What’s in a Name?

by Sally Bligh

This article has been republished here from the American Hyperlexia Association Fall 1995 Newsletter.

Often I hear, "My child is hyperlexic, but the teacher says he’s autistic, the doctor says he’s Pervasive Developmental Disorder -- Not otherwise Specified, and his grandmother thinks he’s gifted! Which is right?"

Here are some guidelines to use:

1. Social interaction. Does your child have an impairment in the social interaction? Observe eye contact, facial expression, body postures and gestures. Does you child fail to develop peer relationships or seem not to share information, interests or achievements with other people? Doe he not understand social or emotional reciprocity?
2. Repetitive behavior. Does your child engage in repetitive and stereotyped patterns of behaviors? Is he interested in activities (such as reading) and with an abnormal intensity? Does your child have a compulsive adherence to routines, repetitive motor mannerisms (hand flapping) or preoccupation with parts of objects?
3. Communication problems. Does your child have difficulty learning to communicate?

If you answered yes to these questions, your child probably will meet the criteria for the autistic spectrum disorder called Pervasive Development Disorder (PDD) as described in the Diagnostic and Statistical Manual IV (DSM-IV). This document gives the disorder a number that can be used by insurance companies.

The next question is, into which subtype does the child fit?

1. He’s autistic if the communication problem is a delay in learning language -- using words after two years of age and phrases after three years.
2. He’s Asperger’s Syndrome if there is no language delay and normal intelligence.
3. He’s Not Otherwise Specified if he does not fit the first two categories.

While PDD usually is the medical diagnosis for children with the syndrome of hyperlexia, there are some children with the characteristics of hyperlexia who do not meet the criteria for PDD. These children generally are classified as "language disordered" because they do not have the difficulties understanding the reciprocal interaction between people and/or do not engage in restrictive, repetitive and stereotyped patterns of behaviors. These children do learn language in the same way as others with the syndrome of hyperlexia.

Because hyperlexia is not a stand-alone diagnosis, there is no real agreement in the literature as to who these children are, how they learn to read and how they learn language. Reports in the literature indicate that hyperlexia occurs in children who carry a variety of diagnostic labels.

The type of diagnosis offered for children who meet the criteria for the syndrome of hyperlexia depends most probably on the severity of the language disorder and the presence of other symptoms in the areas of social interaction and behavior. Even though symptoms may subside as language improves, many researchers and diagnosticians would still classify hyperlexic children as PDD on the basis of their early history.

-Phyllis Kupperman

Treatment techniques

The syndrome of hyperlexia is not a medical diagnosis and probably never will be. It is a term which describes a cluster of children within the medical diagnosis of Pervasive Developmental Disorder who have similar symptomotology, language learning style and social learning style. Most important, they have a better prognosis compared to most other children with the medical diagnosis of PDD.

Because these children are so similar to each other and because they are bright, treatment techniques can be developed for one that will be effective for others. Many of these techniques are similar to effective techniques for autistic children, but there are some significant differences. These include the use of the printed word and the specific teaching of language and social skills according to the children’s learning style -- which is very different from the way most children learn.

Practical value of a label

The most important value in identifying your child as within the syndrome of hyperlexia is that it tells you what to do and what to read:

• When the child is young, obtain intensive speech and language therapy. Occupational therapy may be helpful if the child has low muscle tone. Early childhood education programs or modified regular preschools can be effective.
  
• During the primary years, continue speech and language therapy and sometimes occupational therapy. At school, the child can spend as much time as possible with the regular education programs. Resource help, such as an aide to the classroom or to the child is useful. Extra help usually is needed less as the years go on. When the child is older, teach social skills directly.
  
• Learn about how these children see their world. Learn how they "see" language; they learn language my memorizing chunks and phrases, not by combining individual words. Learn how they learn social rules. In developing strategies for the child, remember to use the child’s strengths -- reading, strict adherence to rules, structure, routines -- to help him learn the areas that are more difficult for him, including language and social skills. Teach both language and social skills using "scripting" and "rehearsal."
  
• Read information on hyperlexia, PDD, high functioning autism and Asperger’s syndrome.

  Most of all, remember to use the child’s strengths to support weaker areas.

  
  Article originally appeared in the Fall 1995 AHA Newsletter
  American Hyperlexia Association
  479 Spring Road
  Elmhurst, Illinois 60126
  Phone: (630) 415-2212 (voice mail)
  Fax: (630) 530-5909
  mail to: info@hyperlexia.org
  mail to: webmaster@hyperlexia.org (Ted Whaley)
  mail to: president@hyperlexia.org(Patti Tebbe)
  

  The American Hyperlexia Association is a not-for-profit organization incorporated in the State of Illinois under the General Not For Profit Corporation Act. The contents of this web page are not medical, legal, technical or therapeutic advice and must not be construed as such.