Treating aspergers in adults

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Treatment of Asperger’s Syndrome: Many Therapies Can Help

Early intervention for Asperger’s is critical to treatment success. Thinkstock

Your doctor might recommend one or several types of therapies to help you or your child cope with Asperger’s syndrome.

Effective treatments can improve how someone with Asperger’s copes with social challenges, impulses, emotions, motor skill deficits, and other behaviors that might be impacting their life.

Options include therapy, medication, alternative approaches, and more.

Just as with other autism spectrum disorders, the sooner you start treatment for Asperger’s, the better.

What types of therapy work for Asperger’s?

Several types of therapy are used to improve Asperger’s symptoms, including:

  • Cognitive behavioral therapy (CBT) This type of “talk therapy” is typically used to help a person with Asperger’s better regulate his or her emotions and impulses. It can also help children and adults cope with anxiety or depression. CBT focuses on encouraging individuals to change their thoughts and perceptions by recognizing and altering specific behaviors.
  • Sensory integration/occupational therapy Kids with Asperger’s often have trouble controlling their senses. Additionally, they may struggle with activities that require fine motor skills. Sensory integration therapy helps children stabilize their senses. An occupational therapist shows kids how to perform certain exercises that can improve balance, hand-eye coordination, and responses to sounds or touches. The idea is that if you can better control your senses, you can better regulate your movements and emotions.
  • Social skills training and speech-language therapy Most kids and adults with Asperger’s don’t have problems with language, but they may not know how to express their thoughts and feelings appropriately. Therapists use social skills training to help individuals learn ways to interact with peers. Speech-language therapy is another useful way to improve communication skills in someone with Asperger’s. This therapy can help kids recognize certain gestures and figures of speech. It can also lead to improved eye contact.
  • Applied behavioral analysis (ABA) This is a comprehensive program that’s been used since the 1960s. It uses different approaches, such as positive reinforcement, to teach or change certain behaviors and skills in children and adults. A therapist customizes the program to each person’s needs. Several studies have shown ABA is effective at improving outcomes for kids with autism spectrum disorders. But some people, including some with autism, feel that ABA therapy is not helpful and can be harmful.
  • Anger management Programs that help people learn to control and cope with their anger may be helpful for children and adults with Asperger’s syndrome.
  • Support groups Group programs, or support groups, may help kids and adults with Asperger’s work on social skills in a safe environment. Certain organizations, such as Autism Speaks, offer lists of resources in your area, which include support groups for parents and children.
  • Family therapies Parent training can equip caregivers with the skills they need to assist individuals with Asperger’s. This type of therapy can help those who interact with the child most incorporate treatment strategies, such as social skills training and behavioral training, at home.
  • Educational therapies Well-structured educational programs can help children with autism spectrum disorders improve communication, social skills, and other behaviors. Educational therapies include many different activities and interventions to help kids learn ways to progress.
  • Neurofeedback Neurofeedback, a type of biofeedback, is a method that involves helping you learn to control your body’s brain function. Research has shown it can improve attention, intelligence, and other symptoms in people with Asperger’s. (1) (2) (3)

Medication can Help With Secondary Symptoms

There’s no medication approved to specifically treat Asperger’s syndrome. But certain drugs can help control secondary symptoms that often accompany the disorder, such as anxiety, hyperactivity, depression, or attention problems.

Some people with Asperger’s take medications like antipsychotics, stimulants, or antidepressants. Your doctor can help you determine if you or your child might benefit from these medicines. (2)

Alternative and Complementary Treatments

Between 30 and 95 percent of children with an autism spectrum disorder have been given some type of complementary or alternative treatment to help their symptoms. (4)

It’s important to know that many of these therapies have not been shown to be effective in scientific studies. Still, many people report anecdotal improvements.

Talk to your doctor before trying any type of alternative treatment. While some are harmless, others may be dangerous or make your condition worse.

Common alternative approaches for autism spectrum disorders include:

  • Massage A massage can be calming for someone with Asperger’s, but there’s no hard data to show it can improve symptoms.
  • Yoga Yoga can promote relaxation, make you more flexible, and improve balance. Some people believe it can help kids with Asperger’s relieve stress.
  • Chelation therapy This treatment is used to remove heavy metals from a person’s body, but it can be dangerous. Also, there’s no evidence to show it works for helping autism spectrum disorders.
  • Hyperbaric oxygen Some people believe breathing oxygen through a pressurized chamber can help symptoms. But this treatment isn’t approved by the Food and Drug Administration (FDA), and it hasn’t been proven effective.
  • Horse therapy Working with animals, such as horses, is a popular therapy for children with autism spectrum disorders. Many people believe the animals can be therapeutic.
  • Art or music therapy Creative treatments that include art or music are sometimes used along with standard therapy to help lessen sensitivity to touch or sound.
  • Intravenous immunoglobulin (IVIG) infusions Some parents believe IVIG infusions can help symptoms of autism spectrum disorders, but there’s no research to show they work.

(2)

Can Diet and Supplements Help With Symptoms?

Many parents believe that special diets improve behavior and symptoms in kids with autism spectrum disorders. There’s not much research to back up these claims, and if you do try a new eating plan, work with a dietitian to make sure your child receives adequate nutrition.

Two popular approaches include a gluten-free diet and a casein-free diet. Gluten is a protein found in wheat, while casein is found in dairy.

Other people try including supplements, such as:

  • Melatonin This natural hormone may improve sleep in children with autism spectrum disorders. (4)
  • Omega-3s Some very small studies have shown that omega-3 fatty acid supplements may help with symptoms, such as repetitive behavior, hyperactivity, and social behaviors. (4)
  • Probiotics Some parents report that using probiotics can ease gastrointestinal problems in their kids.
  • Vitamin methyl B12 Injections of vitamin methyl B12 may improve social behaviors in kids with autism, according to a small pilot study. (4)

Related: The Importance of Omega-3s in a Heart-Healthy Diet

Asperger’s Treatments: What’s the Takeaway?

Early intervention seems to be the key to success when it comes to treating Asperger’s. This means that the earlier you start a therapy, the better.

