An Autism Spectrum Disorder
Asperger syndrome (AS) is a neurobiological disorder that is
part of a group of conditions called
autism spectrum disorders
. The term "autism spectrum" refers to a range of
developmental disabilities that includes
autism
as well as other disorders with similar characteristics.
They are known as spectrum disorders because the symptoms of
each can appear in different combinations and in varying degrees of
severity: two children with the same diagnosis, though they may
share certain patterns of behavior, can exhibit a wide range of
skills and abilities.
As a result, general terms such as "low-functioning,"
"high-functioning," "autistic tendencies,"
"pervasive developmental disorder," and others are often
used to describe children whose behaviors fall within the spectrum.
Kids with AS share many of the same symptoms as those with
"high-functioning autism."
It's estimated that more than 400,000 families are
affected by AS. Because milder cases are being identified more
frequently, the incidence appears to be increasing. However, like
other autism spectrum disorders, AS is often difficult to diagnose
and treat.
About Asperger Syndrome
The disorder is named after Hans Asperger, a Viennese
pediatrician who, in 1940, first described a set of behavior
patterns apparent in some of his patients, mostly males. Asperger
noticed that although these boys had normal intelligence and
language development, they had severely impaired social skills,
were unable to communicate effectively with others, and had poor
coordination.
According to the Asperger Syndrome Coalition of the United
States, the onset of AS is later than what is typical in autism -
or at least it is recognized later. Many kids are diagnosed
after age 3, with most diagnosed between the ages of 5 and 9.
AS is characterized by poor social interactions, obsessions, odd
speech patterns, and other peculiar mannerisms. Kids with AS often
have few facial expressions and have difficulty reading the body
language of others; they might engage in obsessive routines and
display an unusual sensitivity to sensory stimuli (for example,
they may be bothered by a light that no one else notices; they may
cover their ears to block out sounds in the environment; or they
might prefer to wear clothing made only of a certain material).
Overall, people with AS are capable of functioning in everyday
life, but tend to be somewhat socially immature and may be seen by
others as odd or eccentric.
Other characteristics of AS include motor delays, clumsiness,
limited interests, and peculiar preoccupations. Adults with AS have
trouble demonstrating empathy for others, and social interactions
continue to be difficult. Experts say that AS follows a continuous
course and usually lasts a lifetime. However, symptoms can wax and
wane over time, and early intervention services can be helpful.
Signs and Symptoms
Because the symptoms of AS are often hard to differentiate from
other behavioral problems, it's best to let a doctor or other
health professional evaluate your child's symptoms. It's
not uncommon for a child to be diagnosed with
attention deficit hyperactivity disorder (ADHD)
before a diagnosis of AS is made later.
These signs and symptoms might be present in a child with
AS:
- inappropriate or minimal social interactions
- conversations almost always revolving around self rather than
others
- "scripted," "robotic," or repetitive
speech
- lack of "common sense"
- problems with reading, math, or writing skills
- obsession with complex topics such as patterns or music
- average to below-average nonverbal cognitive abilities,
though verbal cognitive abilities are usually average to
above-average
- awkward movements
- odd behaviors or mannerisms
It's important to note that, unlike kids with autism, those
with AS might show no delays in language development; they usually
have good grammatical skills and an advanced vocabulary at an early
age. However, they typically do exhibit a language disorder - they
might be very literal and have trouble using language in a social
context.
Often there are no obvious delays in cognitive development or in
age-appropriate self-help skills such as feeding and dressing
themselves. Although kids with AS can have problems with attention
span and organization, and have skills that seem well developed in
some areas and lacking in others, they usually have average and
sometimes above-average intelligence.
What Causes Asperger Syndrome?
Researchers and mental health experts are still investigating
the causes of autism and AS. Many believe that the pattern of
behavior that characterizes AS may have many causes. There seems to
be a hereditary component to AS, and research indicates that in
some cases AS may be associated with other mental health disorders
such as
depression
and bipolar disorder. Researchers are also looking into whether
environmental factors that affect brain development might play a
role.
