sohn and Cathy
Grayson, Penguin Group, 2005
Asperger’s Syndrome and Difficult
Moments: Practical Solutions for Tantrums,
Rage and Meltdowns. Brenda Smith Myles
and Jack Southwick, Autism Asperger
Publishing Company, 2005
The Many Faces of Asperger’s Syndrome.
Maria Rhode and Trudy Klauber, (Eds.),
Tavistock Clinic Series, 2004
A Parent’s Guide to Asperger Syndrome
and High-Functioning Autism: How to Meet
the Challenges and Help Your Child. Sally
Ozonoff et al., Guilford Press, 2002
Pretending to Be Normal: Living with
Asperger’s Syndrome. Liane Holliday
Wiley, Jessica Kingsley Publishers Ltd,
1999
Alternative Treatments for Children within
the Autistic Spectrum. Deborah Golden
Alecson, McGraw-Hill, 1999
The OASIS Guide to Asperger Syndrome.
Patricia Romanowski Bashe, Crown
Publishers, 2001
Can I Tell You About Asperger Syndrome?:
A Guide for Friends and Family. Jude
Welton, Jessica Kingsley Publishers Ltd,
2004
4 • Instant Help for Children and Teens with Asperger Syndrome
Books for Children and Teens
Books for Professionals
Freaks, Geeks and Asperger Syndrome: A
User Guide to Adolescence. Luke Jackson,
Jessica Kingsley Publishers Ltd, 2002
Addressing the Challenging Behavior of
Children with High-Functioning Autism: A
Guide for Teachers and Parents. Rebecca
A. Moyes, Jessica Kingsley Publishers Ltd,
2002
Asperger’s Syndrome, The Universe and
Everything: Kenneth’s Book. Kenneth Hall,
Jessica Kingsley Publishers Ltd, 2001
Knowing Yourself, Knowing Others.
Barbara Cooper & Nancy Widdows. Instant
Help Publications, 2005.
The Social Success Workbook. Barbara
Cooper & Nancy Widdows. Instant Help
Publications, 2005.
Asperger Syndrome: What Teachers Need
to Know. Matt Winter, Jessica Kingsley
Publishers Ltd, 2003
Asperger Syndrome. Ami J.M. Klin et. al,
(Eds.), Guilford Press, 2000
Asperger Syndrome and Adolescence:
Helping Preteens and Teens Get Ready for
the Real World. Teresa Bolick, PhD, Fair
Winds Press, 2001
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Defining the Problem
The American Psychiatric Association Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition, Text
Revision describes the essential features of Asperger syndrome (AS) as “severe impairment in social interactions and a
restricted repertoire of behaviors, interests and activities with
no substantial delays in language, self-help skills, or curiosity
about the environment.” Current use of the term varies considerably, as do the individuals who are diagnosed with it.
Although the DSM-IV classifies Asperger syndrome as a pervasive developmental disorder that is part of the autistic spectrum, its differences from autism—
which relate to intelligence level and the development of language, curiosity, and self-help skills—
are major.
Children with AS may avoid eye contact, seem eccentric, speak in a monotonous and “professorlike” way (lacking appropriate empathy and give-and-take), have difficulty making friends, fail to
initiate or reciprocate normal sharing and affectionate behavior, and focus exclusively and obsessively on one specific area of interest (in which they frequently exhibit exceptional skill or talent
and an advanced vocabulary). They may also be extremely literal and naïve, become anxious
over any change in the usual order of things (and develop obsessive routines to re-establish their
(continued on p. 2)
Counseling Children
and Teens with AS
There is no single best treatment for children
with AS, who may seem more different from
each other than alike. Research shows that
effective treatment is based upon a thorough
assessment of each child and should be highly
individualized—tailored to the child’s particular
strengths, needs, and abilities.
