A doctor told me: “you will begin to grieve for the imperfect child”… and I started to cry.
This doctor’s phrase changed my life. It was the moment I felt I had to take charge like never before, and in a special way, of the child I carried for nine months in my womb. My son was diagnosed with Asperger’s Syndrome, currently, AUTISM SPECTRUM DISORDER.
No theory is more valid than the experience lived at home
The American Psychiatric Association (APA) published the new version of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5. Both Autistic Disorder, Asperger’s Syndrome, and Pervasive Developmental Disorder Not Otherwise Specified, are merged into a single disorder now called “Autism Spectrum Disorder”. The established criteria were modified, grouping social interactions, communication, and language into a single dimension. Additionally, areas of alteration that consider specific symptoms are organized. In the case of a restricted repertoire of behaviors and interests, the incorporation of sensory alterations as an area of alteration stands out.
Medical literature refers to the period prior to the 20th century. Massie and Rosenthal conducted a historical review in their book “Childhood Psychoses in the Early Years of Life”, ed. Paidós. Among their citations, one from the 18th century stands out, where a series of reports were published throughout Europe about children affected by an hour-long hysteria epidemic, being diagnosed as children possessed by the devil.
In Paris, Voisin (1826) divided children based on symptomatology and etiology:
- The mentally weak: Whose intelligence is situated between that of an imbecile and that of a normal person.
- Those born normal who had received deficient education.
- Those who showed character abnormalities from birth, such as pride and “uncontrolled passions”.
- The children of insane parents and therefore with a genetic predisposition to mental affection. Psychosis and autism. Didactic unit, p.13.
Based on this division, Voisin created a treatment with the aim of improving interpersonal relationships, in addition to providing moral education oriented towards addressing antisocial tendencies.
Other figures in the history of psychiatry and psychology such as Bleuler (term schizophrenia), Kraepelin (term lunatic condition, insanity, madness), Witmer (term childhood psychosis), Ferrari, Klein (first to work on the importance of symbol formation in the development of the EGO) and Frith refer to this topic, evolving in terms and descriptions from the concept of schizophrenia, madness, lunatic condition, childhood psychosis until Kanner in 1943, who first described early infantile autism.
Characteristics of Asperger’s Spectrum
For the purpose of addressing the specific topic, this article will cover the characteristics of Asperger’s Spectrum according to DSM-4, as the focus is on working with children with this condition and no other. The topic will be described and discussed below under this concept.
Hans Asperger, Austrian, published his first article related to Asperger’s Syndrome in 1944. The main traits he chose as relevant were:
- an inadequate social approach
- interests focused on a specific topic
- well-developed vocabulary and grammar
The latter, sometimes monotonous in their speech and without bidirectional communication development; poorly developed motor coordination, sometimes with difficulties in laterality; specific difficulty in one or two learning areas, and a low common sense criterion.
For its part, DSM-4 describes this Asperger’s Syndrome as a Disorder of dubious nosological validity, with the presence of repetitive, stereotyped, and restricted activities. No difficulty in language development is observed. On the contrary, this potential development is literal, extensive, and pedantic, although in the communication process it is observed to be poor and scarce. Intelligence is normal and advanced; however, motor development presents with greater clumsiness. In general, Asperger’s Syndrome occurs on an 8 to 1 scale in the relationship between males and females. The probability that these behaviors persist into adolescence is high; generally, the traits are not modified by environmental influence, but there is a good prognosis for adequate integration into society. Psychotic episodes only occasionally occur in adult life.
Description of a child with Asperger’s activity
In relation to this information, I indeed confirmed that my son, from around 3 years old…
- Did not establish eye contact with people except for his closest circle.
- When speaking or responding to others, he did so looking at the figure in his close environment that he had.
- His impulsive reactions to the denial of his desires were strong and poorly controlled. Insolent, aggressive, and a liar.
- He was bothered by being at birthday parties with many people and by them singing. He covered his ears, ran, or bothered others to get attention.
- He felt uncomfortable with other people in his home who were not the usual ones. He preferred to be alone with his parents.
- At mealtime, he requested “clean” meals. That is, lunch like rice with chicken and lettuce salad. This had to be served on different plates. The rice on one plate, the chicken on another plate, the salad on another plate, the salad in a bowl, and the dressings in another.
- No one could drink from his same glass, straw, or cutlery.
- He showed an attraction to dinosaurs. Readings, games, and toys related to them.
- His toys were of a single line. For example, he only liked Transformers, and only those of different types pleased him… he ignored other toys.
