QUESTION
I have a Kindergarten student whom I highly suspect has Asperger's   
Syndrome.  His health insurance has a waiting list of 3-4 months before beginning testing.  This little boy needs help. I want him to be as successful as possible, but do not feel qualified enough to remediate his social behaviors. I need him to not touch his classmates, to stop pacing the classroom and pulling things off the shelves.  Do you have any suggestions, tips or other avenues that his parents and I may pursue?

ANSWER

I'm on the CKA Board of Directors and am a Marriage and Family Therapist.  I've worked with families with children with Asperger’s. There is a lot of information on the Internet about A.S.  Understanding how it may apply to this child is key. There are variations in how the condition manifests and how a child may react to it.  This needs to be determined.  There are many suggestions depending on how he is affected, regarding how to interact with him.

Over stimulation, misinterpreting social cues, getting stuck on a particular issue, picking out the wrong aspect of a communication to focus on, believing that others are not playing or using a toy or something else "correctly" and getting frustrated, feeling there is only one correct way to do it are possible expressions of A.S.  Training alternative behaviors starts with identifying the behaviors AND the child's process that leads to the behavior.  I cannot and would not offer specific suggestions because it does all depend on actual observation.

Of particular use for diagnosis, is the section part way into this article on Asperger’s Syndrome through the Lifespan.
http://www.udel.edu/bkirby/asperger/as_thru_years.html
I find that bells will ring and lights will flash as a parent of a child, including an adult child who has A.S. reads that part of the article.  If the individual does not have or has not experienced the traits over his or her lifespan, then the parents won't see or feel it.  Unfortunately, because some Asperger’s individuals are not self-aware, they cannot see themselves in the descriptions despite obvious relevance to others who know them. “Aspergians”, is what John Elder Robison calls himself and others in his book "Look Me in the Eyes".  "Born on a Blue Day" by Daniel Tammet is another autobiography of an Aspergian.
 
My work with A.S. individuals or parents of A.S. children starts first and foremost with getting them to understand and accept the diagnosis.  Without that acceptance, I don't believe the rest of the work can proceed.  I can't emphasize this enough.  They have to “get it” or else it's always about others messing with them without cause or reason, the paranoid explanation. This can be a very
difficult process.  It took about 9 months of intermittent therapy to get one 
middle-school student I've worked with to accept the diagnosis.  Now, finally, we can actually proceed to problem solving and behavior change.

Once accepted through psycho education (interviews and prediction of
history and internal experiences: emotional processes, behaviors, and
thought processes characteristic of A.S.), then the progression of the
A.S. as it affects social experiences and relationships (unexpected and
undeserved teasing and mistreatment and resultant resentment) can be
named and deconstructed.  It's not really a step-by-step process, because

there will be need to revisit, remind, and continually reinforce the process that

leads to resentment and paranoia.

With identifying the development, progression, and cycles that lead to the dysfunctional and unsuccessful world view, then work proceeds on identifying the current problematic cycles, triggers, and behaviors; and, then to problem solving including planning, interrupting, and experimenting with alternative responses. The dynamics of communication and conflict among the A.S. person and his or her parents, peers or other relations also needs to be identified based on the false assumptions and the inaccurate interpretations of behaviors and motivations. Family therapy seeks to identify the inadvertent disrespect and resultant emotional injuries, and thus begin the healing process.  It's pretty difficult work!  But the underlying foundation has to be the correct diagnosis.

Also, check to see if one of the parents may have A.S. symptoms, but possibly less severe in the spectrum.  That completely intensifies the negative dynamics, but also explains it.  Getting an unaware parent to accept the A.S. relevance of his or her (usually, his) functioning may be more challenging than with the identified A.S. child.  The parent would have come to relatively successful compensations on his or her own and be fully expectant that the child SHOULD have come up them too and/or can't understand why the child is being so resistant to accepting his or her wisdom.  This then reinforces the resentment, hypersensitivity, vigilance or paranoia and consequently the judgmental and condemning attitude.  The non-A.S. parent will often readily confirm the other parent's A.S. symptoms and has been dealing with them in their relationship for years, as well as compensating for them in parenting.

The Regional Centers run by the State of California Department of Developmental Services also work with the family and the child.  Here's the website with center locations in different areas. They would be a resource to try to get immediate help.  http://www.dds.ca.gov/rc/rclist.cfm
 

Good luck!

Ronald Mah

Member CKA Board of Directors