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Asperger's Syndrome

What is Asperger’s Syndrome?
Asperger’s Syndrome (AS) is one of five autism spectrum disorders (ASD) that are characterized by difficulties in social communication, interaction and reciprocity. AS is distinguished from other ASD’s by linguistic and cognitive abilities that are relatively intact. Although motor clumsiness and the delayed acquisition of language are not mentioned in standard diagnostic criteria, odd speech, language peculiarities and impaired motor skills are frequently reported features of AS.
 
Asperger’s Syndrome was named in honour of Hans Asperger who, in 1944, described children in his practice who appeared to have normal intelligence but lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. In 1994, AS was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder.
 
The diagnosis of AS is complicated by the use of several different screening instruments and sets of diagnostic criteria. Less than two decades after the standardization of AS as a diagnosis, questions about many aspects of AS remain: the diagnostic validity of Asperger’s Syndrome is disputed and there is lingering doubt about the distinction between AS and high-functioning autism (HFA). Experienced clinicians use characteristics beyond the diagnostic criteria to diagnose AS and to distinguish between AS and HFA. The prevalence of AS is not firmly established, due partly to the use of differing sets of diagnostic criteria.

The Cause of Asperger’s Syndrome
The exact cause of AS is unknown, although research supports the likelihood of a genetic contribution, and advanced brain imaging techniques have identified structural and functional differences in specific regions of the brain.
 
Treatment of Asperger’s Syndrome
There is no single treatment for AS, and data supporting the effectiveness of particular interventions are limited; intervention is aimed at ameliorating symptoms and improving function. The mainstay of treatment is behavioural therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and clumsiness. Most individuals with AS can learn to cope with their differences, but may continue to need support to maintain an independent life. The deficits associated with AS may be debilitating and lifelong, but individuals who are able to excel in areas that are less dependent on social interaction may experience positive outcomes and one researcher suggests that people with AS may accomplish innovative research in fields such as computer science, mathematics and physics. Researchers and people with AS have contributed to a shift in attitudes, away from the notion that AS is a deviation from the norm that must be treated or cured, and towards the view that AS is a difference rather than a disability.
 
Studies of children with AS suggest that their problems with socialization and communication continue into adulthood. Some of these children develop additional psychiatric symptoms and disorders in adolescence and adulthood.
 
Although diagnosed mainly in children, AS 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). No studies have yet been conducted to determine the incidence of AS in adult populations.
 
Characteristics of Asperger’s Syndrome
Asperger’s Syndrome (AS) is a developmental disorder that is characterized by:
  1. limited interests or an unusual preoccupation with a particular subject to the exclusion of other activities;
  2. repetitive routines or rituals;
  3. peculiarities in speech and language, such as speaking in an overly formal manner or in a monotone, or taking figures of speech literally;
  4. socially and emotionally inappropriate behaviour and the inability to interact successfully with peers;
  5. problems with non-verbal communication, including the restricted use of gestures, limited or inappropriate facial expressions, or a peculiar, stiff gaze; and
  6. clumsy and uncoordinated motor movements.
 
Other ASDs include: classic autism, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).
 
Parents usually sense there is something unusual about a child with AS 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 AS retain their early language skills. Motor development delays – crawling or walking late, clumsiness – are sometimes the first indicator of the disorder. 
 
Occurrence
The incidence of AS is not well established, but experts in population studies conservatively estimate that two out of every 10,000 children have the disorder. Boys are three to four times more likely than girls to have AS.
 
Educational Implications
Even when children cope well academically, they may have problems socialising and are likely to suffer teasing or bullying. More severely affected children need the specialist help provided by schools for children with learning disabilities.
 
Particular focus needs to be given to behavioural therapy social skills training. Teachers must be aware of the students’ difficulties with communication. Although they may be able to speak fluently, sometimes there are difficulties judging or understanding the reactions of those they are talking to. Common problems include:
  • Failing to notice the body language of others
  • Appearing insensitive to the feelings or views of the listener
  • Continually talking, unaware of the listener's interest
  • Appearing over-precise in what they say
  • Taking comments very literally (for example misunderstanding jokes, metaphors or colloquialisms)
 
Children with Asperger’s Syndrome are often of average or above intelligence, and may be particularly good at learning facts and figures. However they may also lack imagination and find creative play, or thinking in the abstract very difficult. This means that they may be particularly good at topics such as maths or history, but struggle with subjects such as philosophy, religious education or creative arts
 
As they get older, children with Asperger’s Syndrome may become aware that they are different from others. This can lead to a sense of isolation or depression, especially if they have trouble building a circle of friends. Helping them develop some insight into the condition is an important step towards adjusting to, or at least coping with, the way the rest of the world works.
 
With the right sort of support and encouragement, many with Asperger’s Syndrome can lead a relatively normal life. Some do very well, especially in an environment or job where they can use their particular talents.