Asperger's Syndrome: A Guide for Parents and Professionals.

BY TONY ATTWOOD, PHD JESSlCA KINGSLEY PUBLISHERS, TAYLOR & FRANCIS INC.., PHILADELPHIA, PA AVAILABLE FROM THE EP LIBRARY [phone] CODE: TF252AS COST: $18.95 PLUS SHIPPING AND HANDLING

When my daughter Stephanie was diagnosed with Asperger's syndrome (a pervasive developmental disorder in the autism spectrum), I felt I was starting at square one. My daughter had also been diagnosed with kidney disease at birth but we got the diagnosis of Asperger's when she was 7, and I felt like I had a new child. One name kept coming up during the initial stages of my research: Tony Attwood. His book, Asperger's Syndrome--A Guide for Parents and Professionals was the first I read, and though I have read many more since, I can say his is the best one. My daughter's school district was as unfamiliar as I with Asperger's at first, so, along with other resources, I loaned them the book. The school psychologist said it really helped him to understand and plan a behavior modification program for Stephanie.

Dr. Attwood writes that it is common for children to be diagnosed at around kindergarten age because they may function well at home one-on-one, but challenges surface in group activities or in a structured setting like a classroom. The book helps parents and educators realize that the child's perception is different.

Dr. Attwood describes the characteristics of Asperger's and illustrates explanations with quotes from people with Asperger's and their parents. The book is divided into eight chapters, starting with the diagnosis, which discuss the various areas that pose unique challenges for individuals with Asperger's: "Social Behavior;" "Language;" "Interests and Routines;" "Motor Clumsiness;" "Cognition;" "Sensory Sensitivity;" and last, a chapter on "Frequently Asked Questions." Throughout the book, Dr. Attwood points the reader in a certain direction, rather than giving a list of instructions that must be followed.

Many children with Asperger's are visual learners, they need routines and predictability, such as taking the same route to a familiar place. Indeed, they may become upset if their schedule is changed, even by routine things like school assemblies, class trips, etc., or if something out of the ordinary occurs. They may have poor eye contact, difficulty with emotion identification in themselves and others, and may innocently state a fact about a person that may be socially inappropriate (e.g., "Why is that lady's hair gray?")

Social behavior (interacting with peers), the subject of Chapter 2, is strongly affected in kids with Asperger's, and they benefit from counseling, social skills groups, and Carol Gray's "Social Stories." Social Stories is a technique that involves creating a story that describes a particular social situation and includes the appropriate actions and expressions. The situation is described, making use of social cues, describing anticipated actions, reactions, and feelings of others. The story tells what is occurring and why, and provides directions that illustrate what the child is expected to do or say.

As discussed in Chapter 3, children with Asperger's may speak fluently while being unable to have a conversation. Language may be delayed, monotone, have unusual prosody (tone/volume), poor pragmatics (perseverating on a topic, interrupting others, etc.), and literal interpretation (my daughter cried when her grandmother said she was so cute she could eat her up!) Speech therapy is recommended with emphasis on the pragmatics (practical aspects of speech) as well as conversation practice.

Chapter 7 addresses sensory sensitivity issues. For example, a child with Asperger's may be acutely sensitive to sound. This causes distractibility in the classroom and startling/crying at loud noises like thunderstorms, blenders, hair dryers, and vacuums. The sensory stimulation causes the child to feel overwhelmed (sensory overload). Children with Asperger's may also have tactile sensitivity in which some forms of touch or areas of the body are perceived as too intense or overwhelming. Others may be dangerously insensitive to pain, heat, or cold. Sensory integration therapy can be helpful in reducing tactile sensitivity

Chapter 8, "Frequently Asked Questions." addresses many concerns that parents may have, from hereditary factors to handling relationships and choosing a good school. The book ends with a resources section, including books, learning materials discussed in the book, and Web sites.

Lauren Agoratus is the NJ State Coordinator for Family Voices, Maternal/Child Health, and the National Family Caregivers Association.