Every child and adult with Asperger’s is different. You might have to try several treatment approaches before you notice improvement.

Sometimes, a combination of various therapies is most effective.

Finding a trained clinician who can point you toward different options is a must. Autism Speaks has a list of professionals that you can contact in your area. (3)

Cognitive Behavioral Therapy and Autism Spectrum Disorders

Many behavioral therapies have been used to treat young children with autism spectrum disorders (ASD), including Applied Behavior Analysis and Pivotal Response Training. Older children, teens, and adults with ASD may benefit from another intervention with a behavioral component: Cognitive Behavioral Therapy (CBT).

Beyond behavior

Therapies based on the science of behavior have been effective for people of all ages, and are an essential item in any mental health professional’s toolkit. They only go so far, however. Human beings are “meaning makers.” That is, their behavior is not just the result of stimulus and response or reward and punishment. They take in what is happening around them and give it meaning, loaded with emotion. Then they behave.

CBT takes into account the thoughts (or cognitions) we have about things, the feelings that result, and the behavior that follows.

CBT: A powerful approach

People often get stuck in patterns of thinking and responding that are not helpful, partly because they filter everything that happens through a “meaning-making system” that is skewed or inaccurate. Therefore, one way to change people’s feelings or behavior is to target distorted thoughts they have about themselves and their lives. This helps them shift the way they interpret situations, how they feel about those situations, and how they respond to them. It is an extremely powerful intervention, and has been proven effective in the treatment of many conditions, including depression, generalized anxiety disorder, panic disorder, and post-traumatic stress disorder.1

There are a variety of CBT approaches, but most share some common elements.2 These include a structured, goal-directed approach that is time-limited, usually taking 12-16 sessions. Therapy, which is conducted according to a specific plan, does not delve much into the past, but focuses on the here and now. A CBT program’s success is measurable precisely because there is a plan, a goal, and a limited time in which to accomplish it.

At the heart of CBT is a challenge to a person’s belief system. For example, say a depressed person believes he is worthless. He is constantly telling himself this, and views everything that happens to him through this negative lens. If a friend crosses the street before greeting him, he does not think: “He was in a rush and needed to get to the dentist’s office over there.” Instead, he thinks, “I am worthless and so he is avoiding me.” This can lead to a cascade of automatic thoughts. “Nobody will ever be my friend. I will always be alone.” Clearly, these thoughts will lead to more negative feelings, more negative interpretations of events, and more isolation, creating a downward spiral.

With a therapist’s help, the individual is encouraged to challenge both his beliefs and his automatic thoughts through a variety of techniques. He may be asked to view his beliefs as a hypothesis or possibility, rather than a fact, and to “test the validity” of these beliefs by looking for real evidence (which he usually will not be able to come up with). He may use self-talk to coach himself through a situation, deliberately replacing negative thoughts with more positive ones. He may, with the therapist’s help, rehearse a future situation, going through steps (such as relaxation, deep breathing, and an encouraging internal dialogue) that will help him cope. As he gains these skills, the therapist may expose him to increasingly difficult situations in a process called graded exposure.

Another key part of treatment is psychoeducation, which involves teaching someone about her condition. Whether that condition is obsessive-compulsive disorder or anxiety, it is important that she understand why she’s been having so much difficulty; how to identify when the condition is affecting her; and how to interrupt and stop it. Imagine a person with a panic disorder who, as the panic begins, feels a terrible tightness in her chest. She is certain this is a heart attack, and is terrified she may die. Her panic spins out of control, the pain and the panic now fueling one another. After learning about panic attacks, she can understand that this feeling is just part of a dysfunctional process that isn’t her fault. Recognizing the signs of an impending attack early enables her to begin using the skills she has learned to keep herself calm so the cycle is shortened or prevented altogether.

Adapting CBT for ASD

In recent years, there have been a number of attempts to adapt CBT for children and teens on the autism spectrum. The focus has often been on those who also have anxiety because this is so common in individuals with ASD.3,4

One challenge was to find out whether children with ASD have the skills necessary to succeed at CBT. Fortunately, it appears they do. A study published in 2012 evaluated the cognitive skills of children with ASD and compared them to those of typical children. The children with ASD had the skills required for CBT in almost every instance. They were able to distinguish thoughts, feelings, and behaviors, and to work on altering their thoughts. Their only area of difficulty was in recognizing emotions.5

In addition, traditional CBT tends to require strong linguistic and abstract thinking abilities, and these can be a challenge for individuals on the autism spectrum. Realizing this, researchers have worked to develop modifications to CBT that render it more ASD-friendly, such as making it more repetitive, as well as visual and concrete.

For example, instead of merely asking children to verbally rate their anxiety on a scale of 1 to 10, the therapist might have a thermometer showing anxiety from low to high and have the participants point to the prop to illustrate how high their anxiety is around a certain situation. Another strategy is to focus on the children’s talents and special interests, which helps keep them engaged and motivated, and to build in frequent movement breaks or sensory activities for those who might have problems with attention or sensory under- or over-reactivity.6,7,8

The researher Susan White notes that CBT should also address social skills in individuals with ASD because “the core social deficits in young people with ASD contribute to the experience of anxiety, which then serves to intensify the teen’s social problems.” 9

CBT can be delivered in a variety of ways: individual, family, group, or even family and group. The advantage of group CBT is that individuals with ASD learn that others are struggling with the same issues, and they begin to overcome them together. Friendships and social support gained through this process may be healing in themselves.10

The advantage of family CBT is that it involves parents, educating them about their child’s challenges and teaching them to encourage use of CBT techniques when real life situations confront their child. This can make them feel more hopeful and confident in their ability to contribute to positive change in their child’s life.10

Researchers have found that one issue that can be particularly tough for parents of children with ASD is how much to shield or protect them from potentially negative experiences. The children often have a history of emotional and behavioral challenges and of real and painful failures in the world. Parents are reluctant to expose their child to any more failure, and may unwittingly limit exposure to experiences that are necessary to help the child become more independent and less anxious.

Watch Dr. Judy Reaven discuss her research on a modified CBT program for children with ASD and anxiety.

