Asperger’s syndrome is the mildest and highest functioning form of autism on the spectrum. While the term is no longer used as a diagnosis, people with Asperger’s Syndrome have a unique set of characteristics compared to others on the autism spectrum disorder (ASD).
Many doctors still use the term Asperger’s Syndrome, but all autism diagnoses sit under ASD.
What is Asperger’s Syndrome?
Asperger’s syndrome is a developmental disability that affects how a person perceives and interacts with others. There is no longer a separate diagnosis for Asperger’s syndrome. In 2013, the diagnosis changed from Asperger’s syndrome to being on the autism spectrum. However, the World Health Organisation still used the term in 2019 when it released the International Classification of Diseases (ICD) 11th edition.
Asperger’s syndrome affects between 0.03 to 4.84 in every 1,000 people and is four times more common in boys than in girls. But research shows that more women are being diagnosed later in life.
History of Asperger’s Syndrome
An Austrian paediatric psychologist Hans Asperger recognised autism-like behaviours including social and behaviour difficulties in boys in the 1940s. Other doctors believed it was a milder form of autism. In 1994 Asperger’s Disorder was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders(DSM-IV). By 2013 the DSM-5 placed Asperger’s Disorder, Autistic Disorder and other developmental disorders under one umbrella diagnosis called autism spectrum disorder.
What are the Symptoms?
All people with autism spectrum disorder and people previously diagnosed with Asperger’s syndrome may display one or more of the following symptoms:
- Obsessive interest in a single object or topic to the exclusion of any other
- Repetitive routines or rituals
- Peculiarities in speech and language
- Difficulty in understanding others
- Difficulty in social settings and making friends
- Find it hard to work out what others are thinking
- Difficulty in expressing themselves
- Inappropriate behaviour
- Clumsy and uncoordinated motor movements
People with this type of autism have an average or above average level of intelligence and are often quite creative.
How Was Asperger’s Syndrome Diagnosed?
Someone once diagnosed with Asperger’s syndrome, will most likely be diagnosed with ‘high functioning autism’ today, meaning the symptoms are less severe than other forms of autism.
Diagnosis at any early age is difficult because there is no specific test. Blood tests and x-rays are used to rule out other physical disorders and conditions. A doctor may use the following to diagnose the condition in a child:
- abnormal eye contact
- aloofness
- failure to turn when called by name
- failure to use gestures to point and show
- a lack of interactive play
- a lack of interest in peers
The symptoms of Asperger’s are wide ranging and can relate to several other conditions or traits. It often takes a team of health care professionals, parents and teachers to come to a diagnosis.
An adult’s diagnosis may include speaking to parents, spouse and siblings to find out about their development history.
Are There any Treatments for Asperger’s Syndrome?
Like many forms of autism, there is no one single treatment for all children. But most health professionals agree that early intervention leads to better long-term outcomes.
Treatment concentrates on the three main symptoms – poor communication skills, obsessive or repetitive routines and physical clumsiness.
Communication Skills
Speech and language therapy can help with tone of voice and response to verbal and non-verbal cues. Children may be taught socially appropriate behaviour and responses through scripts and story based interventions. They may need to learn how to start and maintain conversations, how to read and respond to social cues.
Obsessive or Repetitive Routines
Psychological therapies such as cognitive behavioural therapy (CBT) may be needed to control emotions and decrease obsessive interests and repetitive routines. It may help in adolescence to assist with anxiety.
Physical
Occupational therapy and physiotherapy may be used to improve poor motor coordination and sensory integration problems.
Treatments may use a child’s strong interest to engage their attention in highly structured activities to provide regular reinforcement of behaviour. Social skills training, cognitive behaviour training and medications for co-existing conditions are all common treatment methods. A predictable schedule can also assist children with Asperger’s syndrome.
Education of family members and caregivers is an important tool in assisting children on the autism spectrum. They can help children better cope with change when they know it’s coming. A greater understanding can develop strategies for understanding their child’s strengths and weaknesses and can help the family cope which can lead to an improved outcome for children.
