Date: April 1, 2011
Question: Michael is 5 years old and is having trouble making friends in his pre-K class. This is not a new situation for him. He is very bright, but that does not seem to help him. Someone said that we should see if he has Asperger's syndrome, which has us worried. It is a kind of autism, right? Please advise us.
Answer: There can be many reasons children have difficulties in social relationships. Below is information to help you understand the framework of Asperger's syndrome and areas to consider for your son.
Understanding social interaction capacity
The inborn, neurologically based ability of a child to reason and learn is cognitive "IQ." Imagine, for example, that IQ is a tank and some people are born with bigger tanks than others. The tank is then filled with experience and education. A child's ability to use his or her mind is the result of the original size of the tank provided by natural biology as well as how much is put into that tank. The same holds true for social IQ. Some babies are just inborn masters of social interchange, while others are at the opposite end of the spectrum. In the case of social development, psychological difficulties can interfere with a child's ability to utilize social IQ.
Consider types of social challenges
The first question to answer is whether your child's social challenges are based on neurological limitations in his social IQ or emotional challenges that have limited his abilities. If Michael's social interferences center on the most common scenario, which is emotional factors, it's important to seek psychological assistance for him and your family. If his problems relate more to neurological limitations, such as his ability to understand and engage in social interactions, or his level of interest in soliciting social interactions, you may consider the possibility of Asperger's syndrome.
Is Asperger's a type of autism?
There is a current controversy about whether Asperger's syndrome is a type of autism or a completely separate condition. Children with limited social IQ vary in two ways. First, children vary with regard to the nature of their social limitations. For example, one child may have a high interest in social interaction without fully understanding the reactions of another child, while a different child may have less interest in social interaction but more of an understanding of the emotional reactions of a playmate. Second, children vary a great deal with regard to the presence or absence of some other neurologically based developmental challenges such as:
* Communication difficulties that range from scripted, "robotic" or repetitive speech to absence of communicative speech.
* Learning difficulties due to uneven intellectual development or a generally low intellectual ability.
* Obsessional or restricted interests, and extreme need for sameness.
* Unusual posturing or ways of using the body and awkward movements.
Children with social difficulties who also have most or all of the other features in the list are generally considered to be on the autistic spectrum.
However, some children who have mild or moderate challenges in their social cognition have average or even above average intelligence. These children also have restricted interests, but these interests tend to be relatively intellectual and complex, even if repetitive.
For example, such an interest in a child Michael's age might involve playing with trucks, but in varied and interesting ways. These children might be awkward, but they would not do highly unusual things with their bodies. Their speech might sound a bit robotic, but it would generally be meaningful and communicative. Children with this particular grouping of issues are currently said to have Asperger's syndrome.
In a soon-to-be-released reworking of the psychiatric diagnostic codes, Asperger's syndrome will disappear as an official diagnosis and will be considered part of the autistic spectrum. Regardless of whether Asperger's syndrome is considered to be a milder form of autism with particular features or a different syndrome altogether, clinicians at the Lucy Daniels Center believe autism itself is a very individualized condition and we focus on how to help children with these challenges related to the autism spectrum.
To that end, there are many resources available, including parent education, special education approaches, language therapies, psychotherapy or behavioral/cognitive therapy, and medications.
Most children with Asperger's syndrome are diagnosed after 3 years of age, so if Michael does have Asperger's syndrome, you have a chance to intervene early. Keep in mind that there is much plasticity in development, and you may be able to help Michael a great deal if he has an Asperger's challenge. With your assistance, and the support of his loved ones, Michael should be able to grow into someone who sees the world in somewhat different ways than most others, but is fully capable of living a meaningful, fulfilling and productive life.
The Lucy Daniels Center for Early Childhood is a nonprofit agency that promotes the health and well-being of children and families. The question may be a composite or illustration of parents' questions. To submit a question, e-mail firstname.lastname@example.org with Ask Lucy Daniels in the subject line.