In the video (above), Dr. Judy Reaven introduces parents to the idea of adaptive vs. excessive protection. Excessive protection results in the avoidance of all challenges, even when the child has the skills to cope with some of them, so that the child remains anxious and dependent. Adaptive protection involves exposing the child, step by step, to bigger and bigger challenges. The hoped-for result is a less anxious and more independent child. Knowing the difference may help parents cope with their child’s discomfort when he or she is facing just the right amount of fear or stress needed to grow.11

CBT effective for ASD

The gold standard for demonstrating a treatment’s effectiveness is the randomized controlled clinical trial (RCT). In an RCT, children receiving a therapy are compared with those who are not. A number of clinical trials have investigated the use of CBT for children with ASD, with promising results for the treatment of anxiety,7,8,10,12 daily living skills,13 and anger management.14 Although only limited research has been conducted so far on CBT for adults with ASD,15 there is every reason to hope the treatment will be as effective for them as for older children and teenagers.

It is well known that early intervention is important, but people with ASD are only young for a brief interval. In years to come, CBT is likely to be a major treatment improving quality of life for older children, teens, and adults on the autism spectrum.

Resources

  • Watch a British Medical Journal video on general CBT:

Anxiety-related symptoms are frequent concerns in children, adolescents and adults with Aspergers and HFA, which may be treatable with Cognitive Behavioral Therapy.

Anxiety is commonly found in high functioning individuals on the spectrum in particular because they have an increased awareness of their own social difficulties. This cognitive awareness may intensify their anxiety toward social interaction and promote isolation.

Recent numbers found that 11-84% of children on the autism spectrum experience impairing anxiety, while only 4.7% of all children aged 3-17 years have experienced anxiety.

Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps individuals recognize how thoughts and feelings influence behavior and cope with these challenges.

CBT is used to treat a wide range of issues, in addition to anxiety, including:

  • obsessive-compulsive disorder
  • sleep disorders
  • sexual disorders
  • depression
  • bipolar disorders
  • phobias
  • eating disorders
  • substance use disorders
  • post-traumatic stress disorder
  • personality disorders
  • Schizophrenia

One goal of CBT treatment is to identify and change thought patterns that have adverse influence on behavior. For people with Aspergers and HFA, concerning thoughts about social relationships may prevent them from engaging in behavioral experiences that would lead to confidence, or even mastery of social skills.

CBT is a popular therapeutic intervention because it is usually short in duration and more affordable in the long run.

Just a small sample of clinical studies have studied the efficacy of CBT in individuals with autism-related disorders. However, the results of these studies have been very encouraging to date.

It is known that combination therapy (psychotherapy and psychopharmacology, for instance) usually works better than single-therapy approach in the treatment of many disorders. But, it is encouraging to know that single-standing therapeutic interventions are also effective on their own merit.

By A Patricia Del Angel, M.D., Clinical Director, Autism Community Network

Sources

Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders. Susan W. White, Thomas Ollendick, Lawrence Scahill, Donald Oswald, and Anne Marie Albano. J Autism Dev Disord. Jun 30, 2009 : Published online Jun 30, 2009.

Development of a Cognitive-Behavioral Intervention Program to Treat Anxiety and Social Deficits in Teens with High-Functioning Autism. Susan W. White, Anne Marie Albano, Cynthia R. Johnson, Connie Kasari, Thomas Ollendick, Ami Klin, Donald Oswald, and Lawrence Scahill. Clin Child Fam Psychol Rev. Mar 2010; 13(1): 77–90.

CDC/MMWR, Supplement /Vol.62/No. 2. May 17, 2013

Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial. Chalfant, AM1, Rapee R, Carroll L. J Autism Dev Disord.2007 Nov;37(10):1842-57. Epub 2006 Dec 15.

Mayo Clinic. 1998-2014 Mayo Foundation for Medical Education and Research.

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Providing the weekly Medical Blogs are the team of professionals, doctors, occupational and behavioral therapists at San Antonio’s premiere Autism Diagnostic Clinic, the Autism Community Network. Contributors include: Executive Director Dr. Loree Primeau Medical Director Dr. A Patricia Del Angel Training and Research Director Dr. Berenice de la Cruz Carrie Alvarado, OTR, PhD©, DIR/Floortime-Certified Lupe Castaneda, MS, BCBA Adriana Sanchez, MA, BCBA Dr. Gayla Aguilar, OTR, OTD, C-SIPT Megan Kunze, MA, BCBA The ACN teams works to maximize the potential of children with autism through their administrative, clinic, training and development departments. Their expertise on Aspergers Syndrome is offered to you through aspergers101.com.

Latest posts by Autism Community Network (see all)

  • Transitioning to Adulthood with Aspergers – December 18, 2019
  • 5 Focuses For Creating a Learning Environment in the Home – October 30, 2019
  • Cognitive Behavioral Therapy for Individuals with Aspergers – September 17, 2019
  • The Two Types of Reinforcement for Individuals with Aspergers or HFA – July 16, 2019
  • ABA and Aspergers: The Three Step Plan You Can Use – July 2, 2019

Asperger’s Treatment: Know Your Options

There are additional alternative treatments that have been used to treat ASD. According to one recent study, 46.8 percent of surveyed adult people with Asperger’s had tried some sort of alternative therapy during their lifetime.

However, it’s important to remember that so far there’s little research into the effectiveness of many alternative treatments. Most haven’t examined Asperger’s directly. The existing studies often involve a small number of participants as well as varied study parameters.

Every individual with ASD is different. Some alternative treatments may seem to be effective for one person, but not for another.

Here are some possible alternative treatments as well as some you should avoid.

Herbal remedies

Various herbal or traditional remedies have been used to treat ASD. These can include things like Ginkgo biloba supplements or capsules containing a variety of herbal components.

A recent review of 10 studies of herbal medicine and ASD concluded that the evidence was promising but was inconclusive overall.

Herbal supplements are less regulated by the FDA than drug products. There is a risk that supplements may contain ingredients not listed on the package, or different amounts of certain ingredients that may not be safe.

It’s especially important to consider these risks when giving supplements to children. Speak with your doctor before giving any herbal remedies to your child.

