Speech Therapy Evaluation

We had one round of evaluations for speech therapy and they want us to go back for a second, more in-depth evaluation next week. Our insurance will not pay a penny toward speech therapy so we are not yet sure what this will cost us financially.

We still have not told our daughter about Asperger's and surprisingly she is not asking questions about all the doctor visits. Her younger brother is full of questions about why she is going places and what she is doing there, but she just goes along, seeming to enjoy it all!

Social Functioning Impairment

One diagnostic criteria is "clinically significant impairment in social, occupational, or other important areas of functioning." In clinical terms, the doctor told me that someone would have to be unable to keep employment or a family in order to legally classify as having Asperger's Syndrome. (I guess so the system of disability payments would not be abused?)

But Stanford (in "Aspergers and Long-Term Relationships") points out that this criteria may be evidenced in the impaired relationships with extended family. This may be seen in the aspie rarely reaching out to them, or having little desire to be "close" with siblings, parents, or other members of the family.

"Aspie Memory"

In "Asperger Syndrome and Long-Term Relationships" Ashley Stanford says it's possible that a person with AS doesn't remember much from his past. This could be because there were many stressful situations and he has "shut out" those difficult memories. But it may just be that most of his "aspie memories" revolve around objects instead of people. He may forget about parties, holidays, and other occasions most NTs tend to remember.

Aspies and Relationships

So far the best book I've read to help me relate to and understand adult aspies is "Asperger Syndrome and Long-Term Relationships" by Ashley Stanford. I needed to see the practical examples she offers for some of the medical lingo to make sense.

The most difficult thing I have encountered in relationships with aspies is stated by both Attwood and Stanford:
"Aspies are less able to learn from their mistakes."
Liane Willey described it by saying "Trials and tribulations will not become lessons learned, they will simply be memories that stand on their own with little relationship to anything other than the day they occurred."

This characteristic of "Weak Central Coherence" explains why the same argument comes up over and over and over again. The aspie doesn't apply the answer to a particular problem that has been dealt with in the past to a similar but slightly different scenario. It's like a whole new scenario being experienced without being able to apply the solution learned in the past. Stanford acknowledges that this was a serious struggle in her life until she tried to see a bright side to it. She now tries to view each (same old) argument as a fresh opportunity to try to find a way of communicating that works best with her aspie spouse, and to find a solution that makes the most sense to both parties.

How to Communicate With an Aspie

Tony Attwood's book "The Complete Guide To Asperger's Syndrome" has been the most helpful book about Asperger's that I have read. It is current (2007) and comprehensive in scope. In the chapter on Language, he gives tips for conversing well with an aspie.

1. Avoid figures of speech.
2. Have a brief pause between your statements if discussing emotional issues or talk slowly about such things.
3. Be very clear without relying on subtlety.
4. Allow the aspie time to think of a response without rushing them to answer.
5. Do not feel uncomfortable if there is lack of eye contact.
6. Make facial expressions clear and consistent with the topic.
7. Avoid sarcasm and teasing.
8. The aspie may need assurance that you understand what they are saying.
9. Understand that the aspie may not know how to respond to praise or compliments.
10. Do not be offended by the aspie's blunt honesty.

In "Asperger Syndrome and Long-Term Relationships" (the best book I've read on aspie relationships) Ashley Stanford lists some ways to effectively use "Aspie-speak":

1. Don't generalize.
2. Be direct, honest, and clear.
3. Go straight to the main point--eliminate meaningless words.
4. Don't go off on a tangent.
5. Don't assume anything!

She says "a few generalizations may send even a simple conversation into that netherworld of incomprehensibility."

Signs of Asperger's (in my daughter)

The following is a list of some of the reasons we believe our daughter has Asperger's. We have a consultation scheduled with a specialist in Autism Spectrum Disorders in a few days and will proceed from there. Taking this one step at a time.

Our daughter:

*Has many collections of small items organized neatly in her room (cards, shells, small toys). As a two year old, she would line up small objects on the edge of her crib. We've always thought that was cute, but are now beginning to wonder if it's a part of AS.
*Talks about her 'best friends' but is avoided by her peers.
*Has odd, rigid ways of carrying herself; stomps when walking; doesn't know what to do with her hands; has no sense of another's personal space.
*Has meltdowns when she gets frustrated; seems unaware what others may think of her behavior.
*Has odd tones of voice; high-pitched, monotonous, or repeating phrases three times in rapid succession.
*Will make blunt, rude comments about how others look and not realize she was being rude.
*Takes things literally.
*Occasionally repeats the last word of someone else's sentence; will sometimes say "you're welcome" instead of "thank you" to a compliment.
*Is highly sensitive to smells, temperature, and textures (will only wear cotton knit clothing).

These are just a few of our concerns. For years we have thought she was badly behaved, immature, and would outgrow these behaviors with time and instruction. But we know that none of her younger siblings do these things. The most difficult observation of late is realizing that her peers are beginning to stare and even laugh at her. These observations along with recent episodes of odd behavior have made us seriously question if there might be a neurological component to what we are seeing in our child.

Signs of Asperger's

There are many sites which list various signs and symptoms of Asperger's Syndrome and it's been helpful to google and study as many as possible. I repeatedly read that because this is a spectrum, a person can have some but not all of the symptoms and it can be in varying degrees per person. I've also found that because AS runs in families, "you probably don't have to look far into the family tree to find AS."

Some symptoms listed By Mayo Clinic staff

Signs and symptoms of Asperger's syndrome include:
*Engaging in one-sided, long-winded conversations, without noticing if the listener is listening or trying to change the subject.
*Displaying unusual nonverbal communication, such as lack of eye contact, few facial expressions, or awkward body postures and gestures.
*Showing an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes.
*Appearing not to understand, empathize with or be sensitive to others' feelings.
*Having a hard time "reading" other people or understanding humor.
*Speaking in a voice that is monotonous, rigid or unusually fast.
*Moving clumsily, with poor coordination.
*Having an odd posture or a rigid gait.