Asperger syndrome (AS), also known as Asperger's or Asperger disorder, is a developmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behaviour and interests.
Doctors used to think of Asperger's as a separate condition. But in 2013, the newest edition of the standard book that mental health experts use, called The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), changed how it's classified.
Today, Aspergers syndrome is technically no longer a diagnosis on its own. It is now part of a broader category called autism spectrum disorder (ASD). This group of related mental health issues shares some symptoms.
The condition is what doctors call a "high-functioning" type of ASD. This means the symptoms are less severe than other kinds of autism spectrum disorders.
In 2015, Asperger's was estimated to affect 37.2 million people globally and more often affects males than females. People with Asperger's have normal to above-average intelligence but typically have difficulties with social interactions and often have pervasive, absorbing interests in special topics.
What Causes Asperger Syndrome?
Researchers and mental health experts are still investigating the causes of Asperger’s. Brain abnormalities are thought to be one possible cause of Asperger’s, because structural and functional differences have been seen with advanced brain imaging.
Genetics might play a role, and research indicates that some cases of Asperger’s may be associated with other mental health problems such as depression and bipolar disorder. Environmental factors are also believed to play a role.
Asperger syndrome is not caused by emotional deprivation or the way a child was brought up. Because some behaviours seen in Asperger’s may be thought of as intentionally rude by others, many people wrongly assume that Asperger’s is the result of bad parenting, but it isn't. It's a neurobiological disorder whose causes are not yet fully understood.
Signs and Symptoms
Signs can begin as early as infancy and typically last through a person's entire life.
If you are a mom or dad of a kid who has Asperger’s, you may notice that he can't make eye contact. You may also find that your child seems awkward in social situations and doesn't know what to say or how to respond when someone talks to him.
The following behaviours are often associated with Asperger syndrome. However, they are seldom all present in any one individual and vary widely in degree:
"robotic" or repetitive speech
lack of social awareness
lack of interest in socializing/making friends
difficulty making and sustaining friendships
inability to infer the thoughts, feelings, or emotions of others
either gazing too intently or avoiding eye contact
lack of changing facial expression, or use of exaggerated facial expressions
lack of use or comprehension of gestures
inability to perceive nonverbal cues or communications
failure to respect interpersonal boundaries
unusually sensitive to noises, touch, odours, tastes, or visual stimuli
inflexibility and over-adherence to or dependence on routines
stereotypical and repetitive motor patterns such as hand flapping or arm waving
tendency to discuss self rather than others
difficulties with understanding the subtle use of language, such as irony or sarcasm
Often, the symptoms of Asperger syndrome are confused with those of other behavioural issues such as attention deficit and hyperactivity disorder (ADHD). Indeed, many persons affected by Asperger syndrome are initially diagnosed with ADHD until it becomes clear that their difficulties stem more from an inability to socialize than an inability to focus their attention.
For instance, someone with Asperger syndrome might initiate conversations with others by extensively relating facts related to a particular topic of interest. He or she may resist discussing anything else and have difficulty allowing others to speak. Often, they don’t notice that others are no longer listening or are uncomfortable with the topic. They may lack the ability to “see things” from the other person’s perspective.
He also may dislike change. For instance, he may eat the same food for breakfast every day. He might also do the same movements over and over.
Asperger syndrome often remains undiagnosed until a child or adult begins to have serious difficulties in school, the workplace or their personal lives. Indeed, many adults with Asperger syndrome receive their diagnosis when seeking help for related issues such as anxiety or depression.
Diagnosis tends to centre primarily on difficulties with social interactions.
If you notice signs in your child, see your paediatrician. He can refer you to a mental health expert who specializes in autism spectrum disorders (ASDs), like one of these:
Psychologist. He diagnoses and treats problems with emotions and behaviour.
Paediatric neurologist. He treats conditions of the brain.
Developmental paediatrician. He specializes in speech and language issues and other developmental problems.
Psychiatrist. He has expertise in mental health conditions and can prescribe medicine to treat them.
The condition is often treated with a team approach. That means you might see more than one doctor for your child's care.
The doctor will ask questions about your child's behaviour, including:
What symptoms does he have, and when did you first notice them?
When did your child first learn to speak, and how does he communicate?
Is he focused on any subjects or activities?
Does he have friends, and how does he interact with others?
Then he'll observe your child in different situations to see firsthand how he communicates and behaves.
Treatment is aimed at improving poor communication skills, obsessive or repetitive routines and physical clumsiness.
Every individual is different, so there isn't a one-size-fits-all approach. Your doctor might need to try a few therapies to find one that works.
Treatments can include:
Education and academic skills: A child who receives a diagnosis of AS can benefit from educational support. Aims can include organizing notes, managing homework goals, and addressing any specific learning needs. Most children with AS are best suited to a mainstream school environment.
Acquiring appropriate social skills: The individual can learn strategies to enhance their interactions with others, for example, by learning how to read and respond to social cues.
Communication skills training: Specialized speech and language therapy can help the person learning how to start and maintain a conversation, for example. This also includes learning how to use tone of voice in questions, confirmations, disagreements and instructions, and how to interpret and respond to verbal and non-verbal cues.
Cognitive behavioural therapy (CBT): The person learns to control emotions and decrease obsessive interests and repetitive routines.
Behaviour modification: This includes strategies for supporting positive behaviour and decreasing ineffective behaviour.
Occupational or physical therapy: This can help those with sensory integration problems or poor motor coordination.
Medication: There are no medications for AS, but drugs may be used to treat symptoms such as anxiety.
With the right treatment, your child can learn to control some of the social and communication challenges he faces. He can do well in school and go on to succeed in life.
How Can I Help My Child?
Asperger’s brings challenges for kids and their parents, but you can help your child adjust and offer support in many ways:
Look into educational or training programs for parents. You are your child's first teacher and you'll continue to be the cornerstone in supporting his or her development.
Teach your child self-help skills. Learning these skills helps kids achieve maximum independence.
Because it's not always obvious that a child has AS, tell others that your child has special needs. As a parent, you may have to be an educator when dealing with teachers, medical personnel, and other caregivers.
Find a treatment or intervention program tailored to your child's specific issues or areas of deficiency.
Choose special programs or treatments that focus on long-term goals and are suited to your child's developmental level.
Remember that your child is part of a family, and that his or her needs should be balanced with those 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 have support groups at a local hospital or mental health centre.
What is the Outlook for Asperger Syndrome?
Children with Asperger syndrome are at risk of developing other mental health conditions, such as depression and anxiety disorders. There are various treatment options available for these conditions.
Because the level of intelligence often is average or higher than average, many people with Asperger syndrome are able to function very well. They may, however, continue to have problems socialising with others through adulthood.
When social, behavioural, and educational support is provided as needed, people with Asperger’s can be expected to lead happy and productive lives.
Can Asperger Syndrome Be Prevented?
Asperger syndrome cannot be prevented or cured. However, early diagnosis and treatment can improve function and quality of life.
The Bright Side
It is very important to note that the challenges presented by Asperger syndrome are very often accompanied by unique gifts.
Today, many experts in the field stress the particular gifts and positive aspects of Asperger syndrome and consider it to represent a different, but not necessarily defective, way of thinking. Positive characteristics of people with Asperger syndrome have been described as beneficial in many professions and include:
the increased ability to focus on details,
the capacity to persevere in specific interests without being swayed by others' opinions,
the ability to work independently,
the recognition of patterns that may be missed by others,