Massage therapy

Massage therapy may help to reduce anxiety levels or sensory-related symptoms. One review found that massage generally improved symptoms in the short-term when compared to no massage.

However, based on the quality of the studies reviewed, the investigators rate the strength of the evidence as low.

It’s also important to remember that some people with ASD may not be comfortable with being touched. Massage therapy would not be recommended for these people.

Acupuncture

Some people believe that acupuncture may help to relieve symptoms of ASD, although the mechanism through which it does so is still unknown.

A recent review of 17 studies found that acupuncture may help to improve symptoms of ASD. The authors encourage additional, more rigorous studies to confirm this.

Neurofeedback

Neurofeedback therapy uses electrical sensors to give people information about brain activity. The idea is that upon learning this information, a person may gain more control over this function.

An older study looked at the use of neurofeedback in people with Asperger’s and found that an improvement was observed for symptoms as well as intellectual function.

Neurofeedback has shown more promise in treating ADHD, which can coexist along with ASD. There is not enough research to support its use in treating ASD itself.

Animal therapy

This treatment involves the use of animals to provide interaction and companionship. Some examples include horseback riding or interacting with more common pet animals such as dogs or guinea pigs.

A limited amount of research has been done into the effectiveness of animal therapy. However, some small studies have reported an improvement in social function after animal therapy.

Potentially harmful treatments

Some alternative treatments may do more harm than good. According to the National Center for Complementary and Integrative Health (NCCIH), the following treatments may be harmful:

  • Hyperbaric oxygen, a treatment that involves providing oxygen within a pressurized container. There’s currently no evidence that this treatment improves symptoms, and adverse effects like ear trauma can occur.
  • Chelation, where medications are used to remove metals such as mercury from the body. There’s currently no evidence of a link between mercury and ASD. This treatment can also have serious side effects such as potentially fatal organ damage.
  • Secretin, a gastrointestinal hormone that’s given intravenously. There’s currently no evidence that single or multiple doses of this treatment are effective.
  • Antifungal agents, which are given to deter Candida overgrowth that’s believed by some to make ASD symptoms worse. Although Candida species and anti-Candida antibodies have been identified from people with ASD, there’s no evidence of the efficacy of antifungal treatments.

Treatment for Asperger’s Disorder

There are a wide variety of helpful treatments for Asperger’s Disorder that help an individual learn better social skills and communication cues, to help them be able to interact socially more naturally. At present, like most mental disorders, there is no “cure” for Asperger’s Disorder. But by focusing on learning ways to cope with the symptoms and pick up on social cues, most individuals with Asperger’s Disorder lead fairly typical lives, with close friends and loved ones.

Psychosocial Interventions for Asperger’s

According to the National Institute of Neurological Disorders and Stroke, the ideal treatment for Asperger’s coordinates therapies that address the three core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. There is no single best treatment package for all children with AS, but most professionals agree that the earlier the intervention, the better.

An effective treatment program builds on the child’s interests, offers a predictable schedule, teaches tasks as a series of simple steps, actively engages the child’s attention in highly structured activities, and provides regular reinforcement of behavior. It may include social skills training, cognitive behavioral therapy, medication for co-existing conditions, and other measures.

  • Individual psychotherapy to help the individual learn social skills training, to better detect social cues, and how to deal with the emotions surrounding the disorder
  • Parent education and training
  • Behavioral modification
  • Social skills training
  • Educational interventions

Psychiatric Medications

  • For hyperactivity, inattention and impulsivity: Psychostimulants (methyphenidate, dextroamphetamine, metamphetamine), clonidine, Tricyclic Antidepressants (desipramine, nortriptyline), Strattera (atomoxetine)
  • For irritability and aggression: Mood Stabilizers (valproate, carbamazepine, lithium), Beta Blockers (nadolol, propranolol), clonidine, naltrexone, Neuroleptics (risperidone, olanzapine, quetiapine, ziprasidone, haloperidol)
  • For preoccupations, rituals and compulsions: SSRIs (fluvoxamine, fluoxetine, paroxetine), Tricyclic Antidepressants (clomipramine)
  • For anxiety: SSRIs (sertraline, fluoxetine), Tricyclic Antidepressants (imipramine, clomipramine, nortriptyline)

With effective treatment, children with Asperger’s disorder can learn to cope with their disabilities, but they may still find social situations and personal relationships challenging. Many adults with AS are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life.

Treatment for Asperger’s Disorder

Asperger’s syndrome: How I Cured My Autism Symptoms

Your mental health team will assess communication and interaction. Your assessor may ask you to rate yourself on a number of items. Or someone who knows you or your child well may do the rating. There are a handful of formalized tests they can use, but they all evaluate for the same things:

  • Use of speech and language such as articulation and sentence structure
  • Non-literal language like idioms and irony
  • Nonverbal communication including gestures and eye contact
  • Prosody: whether speech is sing-songy or flat in stress, volume, pitch, etc.
  • Adherence to social conventions of conversation, like when to speak
  • Content and flow of conversation
  • Interests and how you choose to spend your time
  • Family relationships
  • Self-awareness
  • Reactions in new situations
  • Presence of aggression, tantrums
  • Other mental health issues, including obsessions, compulsions, anxiety and depression
  • The medical team will consider your history that you report, or as people who know you well tell it. They’ll also factor in their own interactions with you.

If you have your suspicions, you can take this test and use the results to start a conversation with your doctor about autism. No matter how it turns out, give the doc a ring if you have any concerns.

What caused my Asperger’s, and how I fixed it

Inflammatory conditions have more than one trigger, and no one factor is going to cause your problems or completely eradicate symptoms. For me, it was eating inflammatory foods, living in a moldy house, and exposure to mercury that all together put me in the sensory blender.

Fixing my Asperger’s took a ton of work and it didn’t happen overnight. Here are the highest-impact things I did.

