12 yr old Skylar...an update frm G'ma/Guardian

[Guest guest]

(from Lynn in Michigan)

From living with Sky for the past five months, coping at home with the emotional, sometimes violent meltdowns and behavioral oddities - and - trying to see the world through his eyes, my husband Spencer and I have learned much, including compassion. We have found Sky to be a hyper-sensitive child; both emotionally and physically. We have gauged our interactions with him to account for that, as well take into consideration the violence he experienced for three years at the hands of a foster family before he came back home to us.

Our essential goals for Sky are for him to be a happy boy who likes himself, is kind to others, and one day be a happy, independent, nice and responsible man. He is quite bright. We hope he will go to college. Sky's is an ever-evolving story, however this article (below) helps us put things in perspective, as well as explain to y'all what's going on.

Btw - after much effort we now have Sky on Spencer's health insurance, and he is being treated by a pediatric neurologist who is well versed in Aspergers. She is the same doctor we used to take Sky to before the foster family stopped all treatment by her (for those three years I was ill and they had him), citing all Sky needed was, "some good ole down-home, behind the woodshed discipline." Also - on Thursday of this week - Sky has his first appointment with our family physician who shares offices with the same neurologist. The family doc will do all the immunizations and minor illness stuff.

The author of the following article, from the Mayo Clinic, could have used Sky as her poster child:

Asperger's Syndrome

OVERVIEW

Asperger's syndrome is a developmental disorder named for an Austrian pediatrician named Hans Asperger. In 1944, Asperger published a paper describing four children who had autistic-like problems in the areas of social interaction and communication, but displayed normal intelligence and verbal skills. He referred to these smart, sometimes precocious, quirky kids as "little professors."

For some children with Asperger's syndrome, the phrase definitely fits. Although children with Asperger's syndrome exhibit a wide variety of signs and symptoms, ranging from mild to severe, social awkwardness and an all-absorbing interest in specific topics are common. Like autism, Asperger's syndrome affects far more boys than girls.

Today, doctors group Asperger's syndrome with four other conditions — including autism — that are called autistic spectrum disorders or pervasive developmental disorders. These disorders all involve problems with social skills. Asperger's syndrome is generally thought to be at the mildest end of this spectrum. Still, the term is relatively new. Asperger's syndrome made its way into the mental health professional's guidebook in 1994 and has only recently gained widespread recognition.

Guidelines for diagnosis and treatment are still evolving, and research on the disorder is growing. But early interventions and special education teaching are already helping kids with Asperger's syndrome learn to use their strengths to overcome their weaknesses. (scroll down)

SIGNS AND SYMPTOMS

Once children are diagnosed with Asperger's syndrome, parents sometimes look back and identify signs of the disorder as early as 30 months of age. But, without the benefit of hindsight, it's often tough to pinpoint a problem until children go off to school and difficulty with social interactions becomes more apparent. In fact, young children with Asperger's syndrome may be extremely bright and may meet all of the usual developmental milestones.

School-age children with Asperger's syndrome exhibit a range of characteristics, with varying degrees of severity. A child with Asperger's may exhibit the following signs and symptoms in these areas:

Social skills

§ Has difficulty making friends

§ Engages in one-sided, long-winded conversations, without noticing if the listener is listening or trying to change the subject

§ Displays unusual nonverbal communication, such as lack of eye contact, few facial expressions, or awkward body postures and gestures

§ Doesn't empathize with or seem sensitive to others' feelings and has a hard time "reading" other people or understanding humor

§ Doesn't understand the give-and-take of conversation or engage in "small talk"

§ Seems egocentric or self-absorbed

§ May speak in a voice that is monotone, rigid, jerky or unusually fast

§ Can be extremely literal or have difficulty understanding the nuances of language, despite having a good vocabulary

Behavior

§ Shows an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes

§ Likes repetitive routines or rituals

§ May memorize information and facts easily, especially information related to a topic of interest

§ May have clumsy, uncoordinated movements, an odd posture or a rigid gait

§ May perform repetitive movements, such as hand or finger flapping

§ May engage in violent outbursts, self-injurious behaviors, tantrums or meltdowns

§ May be hypersensitive to sensory stimulation, such as light, sound and texture

Children with Asperger's syndrome also show signs of poor joint attention (shared attention) at a young age. Joint attention is an early-developing social skill in which two people — usually a young child and an adult — share the experience of looking at an object or observing an event. It includes the ability to point at objects and follow another person's gaze. This skill is crucial to later language and social development.

Some of these signs and symptoms occur in children with high-functioning autism, but there are major differences between the two disorders. Children with high-functioning autism often have greater nonverbal skills than verbal skills, while children with Asperger's syndrome are the opposite. Another difference is that children with Asperger's syndrome don't experience delays in language or cognitive development.

