Asperger’s Syndrome (AS)

Asperger’s Syndrome (AS) is a developmental disorder that is characterized by limited interests or an unusual preoccupation with a particular subject to the exclusion of other activities as well as:

  • repetitive routines or rituals.
  • restrictive patterns of thought and/or behaviour.
  • 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.
  • lack of social and emotional reciprocity.
  • 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.
  • excessive interest in one topic to the exclusion of anything else.
  • difficulty modulating stress and volume of voice.
  • no instinctive knowledge of social cues, turn-taking, sharing, etc.

Warning Signs in the Early Years:

  • motor developmental delay.
  • crawling or walking late.
  • more interest in objects than other babies/toddlers.
  • difficulty catching a ball.
  • difficulty climbing outdoor play equipment.
  • difficulty pedalling a tricycle or bike.
  • poorly coordinated walk and difficulty with steps.
  • not responding to name (not turning head when name is said, etc.).
  • not using gestures to point or show.
  • a lack of interactive play.
  • a lack of interest in peers.

Problems in at least one of the areas of communication and socialization or repetitive, restricted behavior must be present before the age of three (3) in order for a diagnosis to be made. In fact, a parent will usually notice something different about his/her child by that age.

Children with AS do not lose their language skills as classic autistic children do, but their delayed motor development and preference for routines and rituals, coupled with a fear of change, are the indicators that professionals rely on when making a diagnosis. More boys than girls are affected by AS, but the reason for this may be that girls usually exhibit symptoms as they get older, while many boys can be diagnosed by the age of five.

We now know that early intervention makes a significant difference in the outcome for those affected by AS.

AS is one of the neurological conditions on the autistic spectrum and has a genetic component although it is still not known to what extent this is a factor. What is known, however, is that the existence of variations of the core AS symptoms in siblings and parents of those diagnosed are a distinct indication that this is the case. Children and adolescents whose AD/HD is difficult to treat effectively often present with lighter forms of the core AS symptoms as well.

Treatment

There is no medication that will “cure” AS, but there are many other interventions that can make a difference in the lives of children and adolescents with AS.

Those considered to be the most effective include:

  • Social Skills Training.
  • Cognitive Behaviour Therapy (CBT).
  • Specialized Speech/Language Therapy.
  • Parent Training.
  • Treating co-existing conditions.

The Importance of a Differential Diagnosis (AS & AD/HD):

Many children who have AS also have AD/HD and it is important that neither condition be excluded from the treatment plan.

If the first diagnosis is for AD/HD, very often all of the child’s symptoms are attributed to AD/HD. However, children with AS will certainly need other interventions to help them manage their lives.

On the other hand, if the child is diagnosed with AS at a young age, the attention problems only become apparent when s/he goes to school. As concentration problems are not a feature of AS, children who present with these, should be evaluated for AD/HD and appropriately treated.

Some children with AS develop psychiatric disorders, such as Depression and/or  Anxiety Disorders, during adolescence and although they learn to manage these conditions, they will always find social interaction and communication challenging.

Unlike children with Autism, children with AS want to interact with their peers, but their AS symptoms make it difficult for them to do so effectively. Thus, as adolescents and adults, they can become an isolated and "at risk" group.

Many adults - who have struggled since their childhood to understand why they could not seem to make friends - are being diagnosed now with AS and this is giving them a new lease of life.

Adapted from the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV TR) and the International Classification of Diseases (1CD-10).


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