A Neat Little Package Called Asperger’s Syndrome
Yesterday I mentioned to Alexander’s play therapist that the psychiatrist has diagnosed Alexander with Asperger’s Syndrome contrary to the psychologist’s findings. The first thing the therapist said was “I agree.” She is a licensed clinical social worker so unable to make a diagnosis but she works with many HFA (high-functioning autism) and AS (Asperger’s Syndrome) kiddos so is familiar with how they present, clinically. She said she was surprised that the psychologist said that it was just anxiety and feels that the psychiatrist’s diagnosis is correct. I told her that the psychiatrist looked at all of Alexander’s quirks and that it ended up being like “a neat little package called Asperger’s Syndrome.”
In reading over the past week I have learned how Alexander has many classic AS traits that aren’t addressed in the DSM-IV. In the OASIS Guide To Asperger’s Syndrome they have a section called Suggested Solutions for Common AS-Related School Problems and some little things stood out. One section discussed the child having difficulty maintaining a comfortable posture at his desk and different ways to address it. During my son’s occupational therapy evaluation it was determined that he has problems with postural praxis as well as low muscle tone in his upper body leading to problems with fidgeting to get comfortable while sitting at a desk. This isn’t a part of the DSM-IV criteria for Asperger’s Syndrome but evidently it is something common among many children with Asperger’s Syndrome.
Other issues that aren’t classified as diagnostic criteria but when looked at as part of a whole child view could be part of Asperger’s Syndrome are handwriting issues including dysgraphia. At 5 it is hard to determine whether or not Alexander has dysgraphia but he certainly has some of the symptoms - as he gets older and his ability to write his thoughts improves we’ll know better whether dysgraphia is an issue. At school he is learning above grade level in all academic categories except for handwriting - he is considered ‘at grade level’ for handwriting but we have been told we really need to work on his fine motor skills and his writing techniques.
Sensory processing disorder is common for all children on the spectrum, not just those with autism. My son is no exception in this case. Many times children with AS present with sensory defensiveness - they are over-sensitive to certain types of sensory input including sound, touch, taste, smell, and sight. My son is sensitive to all but smell. The bright sunlight hurts his eyes; he is not a touch-feely kid and will wipe off kisses or other light touches as he can feel the sensation of the touch linger; he has a very sensitive sense of taste and thus has problems with food; he does not like loud sounds - especially sudden loud sounds. It is not unusual for a sudden loud sound to make him mad - where it scares my daughter it just makes my son mad.
Another part of Alexander that helps create the neat little package is his coordination/motor-planning issues; sometimes called dyspraxia or developmental coordination disorder. During Alexander’s occupational therapy evaluation the therapist noticed motor-planning issues on his part and is working on them with him through therapy. He has speech articulation issues that will probably be addressed through the school district next year - this could be problems with his oral motor-planning - getting his mouth to form the correct shape to make the proper sounds.
I could go on and on about Alexander’s quirks that fit into the profile of a child with Asperger’s Syndrome but I won’t. I’m definitely not focusing on the negative - these little things make Alexander who he is - my son, my oldest, and my sunshine. I just thought that the neat little package comment really summed it up - all of these varying issues come together to form one neat little package and that package is called Asperger’s Syndrome.