  • Diet changes. I noticed major improvement after eliminating gluten and adopting a cyclical ketogenic diet. I increased my vegetable intake and started feeding my body on a cellular level. All of this reduced inflammation and gave my brain the healing it needed to start sorting information a lot better. If I ate crap for a month, I’d still be better today than I was because of my healing over the years, but I’d notice a dip in my ability to pick up on subtle social cues.
  • Neurofeedback. Neurofeedback teaches you to regulate your own brain function, which can train you to quickly get into a stable state when you’re feeling overwhelmed. You can practice neurofeedback training with at-home devices like the Muse headband or at extended retreats like 40 Years of Zen.
  • Massive detoxing. I had a lot of toxicity from my environment, but the main things I cleaned out of my system were mercury and mold toxins. Here’s how to get started. Quick note: some people will say that mercury causes autism, but I disagree. Inflammatory conditions have more than one trigger, and most of the time it’s a compound effect from a lot of factors. Several studies link inflammatory markers with autism.
  • Brain stimulation. Devices like the Halo Sport and infrared light on the brain stimulate it to make myelin, which improves communication between brain cells. Strong myelin improves overall brain cell functioning and strengthens your brain’s ability to filter sensory input. You can get customized recommendations at Bulletproof Labs in Santa Monica.
  • Observation. Every Thursday for two years, I went to business-networking meetings and people-watched. I had to re-learn social behaviors that you learn in your first few years of life.

Another thing that I’ll continue to do as long as I’m alive is use different technologies to figure out what’s going on in my body, and make appropriate tweaks. The less your body is dealing with, the less inflammation you have, and the more your brain can filter out all the noise and help you focus and communicate better.

It’s impossible to do all of these things at once. You’ll get overwhelmed, and since people with Asperger’s feel overwhelmed to begin with, you’ll quit. Start with your diet and lifestyle, and go from there, adding additional steps as they make sense. No two people are alike, and you have to figure out what works for you.

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Diagnosing Asperger’s vs ADHD

Counselors near you are able to differentiate between aspergers and ADHD and create a treatment plan

Diagnosing Asperger’s vs ADHD can be clinically difficult. Children diagnosed with Asperger’s Disorder and Attention Deficit Hyperactivity Disorder (ADHD) have many similarities at first glance. Both can manifest problem behaviors, inattentiveness, sensory integration problems, poor coordination and impulsivity, and both respond positively to structure and routine.

Given that these disorders share so many similarities, accurate diagnosis is challenging. In fact, the National Institutes of Health estimates that 60% to 70% of children with Asperger’s are initially misdiagnosed with ADHD.

While children with both disorders manifest problems with attention, careful observation often reveals that the attention problems in Asperger’s are quite different from that of ADHD. For instance, in Asperger’s disorder, attention problems are attributed to a need for structured routines, language difficulties, obsessive rituals and self stimulating behaviors. ADHD, on the other hand, compromises a child’s attention by disrupting the way information is processed in the central nervous system producing hyperactivity and impulsivity.

Some other differences between Asperger’s and ADHD include:

  • Children with Asperger’s have the ability to focus on an activity of interest, usually one activity that excludes everything else in his environment. Asperger’s children tend to focus on this one activity for long periods of time. With ADHD, a child tends to focus on multiple activities but is easily distracted by his/her environment and jumps from one activity to another.
  • A child with Asperger’s can talk or play quietly. A child with ADHD finds it difficult to play or talk quietly.
  • A child with Asperger’s may get upset if his routine or favorite activity is disrupted, but does not normally show a lot of emotion in public. With ADHD, a child will express emotions directly and clearly.
  • Both Asperger’s and ADHD children have difficulties socially, especially when making friends. With Asperger’s the child’s behavior is, at times, unusual or idiosyncratic so that the child is viewed as “weird” or “eccentric.” With ADHD, the child’s behavior is very loud and chaotic and the child is viewed as “annoying” or “disruptive” to his peers.
  • Children with Asperger’s can be oppositional or defiant when trying to avoid something that makes them anxious or uncomfortable. Children with ADHD are at times oppositional or defiant in an attempt to seek attention.

While Asperger’s Disorder and ADHD have many similarities on the surface and can both result in behavioral and social difficulties, it is essential to look beyond these similarities and distinguish between them so that the right diagnosis can be arrived at and the proper help can be offered. Structured diagnostic evaluations and assessments are available that can assist in the appropriate diagnosis, intervention and treatment for each individual.

Asperger’s syndrome

Autism is a developmental disability that affects the way people interact with the world. As a spectrum condition, it affects people in different ways. Asperger’s syndrome is considered a type of autism. Affecting an estimated 700,000 people in the UK alone, autism is relatively common.

Autistic individuals will see things differently to other people. It is not a disease, nor is it something that can be ‘treated’, there are however approaches and support frameworks that can be helpful.

On this page, we will explore Asperger’s syndrome in more depth. We’ll look at associated mental health conditions and how counselling can help with these.

Find a counsellor to support you.

What is Asperger’s syndrome?

Asperger’s syndrome is a diagnostic profile that sits within the autistic spectrum. The developmental disability affects people across the globe regardless of gender, race or social background. People on the autistic spectrum will share similar difficulties but will be affected in different ways. Some autistic people will have learning disabilities and other mental/physical health concerns.

Those diagnosed as Asperger’s may not have the learning disabilities often associated with autism, but can have more specific learning difficulties. They typically have fewer problems with speech compared to autistic people, but may still find it hard to understand and process language. Those diagnosed as Asperger’s tend to have average or above average intelligence.

The usual hallmarks of Asperger’s syndrome include:

  • difficulties with social interactions
  • highly-focused interests
  • repetitive behaviours
  • sensory sensitivity

Diagnosis

As Asperger’s syndrome affects people in different ways it can be very hard to recognise. Unlike autism which is usually diagnosed during early childhood, it often isn’t diagnosed until later in childhood, or further into adulthood.

Diagnosis often involves a team. This may include a speech and language therapist, a doctor and a psychologist/psychiatrist. In order for someone to receive a diagnosis, they will be assessed as having ongoing difficulties with social interaction, repetitive (and restrictive) behaviour patterns that have existed since early childhood that impair everyday life.

Those seeking a diagnosis now are more likely to be diagnosed as autism spectrum disorder (ASD) or autism spectrum condition (ASC). Asperger’s syndrome was removed from the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, in 2013 (the DSM is often referred to as the ‘psychiatrists’ bible’ in the US) and seems to be getting phased out by medical professionals here in the UK. Those who have already received a diagnosis of Asperger’s syndrome, however, will retain it unless seeking a second private re-assessment.

