Early Signs Of Asperger’s: When To Seek Help
Autism awareness is on the rise, and, as a consequence, diagnosing children with autism spectrum disorders is easier than ever. Pediatricians and parents recognize delays in language and other areas and take steps to pursue a diagnosis. A two-year-old or three-year-old who doesn't speak or says only a few words, doesn't make typical eye contact, and struggles to complete age-appropriate tasks raises red flags. This child receives early intervention from a therapist who understands the concerns associated with autism and can work with children as they grow older.
But autism spectrum disorders aren't always so obvious. Other types of autism are milder, and the children and adults who live with them may function well. But even if they can successfully blend in and are harder to identify, there's no doubt that these individuals benefit from the help of a professional therapist.
Imagine a toddler who speaks well for his age but doesn't make typical eye contact, a school-age child who gets better-than-average grades but doesn't make friends and doesn't seem to mind, or an adult with obsessive hobbies who feels like they're "faking it" through every social interaction. These descriptions don't fit the stereotype of autism, but they could describe signs of Asperger's in three different age groups. These people aren't always evaluated for autism because they don't have speech delays and may not have developmental delays. And when diagnosis is missed or delayed, they may miss out on therapeutic interventions that could make their lives easier.
The early signs of Asperger's may be overlooked, sometimes delaying diagnosis until adolescence or even adulthood. Here's what to look for in children.
Signs of Asperger's in Children
Signs of Asperger's in toddlers and infants are sometimes overlooked because they don't include developmental delays, but some individuals with Asperger's are more-than-usually clumsy. In an infant or toddler this can translate to delayed crawling or walking. These delays aren't always dramatic and may not cause concern among caregivers if a young child isn't displaying other Asperger's signs. Older children may have an awkward gait, struggle with handwriting, or dislike sports.
These behaviors can include rocking, hand flapping, or in very young children, unusual fixation on a specific object. The repetitive behaviors are a way to self-soothe and help calm children with Asperger's, but they also draw attention from other children and mark the affected child as a target for teasing and bullying. Many parents don't pick up on signs of Asperger's in children until they enter a school or daycare environment and attention is drawn to these types of behaviors.
Avoiding Eye Contact
Many children with Asperger's avoid eye contact. This can begin as early as infancy. For most infants, the human face is the most interesting thing to look at, but babies with Asperger's may be more interested in objects than faces. This is easier to recognize as a child grows older.
Lack of Age-Appropriate Social Skills
For most children, social skills like reading and using facial expressions and body language, taking turns communicating, and showing an interest in other people are learned as language skills develop. But children with Asperger's communicate differently. They may not understand the give and take of conversation and play, making it difficult for them to make and maintain friendships.
Lack of Empathy
Most children gradually learn to care about the feelings of others, but even for developmentally typical children, it can be a slow process. Still, toddlers and preschoolers at least mimic this behavior, expressing sympathy when other children are hurt or sick. Children with Asperger's rarely display an interest in other children and may seem unaffected by others' excitement or sadness.
Unusual Speech Patterns
Children with Asperger syndrome don't seem to pick up on or imitate the ups and downs and starts and stops of typical speech patterns. For most of us, pitch and rhythm go unnoticed in everyday speech, but their absence is obvious and can make children difficult to understand. Adults and children who don't interact with them regularly may have trouble understanding them. Affected children's indifference to pitch can also make them oblivious to sarcasm or emotion when listening to others.
Advanced Vocabulary or Uncommon Word Choice
One of the most surprising signs of Asperger's in children is that, unlike those with more severe autism spectrum disorders, people with Asperger's don't demonstrate speech delays. Sometimes their vocabulary is larger than their peers', and they may choose less common words instead of commonly used phrases. They may ask to "socialize" with someone instead of "hang out" or talk about "relatives" instead of "family." The words choices they make aren't necessarily wrong, but they sound odd or precocious.
It's also common for these children to talk more than their peers, often providing a running commentary of their thought processes, oblivious to others' lack of interest or annoyance. They may not notice or mind if the conversation is one-sided.
