Clinic Notes: Asperger's Syndrome and Bi-polar Disorder

There's is a lot in the literature about bi-polar disorder being co-morbid with the Autistic Spectrum Disorders, especially Asperger's Syndrome. Children with Asperger's Syndrome perseverate and also have social problems. One common perseveration in children with Asperger's is being right. Often I have been running ABA drills in my clinic with a child with Asperger's and noticed that if the child gives the wrong answer and I tell the child that they have made an error they will often insist that they have given the correct answer. When I try and explain why the answer is wrong the intensity of arguing often increases, sometimes to the point that it resembles manic behavior. Once the child calms down they seem often to become "hyper-calm" almost moody and depressed. I have also had two-year old children come to my clinic with a diagnosis of bi-polar disorder, and often heavily medicated. In our assessment we find that the child does display "manic" like bhavior, but the "manic" like behavior always follows the child being given a direction that the child did not want to follow. If the child is made to mind then they also become moody and depressed. These children do well on ABA programs for compliance.