Goals in Developing a Treatment Plan
The primary goal of any treatment plan is to
promote and enhance communication and
social competence, which includes:
Teaching the child how to navigate
social situations
Strengthening ability to interpret nonverbal cues
Learning how to identify and anticipate
anxiety-provoking situations
Identifying and building upon the child’s
individual interests and strengths
Defining and teaching adaptive life skills
necessary for self-sufficiency
Managing disruptive behavior
An effective treatment program builds on the
child’s interests and offers a predictable schedule. Interpersonal and communication skills are
taught as a series of simple steps, in highly
structured activities, and with regular reinforcement. Social skills training may be combined
with cognitive behavioral therapy, medication
for co-existing conditions, and other forms of
counseling.
Specific skills are taught through verbal and
explicit communication and include:
Breaking down tasks, skills, and appropriate behavior into a series of simple and
complete steps—essentially, rule
sequences—that are rehearsed until they
become rote to the child and available for
dealing with social situations (from personal
interaction to taking public transportation)
Encouragement of self-evaluation and
consideration of alternatives
Development of specific problem-solving
strategies
Cultivation of social awareness
Regular reinforcement of behavior
This chart is intended to provide a
summary of the critical information
available on helping children and teens
with Asperger syndrome to insure that
every child gets the most appropriate
and comprehensive consideration.
Assessing AS
Since children with AS differ widely and
it is important to build treatment
programs based upon their specific
skills, interests, and abilities, direct
observation of the child is particularly
important in assessment. In addition,
assessment should include:
Interviews with the parents, teachers, and child
Standardized behavior rating scales
given to parents and teachers, such
as The Social Responsiveness
Scale (Western Psychological
Services)
A review of school records and
reports
Tests to review intellectual ability
and academic achievement
Additional assessment might also
include:
Social Communication
Questionnaire (Western
Psychological Services)
Asperger’s Syndrome Diagnostic
Scale
(Autism/Asperger Publishing Co.)
Gilliam Asperger’s Disorder Scale
(Pro-Ed)
Treatment needs are best determined
by an interdisciplinary team with input
from parents and teachers, focusing primarily on empirical observation. Cultural
biases should also be considered in
doing an assessment of children from a
minority background.
Defining the Problem (continued)
calm), dislike being touched (and react strongly), and be highly sensitive to smell, sound,
color and taste (with intense likes and dislikes
in these areas).
Individuals with AS have inherent difficulty with
“reading” the nonverbal cues that are part of
everyday social interaction. This makes it difficult for them to understand others’ feelings
and results in anxiety when they are required
to meet the social demands of everyday life.
Though the physiological basis of AS is still
not fully understood, research shows that it is
diagnosed much more frequently in boys than
in girls and may be genetically linked. Children
do not outgrow the syndrome, nor is there any
known cure for it, but children who receive
effective treatment—the earlier the better—
can learn to cope with it.
Fast Facts
According to the Asperger Syndrome
Coalition of the United States, the
onset of AS is later than what is typical in autism, or at least it is recognized later. A large number of children
are diagnosed after the age of 3, with
most diagnosed between the ages of
5 and 9.
Asperger syndrome is a relatively new
diagnosis, first appearing in the DSM-IV
in 1994; its definition was reworded in
the 2000 Text Revision. There is still
some debate among professionals
about its proper classification.
Individuals with AS are sometimes misdiagnosed as having oppositional defiant disorder (because of their failure to
follow instructions and strong—even
violent—reaction to others), attention
deficit disorder (because they often
have an attention deficit), obsessivecompulsive disorder (because of their
obsessive behaviors), PDD-NOS (pervasive developmental disorder-not otherwise specified), or even schizophrenia (because of their social deficits and
odd behavior).
In addition to an attention deficit, individuals with AS are prone to generalized anxiety, specific phobias, and low
self-esteem. They are also vulnerable
to depression, especially in adolescence, as they become increasingly
aware that they are different.
Learning difficulties that relate to the
development of fine motor skills and
understanding language are common
in children and teens with AS.