In children, obsessive interests are common. Almost all young children tend toward single-mindedness, but it's unusual for a single interest to dominate all of a child's conversation and play. But children with Asperger's are often transfixed by a single interest and are more interested in details than in broad categories. This can include an unusual interest in and ability to remember the names of people or things and dates or times significant to them.
Sensitive to Sensory Input
For people with Asperger's, normal levels of noise, light, or activity can become overwhelming, and children with Asperger's may use repetitive behaviors to cope. These sensory issues are common in all children with autism spectrum disorders and are sometimes called sensory processing disorder or SPD. All of us can be overwhelmed by input from our senses, but children with SPD have a threshold for sensory overload that is lower than normal.
Odd Facial Expressions or Body Language
This goes along with struggling to accurately interpret the facial expressions and body language of others. Some children with Asperger's may not display many facial expressions or use body language at all, but others attempt to use these forms of communication in a way that seems odd or inaccurate. They may try to apply facial expressions and body language in ways that aren't appropriate for the situation, causing their nonverbal communication to be out of sync with their verbal communication or with what they're really feeling.
Working with a licensed or certified professional can help children practice social skills in a safe space and understand their Asperger's. Adults who are diagnosed with Asperger's later in life often report that the diagnosis is a relief and that they wish their symptoms had been identified at a younger age.
Signs of Asperger's in Teens and Adults
An early diagnosis allows a child with Asperger's to receive help from a licensed therapist and learn to live with Asperger's as they grow older. This makes it easier for a child with Asperger's to become an adult who is comfortable with his or her differences and is able to navigate the complicated world of social interactions that most of us take for granted.
But high-functioning Asperger's isn't always diagnosed in children. When the early signs of Asperger's are dismissed or go unnoticed, the struggle to form connections and communicate can come to a head in adolescence or adulthood. Signs of Asperger's in adults include all of the above, but adults can experience them in different ways.
As teenagers, most people with Asperger's want what all teens want - to make friends and fit in. By this age, they may have become better at imitating appropriate facial expressions and body language, but the effort can be exhausting. The difficulty of trying to fit in and feeling like an outsider can lead to self-isolation, depression, and anxiety. Odd mannerisms or emotional immaturity may encourage bullying that contributes to these feelings. Therapists familiar with these concerns can help teens come to terms with the ways in which they're different, work on social skills, and perhaps most importantly, see their own strengths.
In some cases, the same traits that make it difficult for teens with Asperger's to fit in may have benefits too. Teens with Asperger's may do well in school and keep out of the kind of trouble that can come with trying to fit in with the "wrong crowd." They may be able to go after their creative pursuits and hone skills they're interested in even if those hobbies are unpopular, and their honesty and genuine interest in their activities can draw a few good friends with similar goals.
People with Asperger's continue to learn about social cues, how to use them and interpret them, throughout their lives. Adults with Asperger's can function very well in social situations, but it takes a lot of effort for most. Working with a therapist can help adults with Asperger's manage personal and work relationships and balance their interests.
Adults with Asperger's often have successful careers and succeed in earning higher education degrees. Their tendency toward single-mindedness can help them reach the top of their fields. In addition to pursuing a career, many also marry and start families.
Benefits of Treatment
Asperger's doesn't go away, but people with Asperger's can lead fulfilling and successful lives. The symptoms and severity of Asperger's are different for each person, so treatment goals are individual. Therapy helps children and adults with Asperger's learn to interact with other people in ways that are socially fulfilling. Mastering social cues allows them to function independently and maintain relationships. By encouraging them to pursue their interests, therapists can draw their attention to the strengths that come with an Asperger's diagnosis.
People with Asperger's are also at risk for other conditions like social anxiety disorder, attention hyperactivity deficit disorder, bipolar disorder, depression, and obsessive-compulsive disorder. Therapy can identify and treat these co-existing disorders, improving quality of life. For most people with Asperger's, seeking help from a licensed or certified therapist is an important step toward a healthy understanding of their disorder.