Asperger’s syndrome is a developmental disorder that was until recently, diagnosed as a separate condition, but is now part of the autism spectrum disorder.
Asperger’s is characterized by difficulty with social interaction, intense or obsessive focus on rules and regulations, and engaging in repetitive behavior.
It is considered to be on the mild end of the autism spectrum and a high functioning disorder as it differs from other autism spectrum disorder by relatively average intelligence and use of language. Physical clumsiness can also be used as diagnoses, and signs of the disorder are noticeable before the age of 2 and last for a lifetime.
There is no known cause for Asperger’s syndrome. Although it has been linked to genetics, it has, however, has not been confirmed conclusively. It has also been associated with environmental factors.
The diagnosis was removed as a separate disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. No treatment exists to cure Asperger’s. The available treatment options aim at reducing obsessive routines and improving communication skills and physical clumsiness.
These include cognitive-behavioral therapy, speech therapy, physical therapy, and medication in case of associated problems such as mood or anxiety.
The symptoms in children typically improve as they become older, but social and communication issues remain. Asperger’s syndrome occurs more in boys than in girls and has been estimated to affect 2.5 out of every 1000 children.
Causes of Asperger’s Syndrome
Asperger’s syndrome, as with all autistic disorders, has no precise cause. It is however believed that there is a hereditary (genetic) component involved.
This hypothesis is supported by the fact that Asperger’s syndrome has been observed to run in families. The disorder has also been attributed to exposure to hazardous toxic elements and teratogen, issues with pregnancy or childbirth, and infections affecting the fetus.
These environmental factors may combine and potentially increase the severity of the underlying inherited trait.
Signs and Symptoms of Asperger’s Syndrome
The symptoms of Asperger’s syndrome varies from one person to another. The signs may appear before the age of two. They include:
- Intense and repetitive focus on one subject at the exclusion of all others. This could involve becoming an expert in activities such as numbering, collecting, or listing
- Lack of rhythm or intonation when speaking. This makes the person sound flat like a robot, monotonous, or unusually slow or fast.
- Obsessive focus on rules and rituals that they maintain to reduce confusion. Any sudden changes in routine may sometimes cause anxiety.
- Poor social skills and the proclivity to talk about their singular interest. This could lead to social isolation as they may seem uninterested in other people or appear distant. People with Asperger’s usually have difficulty making and keeping friends.
- People living with Asperger’s syndrome may experience poor coordination and motor skills, which can make it difficult to perform detailed tasks like writing or tying shoelaces. The person may appear stiff or bouncy while walking, and they may not swing their arms.
- People with Asperger’s may have issues with proximity and may not know how close to stand with another person while conversing.
- The person may have trouble with jokes, irony, and sarcasm. They may interpret these literally and may find it difficult to understand jokes and irony, leading to frustration and confusion.
- It may be hard for a person with Asperger’s to imagine alternative outcomes to events or situations. Hence, role-play and games that deal with imagination may seem pointless.
People with Asperger’s syndrome can sometimes have other associated mental conditions and may display behaviors that are common with other conditions.
Some of the associated conditions include:
- Anxiety disorder
- Attention deficit hyperactivity disorder
- Mood disorders like depression
These difficulties may not often be recognized in childhood until the demands of their environment increases. This can occur as late as early adulthood when the individual has to live without supervision.
The person may, however, have a remarkable focus and persistence, attention to detail, and a knack for recognizing patterns. The person may be exceptionally skilled in music, computer science, and maths.
Diagnosis
Parents typically report observed developmental or behavioral difficulties. Diagnosis is based on interviews with parents, teachers, and even counselors.
The child would be assessed in areas such as social interaction, facial expression while speaking, language development, attitude towards change, motor skills, and the interest in interacting with others.
The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association contains specific criteria that can be used to diagnose recognized psychiatric conditions.
Asperger’s syndrome is listed under the same diagnostic group as people with autism and pervasive developmental disorders.
Complications of Asperger’s Syndrome
Asperger’s syndrome may exist with other conditions such as attention deficit hyperactivity disorder (ADHD) or anxiety disorder.
People with Asperger’s syndrome may have anxiety or hypersensitivity to certain stimuli such as loud noises, despite not having anxiety disorder.
In some cases, disruptive behaviors such as self-injury, tantrums, and aggression, or mood disorders like depression may occur in response to the anxiety and frustration that people with Asperger’s syndrome experience.
The severity of these associated conditions ranges from one person to another. Not all persons living with Asperger’s syndrome will experience psychiatric conditions, disruptive behaviors, or depression.
Treatment
A multidisciplinary approach involving several therapies can be used to limit the effects of the symptoms and improve general well being.
These include:
- Cognitive-behavioral therapy (CBT): This seeks to help the person learn to control emotions and decrease obsessive interests and repetitive routines.
- Behavioral modification: These are strategies that support positive behavior and decrease ineffective behavior.
- Occupational or physical therapy: This used to help those with poor motor skills and helps with issues with sensory integration.
- Education and academic skills: This aims to improve the child’s education growth by addressing learning needs, organizing notes, and managing homework goals.
- Social integration: People living with Asperger’s syndrome can learn approaches that can enhance their interactions with others. This would include learning how to respond appropriately to social cues.
- Speech therapy: This seeks to improve speech and language that can help a person with Asperger’s know how to start and maintain a conversation. It would also include learning how to recognize the tone of voice, affirmations, disagreements, and how to interpret and respond appropriately to verbal and non-verbal cues.
- Medication: This seeks to treat behavioral and psychiatric conditions associated with Asperger’s syndrome. They include Tenex and ReVia to reduce hyperactivity; Abilify to reduce irritability; Risperidone to reduce insomnia and agitation; Selective serotonin reuptake inhibitors (SSRI) to reduce repetitive behaviors.
