For Health Care Professionals
It may not be obvious when a patient walks into a consulting room that they have Asperger syndrome, and yet when those affected attend for a medical appointment they are likely to require a special approach. People with Asperger syndrome are likely to be very anxious about meeting new people and being in a new situation. Some have a reduced reaction to pain and because of their communication difficulties, may find it hard to explain what’s wrong with them. They may also be very uncomfortable with being touched or examined.
Asperger syndrome is a developmental disorder that is characterized by:
- limited interests or an unusual preoccupation with a particular subject to the exclusion of other activities
- repetitive routines or rituals
- peculiarities in speech and language, such as speaking in an overly formal manner or in a monotone, or taking figures of speech literally
- socially and emotionally inappropriate behaviour and the inability to interact successfully with peers
- problems with non-verbal communication, including the restricted use of gestures, limited or inappropriate facial expressions, or a peculiar, stiff gaze
- clumsy and uncoordinated motor movements1
As an autistic spectrum disorder, Asperger syndrome is one of a distinct group of neurological conditions characterized by a greater or lesser degree of impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behaviour.
Parents usually sense there is something unusual about a child with Asperger syndrome by the time of his or her third birthday, and some children may exhibit symptoms as early as infancy. Unlike children with autism, children with Asperger syndrome retain their early language skills. Motor development delays – crawling or walking late, clumsiness – are sometimes the first indicator of the disorder.
Although diagnosed mainly in children, Asperger syndrome is being increasingly diagnosed in adults who seek medical help for mental health conditions such as depression, obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD).1
Parental support from doctors following diagnosis
Following a diagnosis of Asperger syndrome, some parents are still given little or no information on the condition by their doctor, and are left to seek information through the media. At this point, carers of those with Asperger syndrome need support in a number of ways, such as:
- Literature on Asperger syndrome
- Information about available resources
- Time to talk about Asperger syndrome with a professional
- Referral to a support group
- Advice on implications for educational support
- Advice on appropriate medical programmes for example on behaviour, social skills and counselling2
The role of nurse practitioners in developing care plans
Nurse practitioners can play a key role in diagnosis, early intervention and coordination of care for children with Asperger syndrome and their families. In both school and primary care settings, nurse practitioners may join an interdisciplinary team of professionals and parents. The team can assist parents, children and school personnel in planning, intervening, and coordinating services for these families with the aim of avoiding academic failure and social isolation.3
The National Autistic Society website has a number of useful fact sheets for a wide range of health care professionals at http://www.autism.org.uk/en-gb/working-with/health.aspx
1. National Institute of Neurological Disorders and Stroke. Asperger syndrome Fact Sheet. National Institutes of Health. Available at http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm
2. The importance of physician knowledge of autism spectrum disorder: results of a parent survey. Rachel A Rhoades†, Angela Scarpa*† and Brenda Salley BMC Pediatrics 2007, 7:37 doi:10.1186/1471-2431-7-37 This article is available from: http://www.biomedcentral.com/1471-2431/7/37
3. Sandra L. Lobar, PhD, ARNP, BC et al. The Role of the Nurse Practitioner in an Individualized Education Plan and Coordination of Care for the Child with Asperger’s Syndrome. J Pediatr Health Care. (2008) 22, 111-119.