Contrary to the incorrect assumptions some may make about people
with the disorder, AS is not caused by emotional deprivation or the
way a person has been brought up. Because some of the behaviors
exhibited by someone with AS may be seen by others as intentionally
rude, many people wrongly assume that AS is the result of bad
parenting - it isn't. It's a neurobiological disorder whose
causes are not yet fully understood.
Currently, there is no cure for the disorder - kids with AS
become adults with AS. But many lead full and happy lives, and the
likelihood of achieving this is enhanced with appropriate
education, support, and resources.
Diagnosing Asperger Syndrome
Asperger syndrome can be very difficult to diagnose. Children
with AS function well in most aspects of life, and so it can be
easy to attribute their strange behaviors to just being
"different."
According to mental health experts, if your child has AS, early
intervention is very important. Intervention involving educational
and social training, performed while a child's brain is still
developing, is highly recommended.
If your child exhibits some of the symptoms and behaviors that
are typical of AS, it's critical to seek help from your doctor.
He or she can refer you to a mental health professional or other
specialist for further evaluation.
When a specialist assesses your child, a thorough
"psychosocial" evaluation will be performed. This
includes a careful history of when symptoms were first recognized,
the child's development of motor skills and language patterns,
and other aspects of personality and behavior (including favorite
activities, unusual habits, preoccupations, etc.).
Particular emphasis is placed on social development, including
past and present problems in social interaction and development of
friendships. A psychological evaluation and assessment of
communication skills are usually conducted to determine your
child's strengths and skills that may be deficient.
Treating Asperger Syndrome
Because AS can present patterns of behaviors and problems that
differ widely from child to child, there isn't a
"typical" or prescribed treatment regimen. However, your
child may benefit from the following forms of treatment:
- parent education and training
-
specialized educational interventions
for the child
- social skills training
- language therapy
- sensory integration training for younger kids, usually
performed by an occupational therapist, in which they
are desensitized to stimuli to which they're overly
sensitive
- psychotherapy or behavioral/cognitive therapy for older
children
- medications
It will help if you involve all of your child's caregivers
in the treatment. The health professionals who are caring for your
child should know what the others are doing, and you will often
find yourself acting as the "case manager" in this
scenario. Teachers, babysitters, other family members, close
friends, and anyone else who cares for your child also should be
involved.
It's important to know that many people can provide
assistance. Finding the right program for your child is key and
getting help early is important. Kids with AS can and do experience
great gains with the appropriate treatment and education.
Helping Your Child
Although AS presents challenges for affected kids and their
parents, you can help your child adjust and offer support in many
ways:
- Look into educational or training programs for parents.
You're your child's first teacher and you'll continue
to be the cornerstone in supporting his or her development.
- Teach your child self-help skills. Learning these skills
helps kids achieve maximum independence.
- Because it's not always obvious that a child has AS,
alert others to the fact that your child has special needs. As a
parent, you may have to take on the role of educator when dealing
with teachers, medical personnel, and other caregivers.
- Find a program that addresses your child's specific needs
or areas of "deficiency." The Autism Society of America
(ASA) encourages family members to talk to the program director
to determine if the curriculum or program addresses their
child's particular issues.
- Choose special programs or treatments that focus on long-term
outcomes and that take the developmental level of your child into
consideration.
- Remember that your child is part of a family unit and that
his or her needs should be balanced with the those of other
family members.
- Get support for yourself and other family members. You
can't help your child if you are not meeting your own
emotional and physical needs. Your community may offer support
groups at a local hospital or mental health center. There is
considerable state-to-state variation in the types of
government-sponsored services and other programs available to
children with autism spectrum disorders and their families.
Your Child's Future
Currently, few facilities are specifically dedicated to
providing for the needs of kids with AS. Some children are in
mainstream schools where their progress depends on the support and
encouragement of parents, caregivers, teachers, and classmates.
However, some go to special schools for kids with autism or
learning disabilities.
Many people with AS can function well in most aspects of life,
so the condition does not have to prevent your child from
succeeding academically and socially.
You may feel overwhelmed and discouraged if your child is
diagnosed with AS. Remember that your child's treatment team
can provide enormous support and encouragement for your child - and
your family.
Reviewed by:
Steven Dowshen, MD
Date reviewed: April 2008
Originally reviewed by:
Anne M. Meduri, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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