Asperger's syndrome, a developmental disorder, is an ASD (autism spectrum disorder). It impacts on the individual's ability to communicate and socialize, among other things.
According to the National Institutes of Health1, children with Asperger's Syndrome (AS) retain their early language skills.
Contents of this article:
You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.
Fast facts on Asperger's syndrome
Here are some key points about Asperger's syndrome. More detail and supporting information is in the main article.
- Asperger's syndrome is an autism spectrum disorder that impacts on a person's communication and socialization abilities.
- A person with Asperger's syndrome has difficulty responding to the body language, facial expressions and tone of voice of others - leading to anxiety and confusion.
- A child with Asperger's syndrome may show signs of the disorder within their first year of life.
- Asperger's syndrome is more common in males than females.
- Signs of Asperger's syndrome include, obsessive interests, formal speech, rituals, social isolation, delay in motor skills, lack of imagination and sensory difficulties.
- The cause of Asperger's syndrome is unknown - genetic and environmental factors may be involved.
- Early diagnosis is often complicated due to each individual having varying combinations of symptoms.
- Diagnosis, in many cases, occurs during adulthood.
- There is no cure for Asperger's syndrome. However, there are several therapies and strategies that can improve symptoms.
- Various therapies, teaching of strategies, and other approaches can have a positive impact on the quality of life of a person with Asperger's syndrome.
What is Asperger's syndrome?
When humans meet they make judgments about each other. People's body language, facial expressions and tone of voice give out information regarding whether they are happy, sad, angry or in a hurry. How we respond depends on how we process these signals.
For a person with Asperger's syndrome, reading these signals instinctively is more difficult. Consequently, they find it more difficult to communicate and interact with others. According to the National Autistic Society2 in the UK, this can lead to anxiety and confusion.
Asperger's syndrome differs from other ASDs in that the symptoms are less severe and there is no language delay. A child with AS generally has good language and cognitive (thinking, intelligence) skills. They tend to have average or above-average vocabularies and reach speech milestones at the same time as children in the general population
The Autism Society3 in Maryland, USA, says that most people who are unfamiliar with AS may just think that the individual is behaving differently.
A child with autism is usually perceived as aloof and not interested in mixing in with others. Children with AS, however, generally want to interact with others. The problem is that they find it hard.
The individual with AS may find it hard to understand conventional social rules and may come over as lacking empathy. Their usage of gestures may appear either lacking or inappropriate, and eye contact may be very limited.
Unlike other children (and adults) with an ASD, those with AS (Asperger's syndrome) have average IQs and are pretty much just as likely to have learning disabilities as those without AS. However, their learning requirements may be different from other childrens'.
Asperger's syndrome was named after Austrian pediatrician Hans Asperger, who first described the disorder in 1944. However, the syndrome was not recognized as a unique disorder until later on.
Autism Awareness Ribbon - awareness and recognition of Asperger's syndrome continues to grow
A child with AS may show signs of the disorder during the first year of life. Parents or caregivers may sense that there is something unusual about their infant - their motor skills may appear uncoordinated, the way they crawl or walk might be awkward or clumsy, or just slightly different. As the baby grows into a toddler, there may be a certain amount of clumsiness.
Experts at Great Ormond Street Hospital for Children4 in London says that in many cases, the AS child's difficulties are not formally recognized until the demands of their environment increase, as may be the case when they leave primary and start secondary school.
Experts say that Asperger's syndrome is much more common in males than females.
Asperger's syndrome is not a disease, it is a syndrome. A syndrome is a collection of symptoms that occur together with a condition.
People with AS have the same life expectancy as in the general population, and are no more or less susceptible to diseases or infections as others.
The likelihood of developing depression later on in life is higher for those with AS, but this is probably a consequence of years of living with the stresses and anxieties that come with coping with life in a "non-AS" world.
Video - What is Asperger's Syndrome?
In this video, a young woman talks about her life with Asperger's Syndrome. How she reacted to her diagnosis when she was 9 or 10 years old, the bullying she experienced at school, and how she enjoys going to college.
What are the signs and symptoms of Asperger's syndrome?
