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What is Asperger’s Syndrome?
Asperger’s Syndrome (AS) is an autistic spectrum disorder. AS is a developmental disorder characterized by limited interests and impairment in language and communication skills, with difficulty integrating socially.
AS may also be characterized by:
repetitive routines or rituals
peculiarities in speech and language, such as speaking in an overly formal manner or in a monotone, or taking figures of speech literally
socially and emotionally inappropriate behavior and the inability to interact successfully with peers
problems with non-verbal communication, including the restricted use of gestures, limited or inappropriate facial expressions, or a peculiar, stiff gaze
clumsy and uncoordinated motor movements
Children with AS appear to develop cognitively at a normal rate alongside their peers, however they lack social and non-verbal communication skills to create and maintain friendships.
*See attachment for DSM IV diagnostic criteria
Symptoms in Children
One of the first symptoms that may emerge in children with AS include an obsessive interest in a specific object or subject to the extent that other activities are excluded from the realm of interest. The child will know everything about that specific topic and his or her conversations will center on that focus of interest.
Children with AS have difficulty matching the level or tone of their voice to their surroundings.
Developmental delays with motor skills are common, such as difficulty pedaling a bike or catching a ball.
Children with AS are not withdrawn like other children on the autistic spectrum. They do however become isolated because of their lack of social skills.
Prevalence
Incidence
It is predicted that 2 out of every 10,000 children have AS (NIH)
Other research suggests it may be as high as 1 in every 1000 or even 1 in every 385 children (Buettel, 2006)
Gender
Boys are three to four times more likely than girls to have the disorder.
Cause?
Recently, researchers are looking at a genetic component as a possible cause of AS. Brain imaging techniques have shown structural and functional differences that may occur from abnormal cell migration during fetal development.
Treatment
The most effective treatment will address the child’s poor communication skills, repetitive routines, and physical clumsiness.
There is no specific treatment or therapy for children with AS, but rather an integration of techniques and programs that fit the child’s needs and behaviors.
It is important that the treatment program builds off of the child’s interests, provides a predictable schedule, teaches activities in small steps, engages the child in structured activity, and gives encouragement through reinforcement of behavior.
Important and effective techniques include:
social skills training, a form of group therapy that teaches children with AS the skills they need to interact more successfully with other children
cognitive behavioral therapy, a type of “talk” therapy that can help the more explosive or anxious children to manage their emotions better and cut back on obsessive interests and repetitive routines
medication, for co-existing conditions such as depression and anxiety
occupational or physical therapy, for children with sensory integration problems or poor motor coordination
specialized speech/language therapy, to help children who have trouble with the pragmatics of speech – the give and take of normal conversation
parent training and support, to teach parents behavioral techniques to use at home
One study has made a different treatment proposal, suggesting the advantages of animal assisted psychodynamic psychotherapy (Topel, 2008). With animal assisted therapy, an animal is chosen to become a part of the treatment to improve social and emotional functioning.
In an academic setting, it may be helpful for the child to have time outside and away from social settings and demands (Buettel, 2006)
Long-term Outlook
Many children with AS may develop anxiety or depression in young adulthood; other possible conditions include ADHD, tic disorders, and OCD.
With treatment, children with AS can lead a functional life. Many adults with AS work in mainstream jobs and can support themselves. These adults will continue to cope with their disabilities and may still find difficulty in creating and maintaining social relationships. Moral support and encouragement are still important and beneficial in helping adults with AS.
Sources:
http://www.ninds.nih.gov/disorders/asperger/detail_asperger.html
Buettel, Monica P. "Exploring current knowledge on Asperger syndrome and best practices for school-based intervention" School Psychology Quarterly. Vol.21(3), Fall 2006, pp. 349-357.
Miller, Judith N; Ozonoff, Sally. "The external validity of Asperger disorder: Lack of evidence from the domain of neuropsychology". Journal of Abnormal Psychology. Vol.109(2), May 2000, pp. 227-238
Topel, Eva-Maria; Lachmann, Frank M. "Life begins on an ant farm for two patients with Asperger's syndrome" Psychoanalytic Psychology. Vol.25(4), Oct 2008, pp. 602-617.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: Autism