Asperger's Syndrome and a Growing Demand for Unique Services
By Dr. Ken Roulx, Clinical Consultant, Devereux Glenholme School

Since 1994 when Asperger's Syndrome was officially designated as an extension of the Autistic continuum, the number of children diagnosed with this neurological disorder is ever increasing. There have been thousands of children and adults diagnosed with this condition. Current estimates suggest that over 400,000 families in the US are affected in some way by the disorder and that it exists in one of every two hundred fifty people. The numbers of children being identified in Asian and Mid Eastern countries, are also rapidly growing. Clinicians and educators are struggling to meet the unique needs of these children. The disorder and associated symptoms are not new, but the diagnosis is. A growing number of children and adults are being diagnosed using the criteria established in the DSM IV Psychiatric manual of the American Psychiatric Association. The Asperger's student frequently find themselves in the public school resource room. Unlike other resource room participants, they are very different, having not acquired the ability to develop friendships and interact appropriately with others. Their speech patterns are different, distinctive, tending to be monotonous, formal and long-winded with little use of common body language associated with normal speech. A central feature of this disorder is the inability to assimilate the rules that govern social behavior.

Being unable to interpret social cues, such as understanding the meaning of personal space, the necessity of maintaining eye contact and the comprehension of others expressions, gestures and non-literal statements, cause these students to be judged as odd, non-compliant, and very different. This lack of social presence places the Asperger's student into social situations, which invite ridicule and harassment.

In addition to their lack of social competence, the Asperger's student exhibits intense interests in one or two subjects almost to the exclusion of all others. These intense interests are aided by a superb ability to think abstractly and develop an extensive library of facts and information on these particular subjects. They have an extensive set of verbal skills designed to tell anyone that will listen, their extensive knowledge in the select subjects. Such a single-minded approach to impersonal communication frequently adds to the impression that they are extremely eccentric and odd.
As is true with all children, they desperately want to "belong". Given their lack of social and personal communication skills, they are likely to become depressed, angry, fearful and isolated. It is not uncommon for the teen-age Asperger's child to contemplate self-harm. Therapeutic intervention designed to deal with these emotions is a critical component of a well-balanced program. Given the unique nature and needs of the Asperger's student, it is essential for school programs to be constructed to accommodate their uniqueness. Academic programs must build upon their strengths. Such programs must have as their central core the teaching of skills and concepts naturally occurring in normal school situations. Strong emphasis must be placed on social awareness, the interpretation of the non-verbal communication of others, and by role playing socially difficult situations with practiced responses.

An environment with consistent rules to be followed is essential to the development of social and academic skills. Schools must have small classes with ample opportunity for individual attention and small work groups to practice in a safe environment free of ridicule and humiliation. Students must be taught how to identify specific situations and to resort to the pre-planned and practiced steps to be taken in order to respond appropriately. Spontaneity in social encounters is not a skill that these students posses. Programs must be offered that add to their repertoire of appropriate responses.
The current DSM IV psychiatric classification does little to aid in the development and provision of effective treatment. Many psychiatrists, researchers, diagnosticians, and program providers question the efficacy of continuing to associate Asperger's Syndrome with autism. While there is a growing disagreement as to whether the original classification is appropriate and helpful to treatment providers, Devereux continues to design unique programs and expand services for these children at many of the Devereux Centers.