For some, receiving a formal diagnosis of autism feels unhelpful, for others, however, it can be beneficial. Understanding what it means to be autistic can help autistic individuals and their loved ones. It also opens the door to further support.

Understanding Asperger’s helped me to realise what I needed to bring to the relationship with my neurotypical wife. Our relationship settled into a much better place and we became more supportive and consistent as a couple and as parents.

– Read Gavin’s experience

What support is available?

Autism and Asperger’s syndrome are not conditions that can be ‘treated’ or ‘cured’ (it is not an illness), however, certain strategies and approaches can be helpful. These include the National Autistic Society’s SPELL framework, the TEACCH programme, visual aids and Social storiesTM. You can find out more about these strategies on the National Autistic Society’s website.

In terms of general support, there are various charities and online forums which provide information and a space to talk for autistic individuals. For more tailored support with concerns, counselling can be useful.

Counselling

Those on the spectrum may find it helpful to speak to a professional. Counselling can help those affected by anxiety, for example, develop coping strategies and learn relaxation techniques.

Counselling provides a safe space for people to talk about how they’re feeling in confidence and without fear of judgement. Depending on what the person is seeking support for, the counsellor can use specific psychological approaches to help. The following are just a few of the approaches that can be helpful.

Cognitive behavioural therapy (CBT)

Evidence shows cognitive behavioural therapy (CBT) can help reduce anxiety symptoms in some autistic people. This therapy looks at the way your thinking relates to your behaviour and how you can make positive changes.

Some people on the autistic spectrum have unhelpful ways of thinking that make everyday interactions difficult. These include:

  • polarised thinking (when someone is either a best friend or worst enemy)
  • all-or-nothing thinking (‘I have to be great at everything all the time’)
  • fatalist thinking (‘things are bad whatever I do’)

CBT can help those affected understand such thoughts, how they affect the way they act and ways of changing them.

Solution-focused brief therapy

Rather than problem-solving, this form of therapy looks at solution building. Solution-focused brief therapy helps clients look to the future, using their own strengths to achieve goals. Aiming to be concise with practical applications, this therapy is often time-limited (although effects are long-lasting).

Psychoanalytic approach

If a counsellor takes a psychoanalytical approach, they will look to the person’s past and their unconscious mind. The aim is to improve the client’s self-awareness and how they have power within relationships. Some people on the autistic spectrum find this method more complex.

Watch John Clark describe his experience of Asperger’s syndrome, clinical depression and generalised anxiety disorder (from the National Autistic Society).

Living with Asperger’s syndrome

For some, living with Asperger’s is an overwhelming experience. It can be very hard to understand and relate to those around them. They may feel different, ‘odd’ or that other people don’t ‘get them’. Feelings of anxiety and burn-out can also surface.

As autism is an invisible disability, other people will not immediately know they are autistic. Indeed, those on the spectrum may be highly intelligent and able to converse with ease. Below are examples of what some autistic individuals experience.

The most interesting people you’ll find are ones that don’t fit into your average cardboard box. They’ll make what they need, they’ll make their own boxes.

– Dr Temple Grandin

Difficulty with social interactions

Autistic people can find it difficult to interpret language and may struggle to understand sarcasm and/or read social cues. Although people diagnosed as Asperger’s typically have good language skills, they can still experience difficulties. They may fail to understand what is expected of someone within a conversation.

Reading other people’s feelings and intentions can be hard. They may also find it difficult to express how they themselves are feeling.

Special interests

Most people have hobbies and interests, but autistic people may have an interest they are incredibly dedicated to. This can lead to them taking a lot of time studying or interacting with said interest (this could be art, computers or collecting memorabilia). Many autistic people say having a special interest or hobby like this is key to them feeling happy and fulfilled.

Repetitive behaviours

Having a regular routine can offer a sense of security to those on the autistic spectrum. It can help them feel safe when other things may be making them feel overwhelmed or anxious. This can make them resistant to change, which is why it’s helpful to build up to changes in routine.

Sensory sensitivity

For some autistic people, sensory sensitivity can occur. This is when you experience an over, or under, sensitivity to smells, sounds, light, temperature or even taste. For example, loud noises may cause physical pain and even anxiety. Alternatively, someone diagnosed as Asperger’s may be especially curious about light and colour.

Mental health and Asperger’s syndrome

Those on the autistic spectrum can be more likely to experience mental health concerns than those not on the spectrum. The following have been found to be more prominent:

Anxiety

It is estimated that 40% of autistic people suffer from anxiety symptoms, compared to 15% of those not on the spectrum. There are a variety of reasons for this, including biological differences in brain structure and dealing with social difficulties.

Anxiety disorders can lead to fears and phobias of certain situations, creating a vicious cycle. If left untreated, it can lead to depression. Talk therapies that look at changing negative thought patterns can help break the cycle and reduce anxiety symptoms.

Depression

While all of us can feel sad or down from time to time, if low moods last a long time and get in the way of day-to-day tasks – it could be depression. Those on the spectrum are just as likely as anyone else to develop this.

It can be hard for autistic people to vocalise how they’re feeling. They may be more worried about asking for help than usual. There is help available however and it can be useful to speak to someone who understands autism and the challenges it can bring.

Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) has been found to be more common in those on the spectrum. The condition involves recurring and intrusive thoughts as well as compulsions to carry out certain behaviours. As people diagnosed as Asperger’s can display repetitive behaviours, OCD can be overlooked. The two are, however, very different.

Speaking to your doctor about your concerns is a great first step to an accurate diagnosis. There are several different treatment options to help with OCD including medication and talk therapy.

What should I be looking for in a counsellor or psychotherapist?

There are currently no laws in place stipulating what training and qualifications a counsellor must have to help someone on the spectrum. However, NICE has developed a set of guidelines that provide advice about the recommended approaches.

In terms of psychological support, NICE recommend cognitive behavioural therapy and/or behavioural therapy. To help manage symptoms such as anxiety and/or repetitive thoughts, medication may also be offered. The guidelines also list various therapies and treatments that should not be offered, including chelation therapy.

