Prime Health Solutions

Asperger's syndrome, also known as Asperger disorder or Asperger syndrome, is one of a group of neurodevelopmental disorders that have effects on an individual's behavior, use of language and communication, and pattern of social interactions. People with Asperger's syndrome typically have normal to above-average intelligence but typically have difficulties with social interactions and often have pervasive, absorbing interests in special topics.

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
• Intensity
• An original way of thinking.

Social-behavioral symptoms can begin as early as infancy. Characteristic differences are seen in social development, but these changes are hard to identify in toddlers and may be attributed to another condition or not perceived as abnormal. Most cases of Asperger's syndrome are identified when the child is school-aged or older; studies have shown an average age at diagnosis of 11 years. Some of the symptoms that may be present are:

• 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, odors, 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.

Another defining characteristic of Asperger's syndrome is the presence of perseverative and obsessive interests in special topics (such as cars or trains, or even more narrow topics such as vacuum cleaners), which may be of little interest to others:

• These interests are unusually repetitive and intense when compared to other children's interests.
• Specific or narrow interests remain the focus of the child's interest and conversation in spite of efforts to redirect the child's attention.

Diagnosis is based upon interviews and observation of the individual along with interviews of his/her family members and sometimes teachers or counselors. The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and includes the diagnostic criteria for all recognized psychiatric conditions.

Asperger's syndrome may coexist with other psychiatric conditions such as attention deficit hyperactivity disorder (ADHD) or anxiety disorder. Even when anxiety disorder is not present, people with Asperger's syndrome may suffer from anxiety or hypersensitivity to certain stimuli such as loud noises. In some cases, disruptive behaviors (tantrums, self-injury, and aggression) and/or depression may occur in response to the anxiety and frustration experienced by sufferers of Asperger's syndrome. Other behaviors that have been reported in people with Asperger's syndrome include obsessive-compulsive behaviors and difficulties with anger management.

As with any condition, the degree of severity of symptoms can vary widely among individuals, and not all persons with Asperger's syndrome will experience associated psychiatric disorders, depression, or disruptive behaviors.

Treatment of Asperger's syndrome involves a multidisciplinary approach.

Medical therapy is not effective in treating Asperger syndrome, although medications may be prescribed to help control troubling symptoms or symptoms of other psychiatric conditions that may coexist with Asperger's syndrome. In some cases, selective serotonin reuptake inhibitor (SSRI) medications are used for relief of anxiety or depression. Medical treatments for ADHD may also be tried if there is significant hyperactivity and/or distraction.

A number of behavioral therapies and educational interventions can help people with Asperger's syndrome, although all of these may not be necessary in a given individual. The type of interventions chosen must be based upon the individual's age and needs. Types of interventions that have been shown to be of benefit include:

• Efforts to reduce overstimulation or overload of sensory input.
• Supporting executive function skills by provision of an environment that is predictable, structured, and organized.
• Organization skills training.
• Speech/language therapy that addresses the ambiguous use of language and the use of language in social settings.
• Social skills training programs, including training in the awareness of social cognition, use of gestures and facial expressions, and conversational language.
• Adaptive skills or life-skills training.
• Educational supports such as assistance with organization, note-taking, allowing oral rather than written testing, use of scripts, and assistance with reading comprehension and subtlety of language use.
• Self-advocacy training.

There is no one single cause for the development of autism spectrum disorders, including Asperger’s syndrome. However, when considering the complexity of the disorder and the fact that symptom severity varies, there are likely many different causes. Some current theories include:

Genetic: Research has determined that several genes appear to be involved in autism spectrum disorder. In some children, the presence of Asperger’s syndrome can be associated with genetic disorders, such as Rett syndrome or Fragile X syndrome. Additionally, genetic changes may make a child more susceptible to autism spectrum disorder or create the possibility for environmental risks. Furthermore, other genes may affect brain development or the way in which brain cells communicate, or will determine the severity of symptoms.

Physical: Brain imaging studies have shown that there are structural and functional differences in specific areas of the brain of those who have Asperger’s versus those who do not. These differences may be caused by abnormal migration of the embryonic cells during fetal development, which then affects the way in which the brain is wired and further goes on to affect the neural circuits that control thought and behavior.

Environmental: Researchers are also exploring the impact that environmental factors, such as viral infections, prenatal complications, and air pollutants, may play in the development of autism spectrum disorders, like Asperger’s syndrome.

Risk Factors:

• Being male.
• Family history of autism spectrum disorders or other mental health conditions.
• Being born 10+ weeks premature.
• Having another medical condition, such as Fragile X syndrome, tuberous sclerosis, epilepsy, and Tourette syndrome.
• Being born to older parents