August 18, 2004, KidsHealth.org
Asperger syndrome (AS) is a neurobiological disorder that is part of a group of diagnoses called "autistic spectrum disorders." The term "autistic 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. Children with AS share many of the same symptoms as children with "high-functioning autism."
It's estimated that over 400,000 families are affected by AS. Because milder cases are being identified more frequently, the incidence appears to be increasing. However, like other autistic spectrum disorders, AS is often difficult to diagnose and treat.
What Is 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. A large number of children are diagnosed after the age of 3, with most diagnosed between the ages of 5 and 9.
Asperger Syndrome is characterized by poor social interactions, obsessions, odd speech patterns, and other peculiar mannerisms. Children with AS often have few facial expressions and have difficulty reading the body language of others; they may engage in obsessive routines and may display an unusual sensitivity to sensory stimuli (for example, they may be bothered by a light that no one else notices or prefer to wear clothing made only of a certain material). Overall, people with AS are quite capable of functioning in everyday life, but they 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 the course of 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 your child's doctor or other health professional make evaluate your child's symptoms. It's not uncommon for a child to be diagnosed with attention deficit hyperactivity disorder (AD/HD) before the diagnosis of AS is made later on.
The following are a number of signs and symptoms that might be present in a child with AS:
It's important to note that, unlike children with autism, children with AS may 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 may be very literal, and they may 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 individuals with AS may have problems with attention span, problems with organization, and skills that seem well developed in some areas and lacking in others, they usually have average and sometimes above average intelligence.
- inappropriate or minimal social interactions
- conversations almost always revolving around self rather than others
- stilted 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 above-average verbal cognitive abilities
- average to below-average nonverbal cognitive abilities
- awkward movements
- odd behaviors or mannerisms
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 wih 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 in the condition.
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 a person 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 - children with AS become adults with AS. But many individuals with AS lead full and happy lives, and the likelihood of achieving this is enhanced with appropriate education, support, and resources.
Diagnosis of Asperger Syndrome
Asperger syndrome can be very difficult to diagnose. Children with AS function well in most aspects of life, and so it may be easy to attribute their strange behaviors to their 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 child's 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 the child's 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.
Treatment of 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:
It will help if you involve all of your child's caregivers in his 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 any other person who cares for your child should also be involved.
- parent education and training
- specialized educational interventions for the child
- social skills training
- language therapy
- sensory integration training for younger children, usually performed by
- an occupational therapist, in which a child is desensitized to stimuli to which he is overly sensitive
- psychotherapy or behavioral/cognitive therapy for older children
It's important to know that there are many people who can provide support and treatment for your child. Finding the right program for your child is key, and getting help early is important. Children with AS can and do experience great gains with the appropriate treatment and education.
Helping Your Child
Although AS presents challenges for both affected children and their parents, there are a number of steps you can take to help your child adjust and help support his progress.
The Future for Your Child
- Look into educational or training programs for parents. You are not only your child's first teachers; you will also continue to be the cornerstone in supporting your child throughout his development.
- Teach your child self-help skills. Encouraging him to learn these skills will help him achieve maximum independence.
- Because it's not always obvious to others that your child has AS, alert others to the fact that he 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.
- When seeking a program for your child, try to find one 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 needs should be balanced with the needs 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.
Currently, there are few facilities specifically dedicated to providing for the needs of children 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 children with AS go to special schools for children 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.