Many kids with Asperger's syndrome have above-average intelligence and good verbal skills, but little understanding for the unspoken rules of social communication. As a result, kids with Asperger's syndrome may seem odd, rude or inconsiderate. But they're not just weird kids "going through a phase," and they're not just adolescents having difficulties making friends. Asperger's syndrome is a serious, ongoing condition. For children with Asperger's syndrome, their obsessive interests and unusual social skills interfere with their ability to function and learn other skills.

In some cases, problems improve as children mature and learn how to cope with uncomfortable situations. However, some children with Asperger's syndrome become depressed in their adolescent years, as they become more aware of their differences.

Adults with Asperger's syndrome exhibit many of the same problems with social interactions. In fact, now that Asperger's syndrome is becoming more widely recognized, adults who never had a name for their eccentricities are recognizing themselves in the description of Asperger's syndrome.

TREATMENT

The core signs of Asperger's syndrome can't be cured. But most children benefit from early specialized interventions that focus on behavior management and social skills training. Your doctor can help identify resources in your area that may work for your child. Options may include:

§ Communication and social skills training. Many children with Asperger's syndrome can learn the unwritten rules of socialization and communication when taught in an explicit and rote fashion, much like the way students learn foreign languages. Children with Asperger's syndrome may also learn how to speak in a more natural rhythm, as well as how to interpret communication techniques used by others, such as gestures, eye contact, tone of voice, humor and sarcasm.

§ Behavior therapies. This general term describes numerous techniques aimed at curbing problem behaviors, such as interrupting, obsessions, meltdowns or violent outbursts. Behavior therapies usually focus on training a child to recognize a troublesome situation — such as new place or an event with lots of social demands — and then select a specific learned strategy to cope with the situation.

§ Medication. There are no medications to treat Asperger's syndrome. But some medications may improve specific behaviors, such as anxiety, depression or hyperactivity, that can occur in many children with Asperger's syndrome.

Treatment for Asperger's syndrome often involves a team of professionals that may include a speech and language pathologist, a psychologist, a social worker, a psychiatrist, or a developmental pediatrician, in addition to your child's primary care physician. It's often possible for children with Asperger's syndrome to succeed in mainstream schools, with the help of teachers and special education instructors. However, make sure your child's teachers understand how he or she learns best and what situations might be troublesome. In children with Asperger's syndrome, high intelligence and good verbal skills can mask areas of real deficiency, so teachers may not realize that special teaching techniques, support services and extra attention are really necessary.

For example, many children with Asperger's syndrome are best motivated by assignments that somehow incorporate their peculiar fixations. On the other hand, social periods during the school day, such as gym, lunch and recess can be difficult times, and children with Asperger's syndrome are sometimes the target of bullying. By working with your child's teachers and other school staff, you can create an environment and curriculum that allows your child to thrive.

Coping skills

Asperger's syndrome can be a difficult, lonely disorder — for children and their parents. By nature, the disorder brings difficulties socializing and communicating with your child. It may also mean fewer play dates and birthday invitations and more stares at the grocery store from people who don't understand that a child's meltdown is part of a disability, not the result of "bad parenting."

Luckily, as this disorder gains widespread recognition and attention, there are more and more sources of help. Here are a few suggestions:

§ Learn about the disorder. Just 20 years ago, many pediatricians hadn't heard of Asperger's syndrome. Now, there are numerous books and Web sites dedicated to the disorder. Do some research, so you better understand your child's challenges and the range of services in your school district and state that may help.

§ Learn about your child. The signs and symptoms of Asperger's syndrome are different in every child, and young children have a hard time explaining their behaviors and challenges. But, with time and patience, you'll learn which situations and environments may cause problems for your child and which coping strategies seem to help. Keeping a diary and looking for patterns may help.

§ Find a team of trusted professionals. You'll need to make important decisions about your child's education and treatment. Find a team of teachers and therapists who can help evaluate the options in your area and explain the federal regulations regarding children with disabilities.

§ Help others help your child. Most children with Asperger's syndrome have no visible sign of their disability, so you may need to alert coaches, relatives and other adults to your child's special needs. Otherwise, a well-meaning coach may spend time lecturing your child on "looking at him while he's talking" — something that can be nearly impossible for a child with Asperger's syndrome. You don't have to give every stranger the private details of your child's medical history, but there are times when a short explanation and a few tips can dramatically help your child.

§ Help your child turn his or her obsession into a passion. The tendency to fixate on a particular narrow topic is one of the hallmarks of Asperger's syndrome, and it can be annoying to those who must listen to incessant information about the topic everyday. But this topic of interest may also provide a tool for engaging kids with Asperger's syndrome in classroom projects and social activities. In some cases, kids with Asperger's syndrome can even turn their childhood fascination into a career or profession.

By Mayo Clinic Staff Nov 15, 2004

© 1998-2006 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.

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