John is an eight year old male who enters my office and is engrossed in Angry Birds on his Kindle Fire. His mom asks him for the device and he mumbles and it is obvious he is not ready to give it up. The mother proceeds to take it from him and he screams at the top of his lungs. He runs to one of my chairs and climbs in with his backside to me. He says he is not going to talk that he wants to play Angry Birds. I tell him in here, this is his special time and that he can say and do almost anything he likes.
You see, I am a child therapist and I work with children with many kinds of problems. As we proceed with the session, he climbs under the chair, kicking his shoes off in the process and climbs on to the bottom shelf of my book shelf and bangs his head. You may be wondering at this point, what is wrong with John. Is he just being oppositional? Actually, John has what is commonly termed Asperger's Syndrome. There are several symptoms of Asperger's Syndrome. They may include all or some of these characteristics:
· Problems reading social cues
· Dislikes changes in routines
· May appear to lack empathy
· May be unable to recognize subtle differences in speech tones
· May avoid eye contact with others
· May have unusual facial expressions
· May be preoccupied with one or more things
· May have one-sided conversations
· Delayed motor development
· Have high sensitivity to noise
This list is not all-inclusive. These are typical behaviors seen in children. John does not like a change in routine, so when he came into counseling, this was totally new and different. His way of coping was to try to make me go away with his behaviors. John sees me the same time each week now. He comes in and asks how long he has until he can leave. He pulls out a game and we play. When you ask him questions his answers reflect his stuffed animal or something else he finds comforting. You cannot have a long drawn out conversation with what he did with his friends. He has no friends according to him because he is so different. I read him a story of a cat that is different then all his friends and ask him if he feels like that. He cannot answer. He has no vocabulary for feelings and has difficulty relating to other things or other people.
Asperger's Syndrome is considered to be an autism spectrum disorder. There are questions as to whether it really exists and whether it is a form of high functioning autism. Asperger's Syndrome was named after a pediatrician Hans Asperger, MD who noted strange behaviors in some of his patients. Specifically they had poor non-verbal skills, demonstrated limited empathy towards others, and where physically clumsy. There is no exact cause of the syndrome and there is no single treatment. Typically, cognitive behavioral therapy interventions are used to teach appropriate social skills. Despite this, social and communication skill deficits may be present. There is no cure.
John likes to talk about Egypt. So we talk about Egypt. He tells me of this cartoon movie that takes place in Egypt and he takes everything it says about Egypt literally. I read him a book about what makes him worry. He says losing his stuffed animal. He has a specific name for it and losing his cats. I ask him if he gets worried can he count to five and take a deep breath and we practice belly breathing. Does it carry over to other things in his daily life, I don't know. I just know he had a bad day at school, refused to do his work because it involved writing and he can't write. He then proceeded to climb underneath the desk and tear up his work book.
My place of employment is near the fire department and when the alarm goes off, John jumps up and says what's that and wants me to make it stop. I tell him that they are testing the fire sirens. He quiets down, as they are now over. He will ask me how much time we have left and when I tell him it is time to clean up and he says "good" and runs out of my office, into the waiting room, and tells his mom it is time to go.
Every week we run through a roller coaster of emotions with Asperger's kids. We go slowly one step at a time and savor the awesomeness that the experience can bring.
Carolyn L. Nelson is a licensed clinical social worker who has been in the field over 20 years. She writes for her Blog at http://blog.therapistscornerblog.com
She also can be reached at her website at http://www.therapistscornerblog.com
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