What is the difference between a sign and a symptom? A symptom only the patient feels and describes, such as a headache or blurry vision, while a sign can be detected by other people, such as inflammation, dilated pupils, or a rash.
Asperger's syndrome is a wide spectrum disorder. This means that not all people have the same symptoms; they vary enormously from person-to-person. Below are some of the most common signs and symptoms:
- Obsessive interests. Some children with Asperger's syndrome have become experts in a single object or topic. This often excludes any other subject. This compulsive interest can range from vacuum cleaners, car models, trains, computers or even objects as strange as kitchen equipment or lawn mowers. These activities usually involve collecting, numbering or listing.
Some are exceptionally knowledgeable in their chosen field of interest. The topic of conversation with others will focus on their special interest. While individuals with AS may present many facts about their interest, the National Library of Medicine5 mentions that "there will seem to be no point or conclusion."
- Speech is formal or distinct - there may be a lack of rhythm or intonation in how a person with AS speaks. Their utterances may come out as flat, monotonous, or unusually slow or fast.
Children with AS commonly lack the ability to modulate the pitch of their voice to match their immediate surroundings. Sometimes there may be a problem in using the right amount of volume.
They may often sound much older than they are. Teachers or family members may describe their speech as that of a "little professor".
- Routines. In an effort to lessen confusion, people with AS may have rules and rituals which they methodically maintain. They are anxious and upset if there is a disruption to their set of patterns. Parents and adults with AS say that the ability to adapt to change is there, even a change of routine, as long as the person knows well in advance. A surprise change in routine can sometimes cause upset or anxiety.
Non-functional routines are also common in people with Asperger's syndrome. A child may insist on going to school using exactly the same route every time, or dress in a specific order. According to NAMI6, "These nonfunctional routines can be of critical importance to the child with Asperger. Given a choice in clothing, the child might create what seems like a uniform that is worn day after day."
- Social isolation. Adults and children with Asperger's syndrome are often isolated because of their poor social skills and narrow interests, i.e. they end up alone a lot. They can become withdrawn and seem uninterested in other people, appearing distant or aloof. Normal conversation may be challenging, because of inappropriate and/or odd behavior. There is a tendency to only talk about their singular interest. Making friends, as well as keeping them is often a problem.
In many cases, the person wants to have friends and mix in, but finds it hard. After trying and trying without much success, there is a risk the child (and adult) may find it safer and less troublesome to be alone. However, being alone might not be ideal. Contact with others, "brushing" with others in our herd, helps people with AS overcome some of their difficulties.
- Delay in motor skills. Usually, children with Asperger's syndrome have developmental delays in motor skills, such as pedaling a bike, running, catching a ball, playing ball games, or climbing. They are often clumsy and poorly coordinated. Carrying out specific detailed tasks, such as tying shoelaces may require extra effort. The way they walk can appear either stiff or bouncy. Arms may not swing while walking, but just hang down (like they would if one were carrying shopping).
Researchers from Sweden wrote in the journal Physiotherapy Theory and Practice7 that people with Asperger's syndrome who were physically active tended to have better gross motor function compared to those who were less active.
- Social skills and communication. Sometimes, people with Asperger's syndrome have difficulty to express themselves emotionally and socially. They find it difficult to understand and interpret gestures, facial expressions or tone of voice. They lack the basic social skills most other people take for granted. The natural ability of knowing when to start or end a conversation may be weak. They do not easily understand jokes, humor, figures of speech and irony.
Childhood banter (or adult's too) may cause distress and confusion. They are not aware of the commonly accepted social rules such as the appropriate distance to stand next to another person or choosing suitable topics of conversation. Also, they may intrude into other people's personal space unintentionally.
The Asperger's Association of New England8 explains that people with AS do not pick up much of the non-verbal social cues conveyed to them. They may simply not be aware of this information, while the cues that they do notice are commonly misinterpreted. This can result in "frustratingly awkward social interactions and ineffective behavioral responses."
- Imagination. People with this syndrome can have difficulty with social imagination. They may have trouble imagining alternative outcomes to situations. Make-believe games may seem pointless, impossible to do, or ridiculous.
Topics based on logic, memory and systems are more interesting (mathematics, computer science and music). Many children with Asperger's syndrome are exceptionally talented or skilled in those particular areas.
Two researchers from the University of Cambridge in England wrote in the Journal of Autism and Developmental Disorders9 that children with AS could offer imaginative suggestions to a situation presented to them, but they tended to be reality-based imaginings, rather than creative ones.
For example, when presented with a rectangular foam shape, they might say that it could be squashed into a flat rectangle, rather than imagining something like a kite floating in the sky among the clouds and seagulls, with a goblin sitting on top.
- Sensory difficulties. In some individuals, the sensory sensitivity is distorted. One or all of the senses (sight, sound, smell, touch, or taste) can be altered. The senses are either intensified or underdeveloped. People with the syndrome might have different perceptions of loud noises, bright lights, intense smells, food textures and materials. Many people with AS say that if they know a noise or smell is going to come, they can cope with them well - often, it is an unexpected sensation that causes distress.
A team of Finnish researchers wrote in the journal Neuroscience Letter10 that auditory sensory processing is weak in children with AS. They suggested that this weakness "might be implicated in the perceptual problems encountered by children with AS."
- Related conditions. In early childhood, children with Asperger's syndrome are often extremely active. Later, in young adulthood they may develop anxiety or depression. Other conditions related with the syndrome are Attention Deficit Hyperactivity Disorder (ADHD), depression, tic disorders (such as Tourette syndrome), anxiety disorders, and Obsessive-compulsive disorder (OCD).
What causes Asperger's syndrome?
The exact cause of Asperger's syndrome is unknown. Research suggests that a combination of genetic and environmental factors may account for changes in brain development. The fact that Asperger's syndrome tends to run in families suggests that a predisposition to develop the disorder may be inherited. The syndrome may be passed on from parent to child.
In 2009 a team of scientists at the University of Cambridge in England identified 27 genes linked to either:
- Asperger's syndrome.
- Autistic traits.
- Empathy problems.
Some researchers suggest environmental factors during pregnancy may have an impact (viral or bacterial infection, mother smoking during pregnancy, the age of the father, air contamination and exposure to pesticides).
The State Government of Australia11 states adamantly that Asperger's syndrome is not caused by choices of parenting styles, junk food, television, tantrums, or family situations.
Kids Health12, part of the Nemours Foundation, among the world's largest non-profit organizations dedicated to children's health, says that researchers believe brain abnormalities may be linked to AS. Advanced brain imaging technology has identified structural and functional differences in specific regions of the brain among people with AS.
How is Asperger's syndrome diagnosed?
There is no specific test for Asperger's syndrome. Physical tests, such as hearing, blood tests or X-rays may be used to rule out other health conditions and to determine whether there is a physical disorder causing the symptoms. Because it is a wide-spectrum disorder, all AS people have varying combinations of symptoms, early diagnosis is often difficult.
The National Institute of Neurological Disorders and Stroke12 says that there are so many different screening instruments currently being used, each one with a different criteria, that the same child could be diagnosed completely differently, depending on which tool the doctor decided to use. For the child and his or her parents, tragically, being accurately diagnosed can be a bit like getting the right number in a lottery.
In many cases this can delay the diagnosis until adulthood.
For a child to be accurately diagnosed, the State Government of Victoria11 in Australia says that the assessment should be carried out by a "specialized pediatrician who works with a team of specialists, such as a psychologist and speech pathologist, to conduct an in-depth assessment of the child's skills and abilities."
The individual is directly assessed and observed. In the case of diagnosing children, parents are required to give detailed information about the symptoms. Observations from teachers are also taken in to account in the evaluation. When assessing adults, many professionals also wish to talk to the person's parents, spouses, and close family members in order to find out about their developmental history.
Diagnosis helps the individual, their families, friends, partners and colleagues to have a better understanding of their needs and behaviour. Once the syndrome is identified, the specific support required can be analysed.
What are the treatment options for Asperger's syndrome?
Currently, there is no way of reversing Asperger's syndrome. But there are several therapies and strategies that can improve functioning, reduce anxiety, and improve behaviors and the perception and delivery of data and events. With the increasing understanding of the syndrome, people with AS today have a better chance of reaching their full potential.
