Understanding Asperger's Syndrome

Think back to the days of grade school. Can you remember a few children, usually boys, who were a bit different from the other kids? Maybe they were noisier than the others, and made odd, distracting noises and constantly wiggled and rocked while sitting at their desks. Maybe they waved their hands and knew all the answers and talked on and on about favorite subjects, always standing too close. Maybe they never raised their hands, never seemed to have any friends and never looked anyone in the eye. They were often teased, chased, shoved, tripped, called names and bullied. These children probably had Asperger's syndrome, but no one knew much about it then.

Asperger's syndrome (AS) is on the end of the autism spectrum and is the mildest and highest functioning form of autism. Asperger's is a relatively new term for a category of developmental disorders having come into general use in the last fifteen years. Students with AS are commonly seen in mainstream educational settings and they are often misdiagnosed or undiagnosed.

Asperger's is a neurologically-based disorder of development, usually of unknown cause, typically affecting the areas of social skills, language and communicative skills and certain behavioral characteristics involving repetitive features and a limited, but intense, range of interests. Individuals with AS have a normal to very superior IQ. They also have a more typical language function compared to other disorders along the spectrum.

The presence of normal basic language skills is felt to be one of the criteria for the diagnosis of Asperger's syndrome although there are almost always more difficulties with social language. Many researchers feel it is the relative strength of these two areas that distinguish AS from other forms of autism and account for the better prognosis in Asperger's syndrome.

There is much controversy among specialists regarding whether there is any difference between AS and what is termed high functioning autism (HFA). Some researchers feel there may be multiple underlying subtypes and mechanisms behind the broad clinical picture of Asperger's syndrome.

Asperger's syndrome is much more common in boys than girls, but the reason for this is unknown. Asperger's is commonly associated with other types of diagnoses such as tic disorders like Tourette disorder, attention problems, depression and anxiety. The reason for this is also unknown. Genetic factors are more common in AS than in classic autism and in some cases there is a clear genetic component with one parent, often the father, showing either the full picture of Asperger's or at least some traits of AS.

Often, a fairly high rate of depression in relatives of children with AS is seen, suggesting a genetic link in some instances. It appears likely that in Asperger's syndrome as well as in autism, the clinical picture is influenced by many factors, including genetic ones, so there is no one single identifiable cause.

The following criteria has been proposed by the Swedish physician, Christopher Gillberg, for the diagnosis of Asperger's syndrome: Social impairment with extreme egocentricity, which may include:

INABILITY TO INTERACT WITH PEERS:

Lack of desire to interact with peers
Poor appreciation of social cues
Socially and emotionally inappropriate responses

LIMITED INTERESTS AND PREOCCUPATIONS:

More rote than meaning
Relatively exclusive of other interests
Repetitive adherence

REPETITIVE ROUTINES OR RITUALS:

Imposed on self or Imposed on others

SPEECH AND LANGUAGE PECULIARITIES:

Delayed early development possible but not consistently seen
Superficially perfect expressive language
Odd prosody, peculiar voice characteristics
Impaired comprehension including misinterpretation of literal and implied meanings.

NONVERBAL COMMUNICATION PROBLEMS:

Limited use of gesture
Clumsy body language
Limited or inappropriate facial expression
Peculiar "stiff" gaze

DIFFICULTY ADJUSTING PHYSICAL PROXIMITY:

Does not understand/respect others 'personal space', may stand too close etc.
Motor clumsiness

As is common in most conditions, not all of the above traits may necessarily be part of the picture in all cases.

Sources:

http://www.asperger.org/Publications/Stephen_Bauer_Article.asp

http://autism.suite101.com/article.cfm/mainstream_education