Counsellors supporting autistic people may have to adjust the way they work. For example, including more visual information. Therefore, it is advised that you seek a professional who has specific training and experience in working with people on the autistic spectrum.

Read the full NICE guidelines:

Managing autism in children and young people

Diagnosing, supporting and caring for adults with autism

Further help

  • The National Autistic Society

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It’s heartbreaking for parents to discover that their child’s development isn’t on par with other children his or her age. Asperger’s Syndrome, which primarily impacts social and communication skills, fits into a category of delayed development formerly known as “pervasive developmental disorders”.

Up until 2013, Asperger’s Syndrome was diagnosed as a distinct disorder. However, since the publication of the latest edition of the diagnostic manual used by mental health professionals, the DSM-5, individuals with symptoms of Asperger’s are diagnosed with autism spectrum disorder, or ASD.

Asperger’s Syndrome (AS for short) is generally considered the mildest and highest functioning type of autism. Since early intervention is crucial, it’s important to be able to identify the warning signs and know what steps to take if you believe your teen has Asperger’s Syndrome. This brief guide is designed to help you do just that.

Adolescent ASD and Asperger’s Syndrome Statistics and Facts

  • According to CDC estimates, the prevalence of ASD is 1 in every 68 births in the U.S.
  • Asperger’s Syndrome is 3 to 4 times more likely to be diagnosed in boys than girls
  • Certain genetic disorders occur in 1 out of every 5 individuals with ASD
  • Adults with AS are much more likely to have suicidal thoughts than the general population (10 times as likely per a survey conducted in England, with over 1 in 3 having planned or attempted suicide at some point in time)
  • The exact cause of AS has not yet been determined, although environmental factors and genetics likely play a role
  • Although there’s currently no cure for AS, proper intervention strategies can be highly beneficial and improve a person’s level of functioning
  • Some individuals with AS are able to work full-time and live relatively or completely independently

Mental Health Disorders that Often Co-Occur with Asperger’s Syndrome

It’s not uncommon for adolescents with Asperger’s Syndrome to have other mental health issues, or at least some symptoms of them, as well. Depression, in particular, is common in teens with AS. This is often triggered by their increasing awareness of their limited social skills and not fitting in with many of their peers. Following are psychiatric disorders that often co-occur with AS:

  • Depression
  • Social Anxiety Disorder
  • Obsessive-compulsive Disorder (OCD)
  • Bipolar Disorder
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Nonverbal Learning Disorder
  • Other Anxiety Disorders

Looking for and Recognizing the Signs of Asperger’s Syndrome

Autism spectrum disorders are often diagnosed in early childhood. However, since individuals with AS are on the higher-functioning end of the autism continuum, an early diagnosis is more likely to be missed. As a parent, the sooner your child is diagnosed the sooner he or she can begin benefitting from proper intervention. Three key things to remember when it comes to Asperger’s Syndrome:

  • Symptoms can range from very mild to severe
  • The primary problem pertains to social deficits, which can manifest in a variety of ways
  • No two teens with AS are alike

Following is a list of warning signs of Asperger’s Syndrome to look for in your teen:

  • Misperceived by others as a smart aleck
  • Has a very limited tolerance for any kind (e.g. reacts to any disruption to his or the family’s normal routine)
  • Has difficulty showing or expressing empathy for others
  • Frequently misinterprets obvious social cues, such as body language
  • Is socially awkward
  • Avoids eye contact or stares at others
  • Is immature for his or her age
  • Talks a lot about himself or herself / conversations tend to be one-sided
  • Intensely focuses on a specific subject (e.g. astronomy or baseball stats)
  • Repeats the same movement again and again
  • Speaks in a manner than seems robotic or monotone
  • Has limited emotional expression (e.g. feels happy but doesn’t smile)
  • Doesn’t know how to respond in conversations
  • Is naïve in social situations
  • Is too trusting
  • Prefers clear rules and structure
  • Says exactly what he or she is thinking (e.g. frequently comes across as blunt or inappropriate, due to a lack of normal “filters” rather than intention)
  • Feels as if he or she doesn’t fit in with peers
  • Is often bullied or teased
  • Is socially isolated
  • Has no interest in fads or trends
  • Marches to his or her own drummer
  • Tends to take sarcastic remarks literally

When looking for signs of AS, it can be helpful to reflect on your adolescent’s early childhood and pre-teen years. Symptoms that may have been present early on include:

  • Motor skill development was delayed
  • Posture or facial expressions were unusual
  • Spoke in a formal manner that seemed advanced for his or her age
  • Got very agitated or upset with any change in routine
  • Had a heightened sensitivity to loud noises or other types of stimulation, such as strong tastes or bright lights
  • Was very pre-occupied with certain subjects or things

As with most disorders, the many of the warning signs listed above are observed in many teens who don’t have Asperger’s Syndrome or qualify for a diagnosis of autism spectrum disorder. For example, many teens will say exactly what’s on their mind (even if it comes across as rude), become obsessed with a subject that interests them, or lack many age-appropriate social skills. But if several warning signs are present, it’s important to have your teen evaluated, as it’s far better to err on the side of caution.

