What is Asperger syndrome?

Asperger 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
* repetitive routines or rituals
* peculiarities in speech and language, such as speaking in an overly formal manner or in a monotone, or taking figures of speech literally
* socially and emotionally inappropriate behavior and the inability to interact successfully with peers
* problems with non-verbal communication, including the restricted use of gestures, limited or inappropriate facial expressions, or a peculiar, stiff gaze
* clumsy and uncoordinated motor movements

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If your grandchild has been newly diagnosed, then welcome to the world of Asperger Syndrome. It is a mysterious and sometimes overwhelming world, but it is not one to be afraid of. Even if you are saddened, disappointed or angry about the diagnosis, keep in mind that it’s for the best. The earlier the diagnosis, the earlier the intervention, and the better the prognosis in the long run. For some grandparents, the news seems to come right out of the blue. Sure, there were difficulties at school - but then, school isn’t as strict as it used to be. And yes, there were some problems at home, but none of them sounded like anything that “good old-fashioned discipline” couldn’t solve. Why, then, do the parents seem to be clinging to this diagnosis as if it were a life-raft in the high seas? And why are counsellors, psychologists, occupational therapists and special education teachers suddenly getting involved?

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Social Communication & Understanding

- Difficulties understanding gestures, body language, and facial expressions.
- Difficulties making eye contact.
- Repetitive speech.
- Difficulties expressing themselves especially when talking about emotions.
- Anxiety in social situations.

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Unofficial

rdos.net
http://www.rdos.net/eng/Aspie-quiz.php

Universidad Tecnica Federico Santa Maria
http://www.alumnos.usm.cl/~davy.bravo/recursos_testasperger.htm

Official (Autism Spectrum Quotient)

OkCupid.com & wired.com
http://www.wired.com/wired/archive/9.12/aqtest.html
http://www.okcupid.com/tests/take?testid=1982215450153908026

Asperger’s Disorder is not widely recognized by the public or by health care providers. What does it mean to have Asperger’s Disorder? Do they have severe AD/HD, mild autism, learning disabilities, or are they just “nerds?”

For years, psychiatrists have debated how to classify and subdivide the category of Pervasive Developmental Disorder (PDD). Pervasive Developmental Disorder is a category that contains several specific diagnoses. Individuals with PDD have problems with the social interaction and often show delays in several other areas. These other areas may include language, coordination, imaginative activities, and intellectual functioning. The degree of severity can vary tremendously in the various forms of PDD. Autism is one of the more severe forms of PDD. An individual with Autism has marked difficulty relating to other human beings. He or she frequently has delayed or absent speech and may be mentally retarded. Asperger’s Disorder is on the milder end of PDD. Individuals with Asperger’s generally have normal intelligence and normal early language acquisition. However, they show difficulties with social interactions and non-verbal communications. They may also show perseverative or repetitive behaviors.

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Hans Asperger (February 18, 1906 – October 21, 1980) was the Austrian pediatrician after whom Asperger syndrome is named.

Life

Born on a farm outside Vienna, Asperger displayed an early talent for languages. He was a member in the youth movements of the 1920s. He studied medicine in Vienna and earned his medical doctorate in 1931, and found his first job a year later as a member of the University Children’s Hospital in Vienna. In 1934, his career developed with a move to the psychiatric hospital in Leipzig.

It is not certain what Asperger did during the early years of World War II. In the later years of the war he was a medical officer in Croatia; his younger brother died in Stalingrad.[1] In 1944, after the publication of his landmark paper describing autistic symptoms, he found a permanent tenured post at the University of Vienna. Shortly after the war ended, he became director of a children’s clinic in the city. He was appointed Chair of Pediatrics at the University of Vienna, a post he held for 20 years. He also later held a post at Innsbruck. Then, beginning in 1964, he headed the SOS-Kinderdorf in Hinterbrühl. During his life, he published over 300 papers, the two major topics being “autistic psychopathy” and “death”.[1]

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History

Named after the Austrian pediatrician Hans Asperger (1906–80), Asperger syndrome is a relatively new diagnosis in the field of autism.[73] In 1944, Asperger described four children in his practice[2] who had difficulty in integrating themselves socially. The children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Asperger called the condition “autistic psychopathy” and described it as primarily marked by social isolation.[4] Unlike today’s AS, autistic psychopathy could be found in people of all levels of intelligence, including those with mental retardation.[74] He called his young patients “little professors”,[75] and believed some would be capable of exceptional achievement and original thought later in life.[2] His paper was published during wartime and in German, so it was not widely read elsewhere.

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Prognosis

As of 2007, no studies addressing the long-term outcome of individuals with Asperger syndrome are available and there are no systematic long-term follow-up studies of children with AS.[3] Individuals with AS appear to have normal life expectancy but have an increased prevalence of comorbid psychiatric conditions such as depression and anxiety that may significantly affect prognosis. Although social impairment is lifelong, outcome is generally more positive than with individuals with lower functioning autism spectrum disorders;[1] for example, ASD symptoms are more likely to diminish with time in children with AS or HFA.[63] Although most students with AS/HFA have average mathematical ability and test slightly worse in mathematics than in general intelligence, some are gifted in mathematics[64] and AS has not prevented some adults from major accomplishments such as winning the Nobel Prize.[65]

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Diagnosis

Standard diagnostic criteria require impairment in social interaction, and repetitive and stereotyped behaviors and interests, without significant delay in language or cognitive development. Unlike the international standard,[6] U.S. criteria also require significant impairment in day-to-day functioning.[13] Other sets of diagnostic criteria have been proposed by Szatmari et al.[43] and by Gillberg and Gillberg.[44]

Diagnosis is most commonly made between the ages of four and eleven.[1] A comprehensive assessment involves a multidisciplinary team[2][4][45] that observes across multiple settings,[1] and includes neurological and genetic assessment as well as tests for cognition, psychomotor function, verbal and nonverbal strengths and weaknesses, style of learning, and skills for independent living.[4] Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior.[45] Many children with AS are initially misdiagnosed with attention-deficit hyperactivity disorder (ADHD).[1] Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age.[46] Conditions that must be considered in a differential diagnosis include other ASDs, the schizophrenia spectrum, ADHD, obsessive compulsive disorder, depression, semantic pragmatic disorder, nonverbal learning disorder,[45] Tourette syndrome,[17] stereotypic movement disorder and bipolar disorder.[26]

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Mechanism

Asperger syndrome appears to result from developmental factors that affect many or all functional brain systems, as opposed to localized effects.[29] Although the specific underpinnings of AS or factors that distinguish it from other ASDs are unknown, and no clear pathology common to individuals with AS has emerged,[1] it is still possible that AS’s mechanism is separate from other ASD.[30] Neuroanatomical studies and the associations with teratogens strongly suggest that the mechanism includes alteration of brain development soon after conception.[27] Abnormal migration of embryonic cells during fetal development may affect the final structure and connectivity of the brain, resulting in alterations in the neural circuits that control thought and behavior.[31] Several theories of mechanism are available; none are likely to be complete explanations.[32]

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