Doctors may prescribe medicines to help with anxiety, hyperactivity and aggression.
Diet has been linked to autism and studies conducted into special diets, gluten-free diets, vitamin supplements and fish oil with no scientific evidence that any make a significant difference.
Alternative therapies have also been studied. In 2015 a review of studies found anecdotal evidence that music therapy, sensory integration therapy, acupuncture, and massage may help but there was no conclusive evidence that complementary or alternative medicines worked in ASD.
What are the Characteristics of a Person with Asperger’s Syndrome?
A child or adult may have displayed one or more characteristics that led to their diagnosis of Asperger’s syndrome including:
Speech and Language
Delayed early speech development (sometimes)
Flat, monotonous & formal speech
Unusually fast or slow speech
Inappropriate volume
Impaired comprehension
Misinterpretation of literal and impaired meanings
Peculiar voice characteristics
Difficulty understanding irony and sarcasm
Behaviour
Preoccupation with one or more interests
Preoccupation with parts of an object
Inflexible to nonfunctional routines or rituals
Role playing and make believe games may seem pointless
Social
Inability or desire to interact with peers
Difficulty picking up on social cues
Lack of interest in sharing experiences with others
Lack of social or emotional reciprocity
Poor non-verbal behaviour to regulate social interactions
Non Verbal Communication
Physical
Delayed motor skills such as riding a bike
Poor ball catching skills
Difficulty climbing outdoor equipment
Stilted or bouncy walk
Difficulty picking up on social cues
Sensitive to bright light or loud sounds
The signs usually begin before the age of two and last a lifetime. Some children may suffer from sensory problems where their senses are either under or over developed. It can affect the way they perceive noise, light, smell and texture.
While there aren’t many complications related to Asperger’s Syndrome, there are other conditions that are often suffered by those people with an Asperger’s diagnosis including:
Depression (from early adulthood)
Anxiety (from early adulthood)
Attention deficit hyperactivity disorder (ADHD)
Obsessive compulsive disorder (OCD)
Tourette syndrome
How Does Asperger’s Differ from Autism?
It’s a common question but Asperger’s Syndrome doesn’t differ from autism, it’s a form of autism.
Asperger’s syndrome is on the autism spectrum disorder (ASD) with other syndromes that include:
The main difference between Asperger’s and other forms of autism is that those with Asperger’s don’t have a clinically significant cognitive delay. They may appear clumsy or awkward but they have an average to above average level of intelligence.
What Causes Asperger’s Syndrome?
The cause or causes of Asperger’s Syndrome aren’t known but there are some risk factors including:
Hereditary – Autism seems to run in families with common symptoms often seen in family members, particularly fathers. Asperger’s may have a stronger genetic component than other forms of autism.
Environment Factors – Yet to be confirmed but health professionals have researched whether environmental factors in early pregnancy may be a factor. Exposure to teratogens that cause birth defects during the first eight weeks after conception have been considered as possible links but they have confirmed none.
Brain Abnormalities – Imaging has identified structural and functional differences in some regions of the brain amongst people diagnosed with Asperger’s Syndrome. Changes are possibly caused by the abnormal migration of embryonic cells during foetal development that then alters the brain circuits.
What is the Long Term Prognosis for Children with Asperger’s?
The prognosis for children with Asperger’s Syndrome is good with many adults able to work in mainstream jobs. Some adults with Asperger’s use their interest and single mindedness to excel in their careers. They follow their interest and choose careers with limited social interactions.
Many need to continually work on living skills such as conversation, taking an interest in others, friendship maintenance and reading non-verbal communication cues.
Ongoing Research Into Autism
With so many people affected by autism worldwide, there is ongoing research into finding the causes, potential cures and the best way to support people on the autism spectrum and their families. More research is required to answer all the questions relating to autism spectrum disorders.
The National Institute of Neurological Disorders and Stroke (NINDS) is one of the US federal government’s leading supporters of biomedical research on brain and nervous system disorders. For more information, visit http://www.ninds.nih.gov. In Australia, you can visit Autism Awareness Australia.