Can Aspergers manifest in different ways?

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VHCaterpillar
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10 Apr 2013, 1:25 am

I just had my SIL and her two children stay with us for a week and I couldn't help but think that her son, 8yrs, had some very similar symptoms to my own niece and sisters, who have been diagnosed with mild Aspergers. But when I looked up the checklist of symptoms online, I saw that it lists the speaking voice as usually being very monotone. This child speaks at a high volume all the time and never in a normal tone of voice. He doesn't seem to be able to control the volume either. It always seems as though he's putting on a 'funny' voice to a greater or lesser degree according to his level of excitement. He finds it very difficult to look anyone in the eye, which has been an ongoing issue.
My SIL is now single and she seems to struggle with his 'differentness' and I don't want to distress her by encouraging her to look for a diagnosis if I am totally off base.
The other things I observed in him were that his 5 yr old sister is more socially developed than him. In fact he played brilliantly with my 4yr old son (which was lovely to see). He will only eat a very limited diet of things such as white bread, avocado, white rice, plain pasta, milk etc. He is exceptionally sensitive to odours and complained of feeling sick from the smell of caramel popcorn when we took him ice-skating. When he got onto the ice for the first time, he was incredibly distressed by the new experience and even though he did show improvement as he went along, he was so locked in fear that it was impossible for him to enjoy it, to the point where it seemed kinder to let him go off the ice and sit down. He is fairly uncoordinated with poor muscle tone, posture and when he runs, his arms and hands are stiff and awkward looking.
I also witnessed him have an angry episode when his sister was not playing by the 'rules' of his game. He was physically hurting her but could not understand, when reprimanded, that hurting her was a 'greater crime' than her not adhering to his rules. His hurting her, seemed to be totally irrelevant and unimportant to him. By the end of the conflict and parental intervention, he was still complaining of unjust treatment because his sister hadn't cooperated with him.
After being here a week he had one BM. His mother said it's not a case of constipation but actively 'storing' it! Then just as they were about to leave for the airport he pooped his pants, which he apparently does fairly often. He is just now out of nappies for bed-wetting...
He sucks his thumb and strokes his side pocket at the same time, constantly wearing holes in his shorts. His mother was hoping that he wouldn't wear a hole in the bedsheets in the 7 days they were here...
My SIL said that at home he has had a number of meltdowns where he is completely out of control. She has resorted to putting him on the back deck until he calms down but on a few occasions he has been hitting the sliding doors with such force that she's had to physically restrain him in a 'body lock' (she's a police officer, so presumably she knows how to do that safely). She's pretty freaked out about this as she's just barely able to restrain him now, and is worried about what will happen as he gets a bit older...
Does any of this sound familiar? As I list all of these traits I feel bad, as it's not the sum total of who he is. He's a lovely boy who is a bit of a challenge. And he certainly seems to have more of an emotional 'range' than is listed on the check list. I wouldn't describe him as being locked away in himself and unresponsive to people.
I know I could say nothing, but as someone who grew up with undiagnosed ADHD, I look back and think what heartache could have been avoided if my parents were aware of my brain type, not to mention my two, then undiagnosed, Asperger's sisters...
I also look at his younger sister, whose needs seem to have to come second in any situation, prompting her to resort to some fairly whiny behaviour on occasion, to get noticed. I could see in one week how quickly she responded to some one on one time and how her behaviour improved and she just seemed happier in general.
Should I say anything? Does this sound like Aspergers? What would be a 'gentle' way for my sister in law to get some information on this stuff without being completely overwhelmed by it: there seems to be an avalanche of information out there.



cberg
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10 Apr 2013, 1:33 am

Reads like an instance in which diagnosis would have some positive results, however I would steer her clear of bringing up the diagnosis before she's read into the possible consequences (e.g. with school Administrators), as well as discouraging her from physically restraining her son. She will benefit from trying to analyze the events leading up to his outbursts as much as he undoubtedly has, and, right you were, taking the gentle part LITERALLY.


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10 Apr 2013, 1:53 am

It sounds to me like Asperger's.. I 'm not an expert but not everyone is textbook - especially if there are co morbids involved. As for tone of voice, it isn't always a monotone. My voice rises lots and also changes pitch - I also have a hard time modulating my voice.

I had a hard time being introduced to Asperger's and I had to bump into on my own accord with unknown guidance from my boyfriend. He would suggest - see my reaction and back off. Then one day it clicked and I was certain. I have never been so grateful to have answers in my life.

I agree with cberg.


Hope it all works out for you and your SIL



VHCaterpillar
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10 Apr 2013, 4:52 am

Thanks to both of you for your replies. I hasten to say my SIL is a very gentle person and only restrained her son because she was scared he was going to bring a glass door down on himself. Unfortunately she's also very much the type to bury her head in the sand about anything that feels emotionally challenging, hence my posting on this forum. I really don't want to bring this up unnecessarily. But if this all sounds familiar to people with Aspergers then I feel obliged for all their sakes.



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10 Apr 2013, 6:57 am

If he has AS and gets a diagnosis (even a self diagnosis) it will probably be easier to tackle his problems.
If he becomes physical when getting meltdowns it is very necessary that he learns to detect them and avoid them, if possible. I think it is very important to get a diagnosis just to be able to understand one self and work with whatever issues.

