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Tuesday, December 24, 2013

Learning Disabilities and Asperger’s Syndrome

From NCLD.org
The National Center for Learning Disabilities

By Sheldon Horowitz, Ed.D.
December 22, 2013

Since children with LD and Asperger’s Syndrome (AS) sometimes share characteristics, it is tempting to say that they meet the diagnostic criteria for either classification. But this is not the case—learning disabilities and Asperger’s Syndrome are separate and distinct disorders, and different types of assessments and strategies for intervention need to be selected to address the distinct and sometimes overlapping features of each.

The article, Nonverbal Learning Disabilities: A Primer, calls attention to some of these overlapping features.

Children with NVLD are described as showing signs of:
  • Physical awkwardness (e.g., not knowing what to do with their hands during casual conversation; showing anxiety-induced behaviors in public that often resulted in embarrassment);
  • Social intrusiveness (e.g., standing too close to someone or following someone around during casual conversation; not knowing when or how to join a conversation or having a hard time engaging in the “give and take” of informal chatter); and,
  • Social isolation (e.g., not being sure of how to join a group or initiate social interaction).

It will become apparent as you read on that there is a great deal of overlap between Asperger’s Syndrome (AS) and Nonverbal Learning Disabilities (NVLD), which sometimes complicates the differential diagnosis process (a term used by clinicians that simply means “figuring out what’s really going on and deciding how best to name it for the purposes of prescribing treatment”).

Further complicating the diagnostic process is the likelihood that educators and clinicians view children’s behaviors through different lenses, some looking primarily at language and cognitive (thinking) skills, and others attending first to social and behavioral concerns. Most professionals seem to agree that these two groups differ in severity, with Asperger’s Syndrome generally showing more severe impairment than NVLD.

That said, the degree of severity in both disorders can range from mild to severe. Children with AS have been described as having “a dash of autism,” and some say that AS is the same as “high functioning autism,” while others are more prone to making a connection to NVLD.

It should also be said that teasing apart AS and NVLD is complicated by the fact that there is no single battery of tests or uniform profile for either of these disorders. NVLD is often difficult to recognize, and children with NVLD are sometimes unfortunately mislabeled as being lazy or unmotivated.

Some of the characteristics of NVLD, such as problems with organization, motor planning, problem solving, and social adaptation, are also present in children with AS. And while both children with AS and NVLD demonstrate areas of significant weakness, they may also have specific areas of incredible talent (this being particularly true for children with AS).

Some Basics on Asperger’s Syndrome

Asperger’s Syndrome is a developmental disorder that affects a child’s ability to socialize and communicate effectively with others. Children with Asperger’s Syndrome exhibit social awkwardness and problems with communication and social skills. AS is one of a number of conditions that fall along the autistic spectrum, with AS at the milder end, and severe autism at the other.

It has been estimated that two out of every 10,000 children has Asperger’s, and boys are three to four times as likely as girls to have the disorder.

Perhaps the most striking feature of this disorder is an all-absorbing (at times obsessive) interest in specific topics. Children with AS typically gather enormous amounts of information about their favorite subjects and seize every opportunity to learn more and talk about them, incessantly if given an audience.

The conversation they generate about these topics may at times seem like a random collection of facts or statistics, with no point or conclusion, and their uncanny expertise is often shared in extraordinary detail, in advanced grammar and with rich vocabulary.

Sometimes called “little professors,” they communicate with a serious and formal demeanor, and their speech patterns often lack rhythm so their conversations have odd inflections and sometimes are either too soft or too loud for the setting.

Children with AS have trouble reading social cues and recognizing other people’s feelings. They tend to be very literal and have trouble understanding nonverbal cues. They may also exhibit strange movements or mannerisms, or have problems with motor skills (e.g., learning to ride a bike, swinging a bat, or catching a ball). Together these qualities can make it extremely difficult for them to make friends.

Other symptoms of Asperger’s Syndrome may include:
  • Obsessive or repetitive routines and rituals;Clumsy or uncoordinated movements;
  • Pronounced sensitivity to sensory information, such as light, sound, texture and taste;
  • Noticeably high levels of restlessness or over-activity in early childhood, which might lead to anxiety or depression in young adulthood; and,

More About Asperger’s Syndrome

By definition, children with AS are of average to above-average intelligence, and some (not all) demonstrate truly extraordinary pockets of skill and knowledge. While they are often able to “fit in” to their peer group because of their intelligence, they struggle because of their social naivete and are often viewed as being eccentric or odd and are therefore frequently considered an easy target for teasing and bullying.

Also noted about children with AS are tendencies to turn away from a person while speaking to them (gaze avoidance) rather than face a person and to not know how to initiate or sustain conversation in a relaxed and socially-inviting and reciprocal (“taking turns”) manner.

If one was to compare AS to autism and more severe disorders on the autistic spectrum, one would find that in AS:
  • The onset of symptoms is usually later (autism is almost always apparent before age two, while the signs of AS can be subtle and in some cases remain undiagnosed throughout the elementary school grades);
  • Overall outcomes for children with AS are generally more positive, meaning that they often benefit from special education and behavioral therapies in ways that make it possible for them to marry and care for children, sustain independent social relationships and engage in competitive employment;
  • Social and communication deficits are less severe;
  • Verbal abilities are usually more highly developed than performance abilities (in autism, the case is usually the reverse);
  • A family history of AS, or similar types of disorder, and;
  • Fewer co-occurring neurological disorders are also present.

A Life-long Challenge


As is the case with LD, Asperger’s Syndrome is not something that is outgrown or that disappears over time. But like LD, many of the challenges faced by individuals with AS can be lessened and even overcome given specific types of therapy. Carefully designed programs of remediation and support that focus on teaching social and pragmatic skills have been shown to be effective, and anxiety and features of Obsessive Compulsive Disorder can often be treated with a combination of medical intervention and therapeutic support.

Additional Resources
  • The National Institute of Neurological Disorders and Stroke (NINDS) is a government-funded program that supports research and publishes resources on Asperger’s Syndrome and other neurological disorders. See this fact sheet on AS for a history of the disorder, an overview of diagnostic criteria, and a listing of organizations that focus on providing information and support on AS.
  • The National Institute of Child Health and Human Development (NICHD) is another government agency that was initially established to investigate the broad aspects of human development as a means of understanding developmental disabilities. The NICHD conducts and supports research on all stages of human development, from preconception to adulthood, to better understand the health of children, adults, families and communities.
  • MAAP offers services for Autism and Asperger’s Syndrome.  A wide range of valuable information on Asperger’s Syndrome, Autism and Pervasive Developmental Disorder can be found on their web site.
  • The Autism Society of America (ASA) is a formative resource for the autism community in supporting education, advocacy, services, research and support. They offer information about autism spectrum disorders (including Asperger’s Syndrome) for educators and families, and maintain a network of chapters, members and supporters who can seek help and share their journey via the web site.
  • Genius May Be an Abnormality: Educating Students with Asperger’s Syndrome, or High Functioning Autism is an article written by Dr. Temple Grandin, a faculty member at Colorado State University and a well-known and highly accomplished person who is living with an autistic spectrum disorder.

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Sheldon H. Horowitz, Ed.D. is the Director of LD Resources amd Essential Information at the National Center for Learning Disabilities.

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