- His dependencies began to be technological. Six, seven, eight hours in front of some type of technological resource, such as television, cell phone, PlayStation, and/or computer.
- Obsessed with the game Minecraft and with others for shorter periods, going to the extreme of wanting to program part of certain characters.
- His specific difficulty in writing began to be observed, despite the efforts being made with calligraphic exercises.
- He habitually walked barefoot. The heat was suffocating for him. He tended to go from a lukewarm shower to a completely cold one.
- With great rigidity in his movements, especially when he got angry, he performed frustration movements (crying, fixed gaze, clenched fists).
- At school, he went unnoticed by his peers. Good grades and good participation; however, upon arriving home, he would vent everything that bothered him.
- His preferences in different areas and/or disciplines tend to be arts and mathematics. He also likes electronic music.
- His clothing had to be almost completely changed to soft, thin fabrics, without labels or tight elastic bands.
- There were situations where he could completely stop eating a food (like milk) or vice versa, consume one every day and several times a day.
- Very affectionate, affable, willing, and good at creating stories. Especially when he is in his comfort zone, with those who love him, care for him, and are with him day by day.
This has been, in part, the description of the characteristics of an Asperger. A difficult path for the parents of these children.
For psychologists, neurologists, therapists, and teachers to reach a diagnosis, other factors that may be intervening variables in the process of discovering what is happening with the child must be ruled out.
Does my child have Asperger’s Syndrome?
Firstly, the basis is to rule out any pathology in the child. Then, rule out social-family risk factors, emotional and/or economic deficiencies. That the behavior begins to be permanent and is not the product of a specific situation that alters the child’s development.
For this, it is necessary to cover the different areas with different professionals, for whom the following is recommended:
- General practitioner.
- Psychologist.
- Neurologist.
- Psychiatrist.
- Concurrently, psychopedagogue.
- Concurrently, occupational therapist.
Each of them will contribute significantly to the process being carried out for both children and parents. Some more than others, undoubtedly, will have the subtlety to understand that there will be good days and not-so-good days.
Adding that, for the child, occupational therapy is visibly more suitable, as it is practical, playful, and direct for working on sensory integration and the socialization process.
Also, adopting a sport will favor a healthy life, discipline, perseverance, motor skills, the socialization process, challenge, and also achieving the goal or prize.
In this case, taekwondo was chosen, as it met all the aforementioned characteristics.
Interaction between family and school
In relation to school, it is important to have a close relationship, communicate the diagnosis as soon as possible to be a focus for teachers and protect them from certain situations that could trigger a decrease in frustration tolerance. It is important, depending on the degree of the evaluation, to differentiate what is required to observe the strengths and weaknesses per area that the child presents. And from that indicator, support the objective.
It is recommended to go hand in hand with the school in this process, the second home of these children. Some go to traditional schools, others get lost along the way, and opting for schools with particular characteristics is a valid alternative that could benefit the child.
At home, it is necessary to warn family and friends about this situation. Probably, the child will not be comfortable with their space being invaded and will do everything possible to make a good welcome for guests difficult. That is why the planning and communication process with the child is important: to tell them that family members will come and that they should feel calm. Likewise, ask visitors for more patience, based on what is already known about the diagnosis.
As parents, it is important to be rigorous with medication, times, and established routines. The assignment of roles is fundamental in relation to activities related to the child (doing school homework, bath time, among others).
Regarding social aspects, the socialization process must be constantly promoted, expressing the pleasantness of being with other people. With this, it is important to open the doors of the house so that the child can invite whoever they want to play, share, or carry out extracurricular activities.
Outdoor activities can positively benefit the child, as they experience greater possibilities for sensory exploration. Family outings to the mountains, the beach, the countryside; are and always will be a contribution in every aspect of the child’s life.
Personal conclusions regarding Asperger’s Syndrome
This process is arduous, tedious, mysterious, and painful. However, little by little the path becomes illuminated when the diagnosis is clear. When specialists work with the same approach; when the child becomes aware of their condition and when parents assume a different reality for their child. It is not easy to understand why, however, the tools are there, although, mainly for parents in the child’s early childhood.
The important thing in this process is not to be discouraged as parents and as educators to bring out the maximum potential of these children who surely hide more than one talent.
My name is Paula González, mother of Maximiliano, recently diagnosed, at seven years old, with Autism Spectrum Disorder.
[1] ICD-10. References:
PT2-T18 Childhood autism F84.3 Childhood disintegrative disorder [299.10]upF84.9 Pervasive developmental disorder, unspecified [299.80]
An explanatory video about Asperger’s Syndrome is “Hugo, a friend with Asperger’s”: