What Is Asperger’s Syndrome?

Overview

Asperger's syndrome, sometimes described as high-functioning autism, is a part of an umbrella group of disorders called autism spectrum disorders (ASD). It is a developmental disorder characterized by difficulty in socializing and exhibiting social skills.¹ Children diagnosed with this disorder have difficulties relating to people and possess rigid thinking patterns. Difficulty making friends, clumsiness, inability to understand emotions and often coming off as rude and tactless are a few of their characteristics. They perceive the world differently from others. Children or adults with Asperger's syndrome are also known to have a limited range of interests, rigid routines, and repetitive behaviors making them averse to change. Unlike autistic people, they do not have learning disabilities although they do have learning difficulties. They also have average or higher-than-average language and intelligence levels when compared to other folks.

Boys are more likely to have Asperger's syndrome than girls in a ratio of 3-4:1. Most cases are usually diagnosed after the age of 3, most likely between 5 and 9 years of age. This is mostly during the early school years. Most adults who have excellent skills and have conformed to societal expectations may have missed being diagnosed in childhood.

According to the DSM-5 classification,² the autistic spectrum of disorder includes:

• Autistic Disorder
• Asperger’s Disorder
• Childhood Disintegrative Disorder
• Pervasive Developmental Disorder Not Otherwise Specified

Causes of asperger’s syndrome

The etiology of Asperger's syndrome is still unknown. The likely factors include:

•  Some events during pregnancy and delivery of a child could lead to the development of this disorder
• Things like teratogens, toxins, low birth weight, viral agents(like cytomegalovirus), maternal obesity, and maternal diabetes are factors still being researched as possible causes of Asperger's syndrome
• Genetics may also play a role in Asperger's syndrome. Some studies have shown that in some families, there are multiple cases of the syndrom

Signs and symptoms of asperger’s syndrome:

People with Asperger's syndrome show the following characteristics:³

Social problems:

Children with Asperger's syndrome have poor social skills. Their low emotional and limited interests make their childhood and subsequently their adulthood lonely and isolated. Some of their social challenges are:

• Absent/limited social interaction
• Difficulty making/sustaining friendship
• Difficulty relating with peers/age mates
• Failure of sustaining normal conversations
• Reduced sharing of interests and emotions

Difficulty showing facial expressions, gaze, and feelings

Communication abnormalities:

Having Asperger's syndrome makes communication difficult and sometimes impossible for the children diagnosed with it. Noticing any of the following in your children could be a pointer to them having the disorder.

• Poor nonverbal communication
• Avoiding eye contact
• Abnormal body language
• Abnormalities in understanding gestures and in using them.
• Inability to keep secrets

Stereotyped and repetitive behaviours:

Children with Asperger's syndrome have narrowed interests and can get so fixed on doing certain things or repeating certain behaviour. They could even throw tantrums when you break the cycle on something that has caught their interest. Some stereotypes are:

• Repetitive motor movements such as rocking, hand or finger flapping, toe walking
• Repetitive and restricted use of objects (or even preoccupation with a part of an object)
• Restricted and repetitive speech
• Masters of routines generally

Other symptoms:

There are other myriads of symptoms people with this disorder have but they aren't limited to the following:

• Artistic interest
• Speech differences
• Delayed motor development
• Development of harmful psychological problems
• Detail-oriented personality
• Persistence
• High integrity
• Management and treatment for Asperger’s syndrome

The diagnosis of Asperger's disorder is made by an experienced pediatric neurologist, child psychologist or psychiatrist, or a developmental psychologist. It can be difficult to make because these children function well in some other aspects of life and their strange behaviours could erroneously be tagged as being different. This is not a one-off assessment as these children can sometimes behave themselves when they are with adults as opposed to their inability to socialize with their peers.  Several visits and interactions may be required. Initial assessment begins with taking the history of behavioural reports at different environments, educational and behavioural interventions and to obtain family history of similar disorders. The diagnostic criteria of DSM-5 arealso very useful at this point. Some assessment tools are employed in addition to looking out for other comorbidities in the child or adult.⁵ 

Genetic testing is also done and some neuroimaging like MRI may be requested if indicated as it is usually not routine. The child psychologist also performs some physical examination for physical abnormalities or any organ involvement.

Once your child has been diagnosed with Asperger's syndrome, treatment/management goals are set based on several factors. These are tailored to meet your child's needs. The various facets of management include:⁴

Behavioural intervention

This is done to improve social interaction and help them develop simple skills that could progress to complex skills over time.

Educational intervention

Educational intervention targets their verbal, nonverbal, motor, social, and language skills. A structured and unique educational plan is laid out for children with Asperger's disorder.

Developmental intervention

This particular intervention is geared towards improving the relationship between patients and adults, especially their caregivers. It targets emotional regulation and also seeks to improve their responsiveness to learning and developing the lacking skills.

Pharmacological intervention

There are currently no core drugs for curing this disorder. Whether your child will need drugs will depend on your health provider's evaluation. Drugs can play a role in situations like aggressiveness, irritability, self-harm, and some other comorbidities like obsessive-compulsive disorders, Tourette syndrome, and even suicidal attempts that may come up in the patient's life. Antidepressants and antipsychotics are some of the drugs used in such cases.

Parent education

People with Asperger's syndrome actually do well with good support. Once they have the love and care they require, they can live fulfilling lives. The training and therapy can help them develop guidelines to enable them to socialize and communicate better. Caregivers of children with Asperger's syndrome are also at risk of developing suicidal ideation as some studies have shown, hence, the need to be placed in support groups where they can be encouraged to care better for their children as well as themselves. They will also be counselled on the need to protect their kids from sexual abuse as children with Asperger's syndrome are more at risk and vulnerable to sexual abuse especially those with additional disabilities.

Others

Physical therapy, speech therapy, and occupational therapy can also be employed in the management of Asperger's syndrome based on the needs of your child at certain stages of life. This helps them to be more independent and have an improved quality of life.⁵

FAQs

How is asperger’s syndrome diagnosed?

Asperger's syndrome is diagnosed by a child psychologist or psychiatrist. This diagnosis is made after thorough history taking has been done to explore the behavioural patterns of the child, environmental factors that could have contributed as well as a family history of similar disorders.

How can I prevent asperger’s syndrome?

Because the cause of Asperger's syndrome is unknown, there are no ways to prevent it from occurring. There is also no cure or remedy. However, most patients go on to lead normal lives while others do so with maximum support from family and therapists.

Who is at risk of asperger’s syndrome?

Several risk factors are associated with developing Asperger's disorder. Boys are three to four times more at risk than girls. Family history of autistic spectrum disorders or mental illnesses, being born to older parents, prematurity at birth, and having some medical conditions like seizure disorders are some of the risk factors.

How common is asperger's syndrome?

Varying estimates exist of how common Asperger's syndrome is. However, some studies done in countries like Sweden and Canada show that about 1:250-300 children have Asperger's syndrome. There's no racial predilection and more males have this disorder compared to females.

When should I see a doctor?

You may need to see a child psychologist/psychiatrist, neurologist or even therapist once you notice your child has some developmental, social, language, or communication abnormality. These specialists will properly manage your child once a diagnosis of Asperger's syndrome has been confirmed.

Summary

Asperger's syndrome is a condition belonging to a group of disorders known as the Autistic spectrum of Disorders (ASD). It is often diagnosed in childhood. Children with this disorder have difficulties establishing good social interaction and they also have language and communication issues. Delayed cognitive and motor development are also noticed in children with this disorder. A pediatric neurologist, psychologist, or psychiatrist isimportant in managing children diagnosed with Asperger's syndrome as they have special needs that must be met. 

There's currently no cure for Asperger's syndrome but medications are for comorbid conditions which are common with them like depression, mania, attention deficiency hyperactivity disorder, social anxiety, and obsessive-compulsive disorder. Drugs like antidepressants and antipsychotics are useful in such cases. Therapies are also essential in the management of patients with Asperger's syndrome; speech therapy, occupational therapy, and physical therapy, which help them become more independent and socially interactive. With the right support, people with Asperger's syndrome can have a better and more fulfilling quality of life and more fulfilling lives.