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Definition

Children with Asperger's disorder share many characteristics with children with autism. The key difference is that children with Asperger's do not experience significant delays in language development.

Asperger's can be diagnosed in individuals who have no notable delays in language development but exhibit other features, such as difficulties in social interaction or specific behavioral patterns similar to those seen in autism. Some experts define the condition more loosely, suggesting that children with autism who develop certain language skills by the age of 5 may also be classified as having Asperger's disorder.

However, by observing the development of children with Asperger's Syndrome, it has been noted that there are no significant differences in academic performance, social adaptation, work ability, and interpersonal relationships between individuals with mild or high-functioning autism and those with Asperger's Syndrome. This observation suggests that Asperger's Syndrome may essentially represent a form of mild or high-functioning autism.

Diagnostic Criteria

Three Main Characteristics of Asperger's Syndrome

1. Interpersonal Interaction:
   Individuals with Asperger's tend to avoid or limit eye contact. Their interpersonal interactions are often clumsy and self-centered. They may struggle to observe verbal and non-verbal cues, show weak empathy, and fail to understand or abide by social norms (e.g., refusing to line up). They also find it difficult to exhibit appropriate social behaviors based on context and face challenges in integrating into group settings.
2. Language Communication:
   While language development is more quickly than in typical autism, individuals with Asperger's struggle to engage in natural conversations or casual chats. Due to self-centered thinking and a tendency toward negativity, they may say things that annoy or upset others. They often fail to understand metaphors, sarcasm, or jokes and tend to repeatedly discuss topics of personal interest.
3. Special Behaviors:
   Individuals with Asperger's display intense interest in specific subjects and often lack motivation for other activities that do not interest them. They can be rigid in their habits, such as following a fixed route home or eating only specific foods. They also demonstrate a strong sense of preferences, dislikes, and personal morals.

Children with Asperger's Syndrome often exhibit negative thinking, emotional instability, and a low tolerance for frustration, which can sometimes provoke others. Due to their difficulties integrating into group settings, they are more likely to be noticed by teachers after entering school.

In the preschool stage, children with Asperger's often prefer to play and learn independently. Many also exhibit poor coordination skills, which may hinder their ability to learn activities such as writing or gymnastics.

In the school-age stage, children with Asperger's may act as "rule enforcers", frequently correcting others, which can make them unpopular among classmates. As a result, some children may experience social exclusion, verbal scolding, and frustration, which can eventually lead to prolonged refusal to attend school.

Therapeutic Modalities

• Drug therapy

For some behavioral problems in children with Asperger's Syndrome, such as noisemaking, nighttime sleep disturbances, impulsivity, hyperactivity, and difficulty concentrating, medication can provide improvement. However, current medications cannot address the core deficits of Asperger's Syndrome and can only serve as adjuvant therapy to manage symptoms.

• Behavioral therapy

Structured and engaging activities can be used to capture the interest of children with Asperger's Syndrome. These activities can help guide them out of their self-isolated space, encourage them to pay attention to their surroundings, and teach essential communication and daily living skills.

Card Application

To teach children with Asperger's Syndrome, picture cards can be an effective illustrative tool:

• In Social Interaction:

Parents can create social stories to help their children understand and navigate social situations. Children with Asperger's often struggle to understand the context of human interaction and may have difficulty expressing themselves appropriately in social settings, even when they are interested.

For example, before taking a child to a wedding, parents can outline appropriate behaviors expected at the event and use picture cards to teach these manners. It is essential to use sentences framed as "I (the child) should…" instead of "You should…", as this phrasing makes children more willing to follow instructions. Additionally, avoid overloading children with excessive or irrelevant information, as it can increase anxiety for both the child and the caregiver.

• Situational Cards:

Write or draw real-life scenarios on cards to help children understand situations and appropriate responses. Providing clear visual cues along with step-by-step instructions on how to act in each situation can be highly effective in guiding their behavior.

Conclusion

Current treatment for Asperger's Syndrome focuses on improving social behaviors, including enhancing the ability to interpret social situations, adapt to social norms, and interact effectively with others. Achieving these goals requires long-term care, support, and acceptance from parents, teachers, peers, and the general public.

Only through consistent support and understanding can individuals with Asperger's continuously learn and progress toward treatment goals.

Related websites:

• Foundation for Autistic Children and Adults in Taiwan http://www.fact.org.tw/
• Kanner Foundation of Taiwan http://www.kanner.org.tw/