Just my thought


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10 Apr 2013, 6:58 am

About your question, the answer is: yes, AS can manifest in different ways. AS is a syndrome. People can present several characteristics from a list, but not all have the same characteristics. My daughter was diagnosed with AS and when I read the list I thought she did not fit.
If I was you I would talk to your brother instead of your SIL. Why? Because I assume you have a closest relationship with your brother, and he could react in a better way. Parents do not like being told there is something wrong with their children. It doesnt matter if they complain about the same things about the kid. Maybe instead of saying you were reading and you think he has AS, you might say something like it would be a good idea to take the kid to a neurologist just to test for ADHD, and AS, because it runs in the family (you said you have ADHD yourself, and people with AS is often thought to have ADHD - my own daughter was diagnosed with ADHD before she was diagnosed with AS) and you read somewhere it is genetic and can he enherited (that is true). Besides, it if is ADHD or AS, it will bring trouble at school. The best thing to do is getting him tested just in case.
You should be aware the signs your nephew presents might be consistent with psychological issues as well.



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10 Apr 2013, 9:49 am

These are the four sub-types of Aspergers (as per Lorna Wing an expert clinician):

Quote:
Aloof

Most frequent subtype among the lower functioning. Most high-functioning in this group are a mixture of aloof and passive. Limited language use. Copes with life using autistic routines. Most are recognised in childhood. Independence is difficult to achieve. There may be loneliness and sadness beneath the aloofness. Rain Man is an excellent example of this subgroup.

Passive

Often amiable, gentle, and easily led. Those passive rather than aloof from infancy may fit AS. More likely than the aloof to have had a mainstream education, and their psych skill profiles are less uneven. Social approaches passively accepted (little response or show of feelings). Characteristic autistic egocentricity less obvious in this group than in others. Activities are limited and repetitive, but less so than other autistics. Can react with unexpected anger or distress. Recognition of their autism depends more on observing the absence of the social and creative aspects of normal development than the presence of positive abnormalities. The general amenability is an advantage in work, and they are reliable, but sometimes their passivity and naivete can cause great problems. If undiagnosed, parents and teachers may be disappointed they cannot keep a job at the level predicted from their schoolwork.

Active-but-odd

Can fall in any of the other groups in early childhood. Some show early developmental course of Kanner's, some show AS. Some have the characteristic picture of higher visuospatial abilities, others have better verbal scores (mainly due to wide vocabulary and memory for facts). May be specific learning disorders (e.g., numerical). School placement often difficult. They show social naivete, odd, persistent approaches to others, and are uncooperative in uninteresting tasks. Diagnosis often missed. Tend to look at people too long and hard. Circumscribed interests in subjects are common.

Stilted

Few, if any clues to the underlying subtle handicap upon first meeting. The features of AS are particularly frequent. Early histories vary. Normal range of ability with some peaks of performance. Polite and conventional. Manage well at work. Sometimes pompous and long-winded style of speech. Problems arise in family relationships, where spontaneity and empathy are required. Poor judgement as to the relative importance of different demands on their time. Characteristically pursue interests to the exclusion of everything and everyone else. May have temper tantrums or aggression if routine broken at home, but are polite at work. Diagnosis very often missed. Most attend mainstream schools. Independence achieved in most cases. This group shades into the eccentric end of normality.


As Asperger's is a spectrum, everyone has their own blend of traits.


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ASDMommyASDKid
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10 Apr 2013, 10:18 am

This sounds like it could be autism (I am not a medical professional, standard disclaimers apply) and it bears looking into. You say that this is your now single sister-in-law, so I am guessing that this is your husband's sister. If so, have you spoken to your husband about this? He might have a good gauge of how to approach this with her, and know if it might come out better from him. Sometimes stuff with in-laws can get complicated, and you don't want to throw yourself on a minefield. Many people start out in denial, and would not take the information well, is why I say this.



cberg
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10 Apr 2013, 6:52 pm

ASDMommyASDKid wrote:
This sounds like it could be autism (I am not a medical professional, standard disclaimers apply) and it bears looking into. You say that this is your now single sister-in-law, so I am guessing that this is your husband's sister. If so, have you spoken to your husband about this? He might have a good gauge of how to approach this with her, and know if it might come out better from him. Sometimes stuff with in-laws can get complicated, and you don't want to throw yourself on a minefield. Many people start out in denial, and would not take the information well, is why I say this.


Seconded. I may be high-functioning, but I observed all of the above issues (as well as divorce) in my family. Where my Aspergers diagnosis was a hindrance in School and what I was allowed to do there (vastly more time forced into study hall), I believe your nephew's diagnosis would come as a revelation. He stands to learn, far younger than most of us did, about the possible root causes of his difficulties and where he can go to study them in more depth.

SEND HIM HERE. DIAGNOSIS OR NOT.


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VHCaterpillar
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11 Apr 2013, 1:49 am

My husband is in complete agreement with me but he gets bit frustrated with his sister's blinkered ways and his delivery would probably not be particularly gentle. Possibly an approach would be to go to my mother-in-law, who I get on well with and would be able to make a suggestion in a way that my SIL could handle. I'm studying to be a coach for adults with ADHD and maybe at some point I can put that training to use for my nephew in helping him identify and then focus on his strengths.

Thanks to everyone who replied, it's really fascinating to read everyone's experiences and observations. I appreciate it.