Children with AS may also develop
other personality disorders, which can
complicate the diagnosis and treatment.
The Dos and Don’ts of Communicating
DON’T
• Give complicated directions.
DO
• Break down into clear, short steps what the
child needs to do.
• Scold, punish, or yell.
• Set limits and provide clear steps for managing
• Try to force affectionate behavior.
• Label, mock, or tease.
• Accept what the child can tolerate.
• Recognize that the child sees the world very
• Expect “normal” conversation.
• Engage children and teens in areas where they
behavior.
differently and is easily overwhelmed.
show interest.
What Parents Need to Know
The suggestions that follow can be helpful to everyone in the family.
Recognize that Asperger syndrome is not the result of poor parenting.
Though the physiological reasons for Asperger syndrome are not fully understood, the
syndrome is not the result of poor parenting. Parents who think their child may have AS
should not react as if they are the cause. It may be difficult not to take it personally when
a child does not reciprocate socially or emotionally, but appropriate counseling for parents
can help.
What Teachers Need to Know
Most students with AS benefit from small settings, specially trained and readily available
communications personnel, and highly individualized instruction, attention, and curricula.
The behavior of students with AS is not willful; it is the result of their inability to understand
everyday social interaction and expectations. Reprimands and punishment will not help.
Get informed.
Parents who think their child may have AS need to have the child professionally and sensitively evaluated. Because the syndrome is
relatively new, parents whose children are diagnosed with AS might also want to get a second opinion.
Children with AS do better when instruction is activity based and taught through relevant
activities and across contexts, based upon the child’s individual characteristics, interests,
and talents.
The most effective teaching approach is a structured one-to-one format with clear and concise presentation of information.
Students with AS benefit from additional prompts and an explicit reward for improved behavior.
The teaching of skills should be embedded in activities that engage the child and are personally meaningful to them.
Structure and predictability are essential; creating and presenting mini-schedules in readily accessible ways, such as through pictures, is
very helpful.
The student will learn better if physically comfortable in an environment that is safe, stimulating, and pleasurable. Small groups and cooperative learning groups can be beneficial.
Behavior problems are best dealt with through positive support, which involves a functional behavioral assessment (FBA), and the subsequent development and implementation of an individualized support plan.
Parents and other family members—who have the greatest familiarity with the child or teen—should be included in the process of assessment, curriculum planning, instruction, and monitoring.
Transitions to any new school experiences or placements should be carefully planned, with assistance provided, where necessary.
Younger children need to develop social and communication skills, while teens benefit from practical preparation for adulthood. Although
the focus of instruction shifts as the child ages, the goal continues to be the development of skills that will be of use to children in all
facets of their lives.
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Get support.
Coping with AS is not easy. Joining support organizations and talking to other parents who have children with AS can help. Parents can
also get information and support through Web sites such as O.A.S.I.S. (http://www.udel.edu/bkirby/asperger/).
Create as calm and predictable a home environment and schedule as possible.
This is very helpful in reducing the child’s anxiety—which, in turn, benefits everyone else in the family.
Accept and allow the child’s efforts at self-soothing without criticism or interference, as long as these efforts don’t harm the
child or others.
Parents need to recognize that children and teens with AS see the world very differently; their odd behavior is actually an attempt at selfsoothing when they feel overwhelmed. Interfering with this behavior may result in even greater distress and anxiety.
Explore different kinds of educational options.
Parents need to familiarize themselves with the entire range of services available in their school district and should try to visit each
possible educational placement to learn about it firsthand. They should also learn as much as possible about the placement process, as
well as about model programs (public and private). Programs will ideally build upon the child’s unique strengths, interests, and needs.
Learn to appreciate children for who they are.
Children with Asperger syndrome simply don’t perceive, experience, or live in the world the same way other children do. Instead of
focusing on differences or deficits, parents should work toward appreciating who their children are and what they have to offer.
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