Josh is a seven-year old with Asperger’s Syndrome. He comes into my office and we have one way conversations. Usually, he is talking about combat games his brother plays or he is talking about Egypt. These are two topics he is highly interested in. He sets up my soldiers and tanks and blows everyone to pieces. He has me play “with” him. Instead he is playing as if you are him. He tells you what to do and if you don’t do it his way, he corrects you and does it his way. He would rather have you sit there with your guys and he plays both parts. He is a very sensitive child. His brother is not potty-trained and his mom says we have no problems with that and he crawled under the chair whining and crawled into the lower shelf of my book-case. I told him that he probably feels embarrassed and he just grunted. I told him that I had not seen him do this in a while. He must really be embarrassed. Again he moaned and groaned. I did not know if we would have the rest of the session like this. After 10 minutes he came out and wanted to play a game with both of us according to his rules. When it was time to go, he was able to clean up.
Autism and Asperger’s Syndrome are difficult disorders to figure out and treat. Children with these disorders typically have problems with this scenario. It is not meant as a tool for determining whether your child has Autism or Asperger’s Syndrome or not. It is an observation. You take a normal three-year old child and show her a box of crayons and then you show her inside that there are candles. You close the box back up. Then you pull out a stuffed animal character and ask her what do you think, say Snoopy, thinks is in the crayon box. The child replies candles. By the time the child is four they are able to say Snoopy thinks there are crayons in the box. A normal five-year old looks at you as if you are crazy and says that off course he thinks there are crayons in the box. When you do this with a child with an Autism Spectrum Disorder they will always say that the other “person” thinks there are candles in the box. They cannot differentiate what they see and look at another’s perspective. Again, this is an observation, not a test to determine whether the child falls on the Autism Spectrum.
There are certain things to consider when looking at Autism Spectrum Disorders. Diane Yapko, a Speech and Language Pathologist for thirty years and who has specialized in children on the Autism Spectrum noticed these behaviors across the board. She spoke of these at a conference given by the Psychotherapy Networker Symposium in Washington, D.C.
· These children have difficulty taking the other person’s perspectives into account resulting in egocentric thinking and behavior, and idiosyncratic references.
· These children have difficulty responding to a listener’s feedback leading to endless monologues on obsessional interests.
· They have difficulty understanding opinions or fact from fiction leading to rigidity and gullibility.
· These children have difficult predicting other’s behaviors leading to fear and avoidance.
· These children have difficulty reading other’s intentions and motives including humor and sarcasm, leading to being used/manipulated by others.
· These children have difficulty understanding/interpreting emotions leading to problems with empathy and inter personal skills.
· These children have difficulty understanding/appreciating that one’s behavior affects how others think/feel leading to inappropriate behaviors.
These are just things to consider. There are certain interventions that can be used in therapy and at home to help ameliorate these behaviors. It takes a lot of training and thinking outside of the box as each child is so different. These children are special gifts and if we can get through to them just a little, we have made a great improvement. You have to be willing to put in the work required. A lot of it is repetition, doing it over and over, to make a lasting impression.