Q. My eleven-year-old son was diagnosed with high-functioning autism/Asperger Syndrome. How can I get him to be more sociable?
A. You are correct in referring to Asperger Syndrome as "high-functioning autism," as it's a part of the whole spectrum of autism. I prefer to simply call it Asperger Syndrome, and separate it from the stigma of autism since many of these children act quite differently than those who are more severely autistic. I have had the experience of being pediatrician to several of these children in my practice, and have followed one child with Asperger Syndrome from birth -- and he's now a 24-year-old computer whiz who is a senior programmer in a major computer firm.
Like my former patient, many children with Asperger Syndrome are extremely bright. The most obvious characteristic of children with this syndrome are their social quirks. "Quirky" is not necessarily a negative attribute, in this instance -- these are kids who think out of the box and, if treated professionally, they will grow up to build better boxes. The so-called quirks that A.S. children exhibit are variable, but the one thing that characterizes these children is their social inappropriateness. Some are very aloof; many have problems picking up on normal socialization cues and come across as awkward. They often shun prolonged eye contact, and are less engaging in conversation. Unlike most children with autism, A.S. children rarely have any delay in speech; in fact, many are extremely bright and eloquent. Their eloquence just appears at the wrong time. For example, they may blurt out their opinion about a topic right in the middle of the teacher's lesson in school instead of waiting until she is finished. Difficulty with the back-and-forth listening and speaking of normal conversation is also typical. Here are five ways to help your child become socially more appropriate:
Get him counseling. Interview specialists in Asperger Syndrome in your area and choose one that is a good match with your child. Because your child is precociously bright, he will likely perceive on his own whether or not this counselor is right for him.
Be his social chairman. You may notice that he'll relate appropriately with some children and inappropriately with others. He may do better with one-on-one relationships or shine in group play. Identify the most compatible peers and foster those relationships. Invite temperament-compatible friends over to your home for parties and sleep-overs. Keep track of "high-risk" situations that cause him to get frustrated and become socially inappropriate, such as too many kids in a small room, and avoid these situations as much as possible. In my experience, children with Asperger Syndrome get bored around boring kids, so you may need to encourage relationships with other children who are bright and interesting. Remember, your goal is to help him enjoy the company of other children, and he needs to enjoy socializing in order to do it appropriately.
Model social skills. Get him comfortable with making eye contact during conversations. When you speak to him, make eye contact that is brief, soothing, and non-threatening. Use animated facial gestures so that he enjoys looking at someone's face. Teach him how to respond in emotional situations. If he laughs when his friend is upset, for example, play show and tell. Show him why his friend is sad, and how to be sympathetic with responses such as "I'm sorry." If that doesn't work, tell him. Even a five-year-old can understand the admonition, "That's inappropriate!" As he gets older, you can show him how to further respond appropriately to social cues. If another child brings him a toy and invites him to play, he may not get the hint and need you to tell him, "Billy wants you to have fun with him playing with the truck."
Get him moving. Boys with Asperger Syndrome are often also labeled A.D.H.D. One of the newest treatments for hyperactive children is intense exercise. I suspect that the basic therapeutic mechanism is that exercise stimulates neurochemicals that make the entire brain work better. Set him up to succeed: If there's a particular game or activity that he's good at, whether it's softball or soccer, encourage him to participate and excel at it. Team sports are good for A.S. kids to pursue, although many of these children are more comfortable with one-on-one sports, such as tennis.
Foster his "special something". Discover your child's special talent (e.g., sports, academics, art, music) and nurture its development. I call this the "carryover effect:" If your child excels in one thing and feels that he is good at it, this feeling is likely to carry over into helping him generally develop appropriate behavior in other circumstances.