Instant Help for

Children and Teens with Asperger Syndrome

2005, 2011 Childswork/Childsplay

About Instant Help Charts

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 nave, 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
individualizedtailored to the childs 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:
l Teaching the child how to navigate
social situations
l Strengthening ability to interpret nonverbal cues
l Learning how to identify and anticipate
anxiety-provoking situations
l Identifying and building upon the childs
individual interests and strengths
l Defining and teaching adaptive life skills
necessary for self-sufficiency
l Managing disruptive behavior

An effective treatment program builds on the

childs 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:
l Breaking down tasks, skills, and appropri-

ate behavior into a series of simple and

complete stepsessentially, rule
sequencesthat are rehearsed until they
become rote to the child and available for
dealing with social situations (from personal
interaction to taking public transportation)
l Encouragement of self-evaluation and

consideration of alternatives
l Development of specific problem-solving

strategies
l Cultivation of social awareness
l 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:
l Interviews with the parents, teach-

ers, and child

l Standardized behavior rating scales

given to parents and teachers, such

as The Social Responsiveness
Scale (Western Psychological
Services)
l A review of school records and

reports
l Tests to review intellectual ability

and academic achievement

Additional assessment might also
include:
l Social Communication

Questionnaire (Western
Psychological Services)
l Aspergers Syndrome Diagnostic

Scale
(Autism/Asperger Publishing Co.)
l Gilliam Aspergers 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 treatmentthe earlier the better
can learn to cope with it.

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).

Fast Facts
l 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 l In addition to an attention deficit, individuals with AS are prone to generalmost diagnosed between the ages of
ized anxiety, specific phobias, and low
5 and 9.
self-esteem. They are also vulnerable
l Asperger syndrome is a relatively new
depression, especially in adolesto
diagnosis, first appearing in the DSM-IV
cence,
as they become increasingly
in 1994; its definition was reworded in
aware
that
they are different.
the 2000 Text Revision. There is still
some debate among professionals
about its proper classification.

l Learning difficulties that relate to the

l Individuals with AS are sometimes mis-

development of fine motor skills and

understanding language are common
in children and teens with AS.

diagnosed as having oppositional defiant disorder (because of their failure to l Children with AS may also develop
other personality disorders, which can
follow instructions and strongeven
complicate the diagnosis and treatviolentreaction to others), attention
ment.
deficit disorder (because they often

What Teachers Need to Know

l Most students with AS benefit from small settings, specially trained and readily available

communications personnel, and highly individualized instruction, attention, and curricula.

l 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.
l Children with AS do better when instruction is activity based and taught through relevant

activities and across contexts, based upon the childs individual characteristics, interests,
and talents.
l The most effective teaching approach is a structured one-to-one format with clear and concise presentation of information.
l Students with AS benefit from additional prompts and an explicit reward for improved behavior.
l The teaching of skills should be embedded in activities that engage the child and are personally meaningful to them.
l Structure and predictability are essential; creating and presenting mini-schedules in readily accessible ways, such as through pictures, is

very helpful.
l The student will learn better if physically comfortable in an environment that is safe, stimulating, and pleasurable. Small groups and coop-

erative learning groups can be beneficial.

l Behavior problems are best dealt with through positive support, which involves a functional behavioral assessment (FBA), and the subse-

quent development and implementation of an individualized support plan.

l Parents and other family memberswho have the greatest familiarity with the child or teenshould be included in the process of assess-

ment, curriculum planning, instruction, and monitoring.

l Transitions to any new school experiences or placements should be carefully planned, with assistance provided, where necessary.
l 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.
2 Instant Help for Children and Teens with Asperger Syndrome

Childswork/Childsplay

The Dos and Donts of Communicating

DONT

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.
l 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.
l 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.
l 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/).
l Create as calm and predictable a home environment and schedule as possible.

This is very helpful in reducing the childs anxietywhich, in turn, benefits everyone else in the family.
l Accept and allow the childs efforts at self-soothing without criticism or interference, as long as these efforts dont 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.
l 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 childs unique strengths, interests, and needs.
l Learn to appreciate children for who they are.

Children with Asperger syndrome simply dont 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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Instant Help for Children and Teens with Asperger Syndrome 3

This Instant Help Chart was written by

Corinna Fales

Instant Help for

Children and Teens with Asperger Syndrome

Published by Childswork/Childsplay
A Brand of The Guidance Group
1.800.962.1141
www.guidance-group.com

Medication and Asperger Syndrome

Keep In Mind
Through everyday conversations you
can help individuals with AS to:
l See that there are different choices

they can make and different

consequences to their choices.
l Recognize that there are different

ways to interact with people,

including negotiating, persuading,
discussing, and disagreeing.
l Understand that different people

have different ways of expressing

themselves.
l 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 and irritability (anti-anxiety medications), and
for severe obsessive behavior and
depression (antipsychotics and/or

antidepressants). 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 issues.
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 childs 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

Ozonoff et al., Guilford Press, 2002

Adams Media, 2010

Parenting Your Asperger Child:

Individualized Solutions for Teaching Your
Child Practical Skills. Alan Sohn and Cathy
Grayson, Penguin Group, 2005

Can I Tell You About Asperger Syndrome?:

A Guide for Friends and Family. Jude
Welton, Jessica Kingsley Publishers Ltd,
2004

101 Games and Activities for Children With

Autism, Aspergers and Sensory
Processing Disorders. Tara Delaney,
McGraw-Hill, 2009

Aspergers Syndrome and Difficult

Moments: Practical Solutions for Tantrums,
Rage and Meltdowns. Brenda Smith Myles
and Jack Southwick, Autism Asperger
Publishing Company, 2005

Books for Children and Teens

Knowing Yourself, Knowing Others.

Barbara Cooper & Nancy Widdows. Instant
Help Publications, 2005

The Many Faces of Aspergers Syndrome.

Maria Rhode and Trudy Klauber, (Eds.),
Tavistock Clinic Series, 2004
A Parents Guide to Asperger Syndrome
and High-Functioning Autism: How to Meet
the Challenges and Help Your Child. Sally

The New Social Story Book, Revised and

Expanded 10th Anniversary Edition: Over
150 Social Stories that Teach Everyday
Social Skills to Children with Autism or
Asperger's Syndrome, and their Peers.
Carol Gray Bym, Future Horizons, 2010
The Everything Parent's Guide to Children
with Asperger's Syndrome: The sound
advice and reliable answers you need to
help your child succeed. William Stillman,

4 Instant Help for Children and Teens with Asperger Syndrome

The Social Success Workbook. Barbara

Cooper & Nancy Widdows. Instant Help
Publications, 2005
Freaks, Geeks and Asperger Syndrome: A
User Guide to Adolescence. Luke Jackson,
Jessica Kingsley Publishers Ltd, 2002
Books for Professionals
Asperger Syndrome: What Teachers Need

to Know. Matt Winter, Jessica Kingsley

Publishers Ltd, 2011
Doing Therapy with Children and
Adolescents with Asperger Syndrome.
Richard Bromfield, Wiley, 2010
School Success for Kids With Asperger's
Syndrome: A Practical Guide for Parents
and Teachers. Stephan M. Silverman,
Prufrock Press Inc., 2007
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 Syndrome. Ami J.M. Klin et. al,
(Eds.), Guilford Press, 2000

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