On Asperger’s Disorder

In the 1940s, a pediatrician working in a clinic in Vienna named Hans Asperger treated several patients who displayed similar symptoms. However, because his work was conducted during World War II, none of it was seen amongst the English-speaking world so it wasn’t until the 1980s that his work was discovered by the English-speaking community and was translated in 1991 by Uta Frith. The characteristic first described by Hans Asperger became known as Asperger’s Disorder.

What Is Asperger’s Disorder?

Just like all of the Pervasive Developmental Disorders, children with Asperger’s have trouble relating to others.  In some children this means that they do not like interacting with others, or that they do enjoy interacting with others but lack the non-verbal skills (i.e. eye contact, smiling, facial expression, touching) necessary to have full interaction. Having a two way conversation with a child with Asperger’s is often very difficult because they have trouble understanding figures of speech, sarcasm, subtle suggestions and often take speech very literally.  These children are also often unaware of their own behavior and can’t relate to other children at their developmental level.

Children with Asperger’s also often have unusual behaviors and interests. Some children become almost obsessed with an object or ideal to the point that they exclude everything else. For example, a young man I worked with was very interested in sports and would talk you to death about sports, but only sports and if you tried to talk to him about anything unrelated to sports he would just go back to talking about sports. In other children, they may have extreme reactions to simple changes to their environment (i.e. movement of furniture or objects) or routine.

While all children with Asperger’s have impairment in social and behavior functions, the degree of impairment differs in each child. To be diagnosed with Asperger’s the symptoms have to be severe enough that it impacts their life (i.e. school functioning, family function, or social life).

How Does Asperger’s Differ from Autistic Disorder?

Asperger’s differs from Autistic Disorder in that there are no significant delays in cognition or language development.  Many children with Asperger’s have difficulty with non-verbal communication, hand eye-coordination and may appear clumsy. Some children with Asperger’s have an exceptional vocabulary and may speak earlier than expected. Because children with Asperger’s appear to develop normally, they usually aren’t diagnosed before the age of five while children with Autistic Disorder are generally diagnosed earlier. Some people reach all the way to adulthood without being diagnosed with Asperger’s, whereas children with Autistic Disorder generally aren’t expected to live independently.

Risk for Other Issues

Children with Asperger’s Disorder are often also diagnosed with Attention Deficit/Hyperactivity Disorder. They are also at a higher risk for Obsessive-Compulsive disorder. Undiagnosed children with Asperger’s often experience depression and social isolation, especially in their adolescent years when peer interactions and relationships become more important.

Diagnostic Criteria (Diagnostic and Statistical Manual of Mental Disorders IV)

I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects
(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.”

I Think My Child May Have Asperger’s Disorder, What Do I Do?

If you think your child has symptoms of Asperger’s Disorder, contact your physician, school psychologist or a licensed psychologist to initiate an evaluation. Thorough medical, family and developmental histories will be taken, as well as interviews with the family and child as well as behavioral observations to help determine if a diagnosis of Asperger’s Disorder is correct.

All of the interventions and prognosis for Asperger’s Disorder are basically the same for all the other Pervasive Developmental Disorders and you can find those on my post about Pervasive Developmental Disorders.

Resources

Attwood, Tony. (2006) The Complete Guide to Asperger’s Syndrome. Jessica Kingsley Publishers.

Online Asperger Syndrome Information and Support

(OASIS) http://udel.edu/bkirby/asperger/

Center for Autism and Related Disabilities (CARD): http://card.ufl.edu/

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