Knowing the First Steps to Take

If you’re concerned that your teen is exhibiting signs of Asperger’s Syndrome, and he or she has never been formally diagnosed with AS, don’t ignore it. Adolescents with AS have unique needs that require specialized education and other forms of intervention. A formal diagnosis can open the door to resources for your child. Following are important first steps to take:

1 – Consult with your primary care doctor or your child’s pediatrician. Discuss your concerns regarding the warning signs you’ve noticed, such as difficulties reading social cues, quirks in communication, or making friends. Your doctor can refer you to someone who specializes in diagnosing and treating individuals with ASD. This leads to the next step:

2 – Have your child evaluated by someone who specializes in ASD – It’s not uncommon to have a team of professionals treating your child. These professionals may include:

Mental health professionals:

  • Psychologist
  • Psychiatrist

Other healthcare professionals:

  • Developmental Pediatrician
  • Pediatric or Child Neurologist

The evaluation process will determine whether the signs you’ve been noticing are related to Asperger’s Syndrome, warranting a diagnosis of autism spectrum disorder. The evaluation process may include any or all of the following:

  • Psychological assessment
  • Communication assessment
  • Neuropsychological evaluation
  • Psychiatric evaluation

3 – Get your teen into treatment. Once your teen has been evaluated and diagnosed, a treatment program will be recommended based on his or her unique needs. Treatment for ASD usually involves a combination of the following:

  • Applied behavior analysis – Focuses on increasing positive / desired behaviors and reducing unwanted behaviors using behavioral methods, such as positive reinforcement
  • Social skills training – Focuses on learning more appropriate social skills
  • Speech-language therapy – Focuses on improving conversational skills and overall communication, including reading social cues more accurately
  • Parent education and training – Focuses on teaching parents how to help their child with Asperger’s
  • Sensory Integration / Occupational Therapy
  • Cognitive behavioral therapy (CBT) – Focuses on changing negative / unhealthy thoughts patterns with more positive / healthy ones that will improve both emotions and behaviors
  • Medication – This may be prescribed to reduce symptoms of co-existing disorders such as depression or anxiety. Medication can also help the following:
    • Aggressive behavior
    • Hyperactivity
    • Difficulties with attention
    • Repetitive behaviors
    • Irritability

Remember, every child with AS is different so there isn’t a one-size-fits-all approach to treatment and intervention. What is true, regardless of your teen’s unique needs, is that the sooner intervention starts, the brighter his or her future will be.

4 – Get your teen into an IEP (individualized education program). Public schools are required by law to offer appropriate services for anyone between the ages of 3 and 21 years who has a disability (which includes ASD). Contact your local school district and meet with them to set up an IEP for your teen.

Supporting and Encouraging Your Child

One of the best things you can do for your teen with AS is provide ample support and encouragement. There are many ways you can do this including:

  • Learn everything you can about Asperger’s Syndrome and ASD so you’ll know what to expect and how you can help
  • Encourage your teen to explore his or her interests, both at school and at home
  • Find ways to facilitate friendships between your teen and other kids his or her age (e.g. have your teen invite a friend to spend the night or go on a fun family outing)
  • Be flexible
  • Create a routine at home (e.g. for meals, bedtime, etc.) and stick to it as much as possible to minimize stress for our teen
  • Set rules and expectations that are clear and specific
  • Take note of (and minimize, if possible) things that may be distracting your teen, such as certain noises (e.g. a ticking clock)
  • Help your child learn and practice coping skills for stressful situations that can’t be avoided; prepare him or her in advance if possible (e.g. company coming to visit, moving to a new home, etc.)
  • Learn what things are particularly stress for your teen and avoid (or at least minimize) them as much as possible
  • Help your teen develop better social skills by using role-play and discussing people’s behaviors you see while watching TV or movies together
  • Be generous with your praise, focusing on frequently praising desired behaviors
  • Use visual props and aids (e.g. calendars or lists) to help your teen stay organized and on track
  • Use clear, verbal instructions and explanations (e.g. for rules, expectations, etc.)
  • Strive to be patient and calm, even when you’re feeling frustrated or overwhelmed
  • Be understanding and empathetic regarding your teen’s limitations and challenges

What to Do When Things Escalate

Adolescence is difficult for almost everyone. With Asperger’s it can be particularly difficult to navigate. Occasional emotional “meltdowns”, which can lead to withdrawal, shouting, aggression, or fits of rage, are also not uncommon in teens with AS. Social challenges, sudden changes, academic pressure, and rejection are just a few things that can trigger a meltdown or worse.

Many teens with Asperger’s develop co-existing disorders, such as depression, anxiety (particularly social anxiety), and substance use disorders (the latter often develops as a way to cope). In the U.S., suicide is the second leading cause of death among all teens between the ages of 15 and 19. Teens with AS and one or two other disorders, particularly depression alone or combined with substance abuse, the risk for suicide can be dangerously high.

If your teen has become violent or suicidal, it’s essential to take immediate action to ensure everyone’s safety. This may include:

  • Enlist the help of a family member or friend / make sure your teen isn’t left alone
  • Contact your teen’s therapist or doctor asap
  • Take your teen to the nearest hospital ER
  • Call 911

A brief hospitalization may be necessary, especially if your teen is actively suicidal.

When Individual or Regular Outpatient Treatment isn’t Enough

While many teens with Asperger’s (and a stable, supportive home environment) do well with a comprehensive outpatient individual treatment program (discussed above), others need a higher level of treatment. This is even more likely if your teen is battling more than just AS. More intensive levels of treatment include:

  • Intensive outpatient treatment (IOP) / Psychiatric day treatment
  • Residential treatment
  • Dual diagnosis treatment
  • Inpatient psychiatric treatment

Intensive outpatient treatment or psychiatric day treatment can vary in terms of the amount of time spent in treatment and how often (e.g. twice a week, 5 days a week) your child is required to go. These programs are the next step up from regular outpatient treatment.

Residential treatment involves having your child stay at a non-hospital treatment facility that specializes in treating adolescents with ASD and other mental health disorders. Residential treatment typically lasts between 30 to 180 days, depending on the disorder and its severity.

Dual diagnosis treatment may be necessary if your teen has a serious substance use disorder. This can occur on an outpatient or residential level.

Inpatient psychiatric treatment is involves admitting your child to an adolescent psychiatric hospital unit where medical staff is monitors patients 24/7. It may last for a few days to a few weeks, and is particularly beneficial for adolescents who are an imminent danger to themselves or others, usually due to severe depression, psychosis, or mania.

Taking Care of Yourself

Parenting a teen with AS is a difficult and, at times, exhausting task, so it’s important that you make a conscious effort to take care of yourself. Some things you can do include:

  • Make sure you get sufficient sleep and rest
  • Make time for yourself
  • Surround yourself with supportive people
  • Join a support group geared towards parents of children or teens with ASD

Many teens with Asperger’s Syndrome become adults with relatively happy, fulfilling lives despite the challenges they face daily. Getting your teen help now will help ensure a bright future for him or her.

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