Your Health - Asperger Syndrome

Asperger Syndrome

(Asperger Disorder)

Definition

Asperger syndrome is one of the pervasive developmental disorders resulting in social and behavioral problems. Autism is another condition within this category. Asperger syndrome is viewed by some scientists as a distinct disease; others see it as a less severe type of autism. Children with Asperger syndrome usually have normal intelligence and do not have the language problems typical of autism.

Causes

The cause of Asperger syndrome is unknown. Some experts believe a variety of factors may be responsible for the faulty brain development.

Infant Brain—Period of Rapid Development

Risk Factors

Asperger syndrome is more common in boys.

Symptoms

Symptoms usually become noticeable around 2-½ or 3 years of age. Symptoms may range from mild to severe and can include:

Difficulty interacting with others
Trouble making friends
Poor understanding of other people's feelings
Insensitivity to social cues and facial expressions
Inappropriate social and emotional responses
Preoccupation with one's own world
Not sharing enjoyment, interests, or achievements with others
Following repetitive routines or rituals
Difficulty with any changes in routine or schedule
Single mindedness
Limited interests, usually one or two subjects
Repeating words or phrases over and over
Intense interest in a few topics
Good rote memory without understanding the information
Limited verbal skills or using words in odd ways
Difficulty imagining things or thinking abstractly
Taking things very literally
Focusing on small details and having trouble seeing the bigger picture
Ability to read without understanding the words
Problems with nonverbal communication
Poor eye contact
Few facial expressions, except for anger or unhappiness
Impaired body posturing or use of gestures
Clumsy movements
Hand flapping
Poor coordination
Inflexibility or trouble accepting change
Difficulty accepting loss or criticism
Obsessive desire to finish any tasks that are started

Diagnosis

There are no tests for Asperger syndrome. The diagnosis is based on observations of the child's behavior. Neuropsychological and IQ tests may be given. Medical tests may be ordered to help rule out other conditions. Children and their families can benefit from early intervention. Knowing what is wrong also helps families understand why the child acts differently than other children.

Treatment

There is no treatment to cure Asperger syndrome. Treatments aim to control symptoms and improve social skills. Patients often learn to function independently as adults. However, they usually continue to experience problems with social interaction. They also may develop mental health problems, such as depression and anxiety. Children with Asperger syndrome need love and understanding, as well as a structured schedule.

Therapies include:

Medication

Drugs to help control symptoms may include:

Stimulants
Mood-altering drugs
Drugs to control seizures
Serotonin selective reuptake inhibitors (SSRIs)—such as citalopram (eg, Celexa), sertraline (eg, Zoloft), fluoxetine (eg, Prozac), paroxetine (eg, Paxil CR)
Neuroleptics—such as risperidone (eg, Risperdal)

Counseling

Behavior modification therapy and training can help children develop social skills. Learning how to make and keep friends is difficult for these children. As they grow up, many find the lack of friends troubling.

Family Care

Caring for a child with Asperger syndrome can be very stressful. Counselors help parents learn how to manage the child's behavior. Suggestions include:

Give warnings that an activity is about to end and provide ways to "save" the task for later. For instance, a favorite television show may be recorded for later viewing.
Try to incorporate some flexibility into the day.
Set limits on the amount of time the child can spend on a single, obsessive activity.
Keep directions simple.
Use precise words.
Limit choices to two or three things.
Avoid using figures of speech.
Make lists.
Do not assume a child with this disorder understands what has been said simply because he can repeat it back to you.
Start explaining at an early age what is appropriate behavior for public and private places.
Do not make idle threats or promises.
Give praise for accomplishments, especially social skills.

Educational Needs

Children with Asperger syndrome usually have a normal IQ. but have special educational needs. They often can attend regular schools. Teachers should be informed of the child's needs. Children with Asperger's syndrome may be teased or bullied because they seem different.

Prevention

There are no guidelines for preventing Asperger syndrome.

RESOURCES:

Asperger and Autism Information by MAAP Services
http://www.asperger.org/

Online Asperger Syndrome Information and Support
http://www.udel.edu/bkirby/asperger/

CANADIAN RESOURCES:

Autism Society Canada
http://www.autismsocietycanada.ca/index_e.html/

Online Asperger Syndrome Information and Support
http://www.udel.edu/bkirby/asperger/suppCAN.html/

References:

Asperger Syndrome Coalition of the United States website. Available at: http://www.asc-us.org.

Carpenter, LA, Sprate, EG, Macias, MM. Asperger syndrome. MedLink Neurology website. Available at: http://www.medlink.com. Accessed Feb 4, 2009.

Cashin A, Sci DA. Two terms-one meaning: the conundrum of contemporary nomenclature in autism. J Child Adolesc Psychiatr Nurs. 2006;19:137-144.

National Autistic Society website. Available at: http://www.nas.org.uk/.

National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/.

National Organization for Rare Disorders website. Available at: http://www.rarediseases.org/.

Nelson Textbook of Pediatrics.16th ed. Philadelphia, PA: WB Saunders Company; 2000.

Nass R, Ross G. Developmental Disabilities. In: Bradley WG, ed. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth Heinemann Elsevier; 2008.

Online Asperger Syndrome Information and Support website. Available at: http://www.udel.edu/bkirby/asperger/. .

Last reviewed January 2009 by J. Thomas Megerian, MD, PhD, FAAP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.