A combination of therapies, teaching of strategies, and some other approaches can have a significant impact on the quality of life of a person with Asperger's syndrome. Problems and issues related with routines, obsessive thoughts and behaviours, communication skills, inhibition, dexterity, clumsiness, anxiety, etc. may include the following:
- Acquiring more suitable social skills - the individuals learns how to interact more effectively and successfully with other people. The approach focuses on the ability to understand other people's feelings and respond accordingly. This training teaches how to read and respond appropriately to social cues. It is possible to learn how to improve one's empathy.
- Communication skills training. This training helps develop the ability to start conversations. This can include specialized speech and language therapy to help handling normal conversations. Learning how to use intonation in the interrogative, affirmative, negative and imperative forms can help a person with AS considerably. Also, learning how to interpret language, verbal and non-verbal, in order to know how to respond or interact properly helps the person with AS become less islolated.
- Cognitive behavioral therapy. This therapy focuses on learning to control emotions and decrease obsessive interests and repetitive routines.
- Behavior modification. This includes strategies for supporting positive behavior and decreasing problem behavior.
- Occupational or physical therapy. This can be useful for individuals with sensory integration problems or poor motor coordination.
- Medication. There are no medications to treat Asperger's syndrome itself. Drugs may be used to treat particular symptoms and co-existing conditions (depression, anxiety, hyperactivity, obsessive-compulsive behavior).
- Alternative medicine. Some studies suggest that special diets, such as gluten-free diets and vitamin supplements can be beneficial. Anecdotal evidence suggests that a regular intake of fish oils may help with anxiety, and some cognitive issues.
Training and providing support to parents, caregivers and other household members is important. Sometimes people in the household, usually the parents, may need emotional and psychological support themselves - especially if diagnosis did not occur early.
Education and academic skills - some children with AS benefit from an educational approach that provides them not only with certain kinds of support, such as organizing notes, homework, timetables, but also certain learning needs. If the approach is well organized, long-term, and carried out by trained professionals, the child will most likely do well in a mainstream school environment.
Although the core characteristics of Asperger's syndrome will be there for life, the majority of children with AS can lead happy and fruitful lives, well into adulthood and old age. Early intervention and support significantly increase this likelihood.
For the person with Asperger's syndrome as well as parents and family members, life can sometimes feel lonely and tiring. The AS person struggles with the social isolation and other things that the disorder brings, while the rest of the household either look on helpless, or become involved in confrontations and misunderstandings.
An AS child's moment of desperation and seeming fury is easily perceived as a tantrum by a spoilt kid when this occurs in public places - this can be embarrassing for the child, and upsetting for the parent who imagines everybody around blames over-indulgence and a lack of firm discipline.
Fortunately, more people know about Asperger's syndrome, and its recognitions continues to spread. There is much more help and support today than even ten years ago.
The individual with AS, and his/her family and close friends benefit greatly by reading up on AS. Most problems with Asperger's syndrome arise from ignorance (not all), and the more you know, the better you will understand what is going on, why and what expectations to have, and also what to do about certain things.
As children with AS might not appear to be as forthcoming with their emotions and thoughts, it is important that family members learn to read their signs and cues, and respond to them. Not only does that help not isolate the child, but also encourages the development of communicative skills.
With a keen eye and understanding, parents can learn what makes a child with Asperger's syndrome thrive, and what has the opposite effect. Unless otherwise told to do so by an expert, avoid situations which may distress or upset the child. Make sure the child is aware of any changes in routine, teach him/her what acceptable and unacceptable is, practice them and provide vital feedback.
If you can, seek out a school with well trained professionals who have experience with children with AS. Talk to them about your child's education, ask them to explain what they have in mind for him/her and what support there might be.
Make sure certain people, such as sports coaches, scout masters, etc. know your child has AS. If they are unsure what to do, make a decision there and then - either explain what the best approaches are, or take the child away and find an alternative activity.
Video - Asperger's syndrome
This short video documentary shows how somebody who was diagnosed with Asperger's Syndrome in 2002 perceives his life, that of others, and copes.
Some parents have succeeded in channeling an Asperger's syndrome child's obsessive tendencies into themes which may eventually provide him/her with a career. Examples include mathematics, information technology, ecosystems, and some other sciences.
A child with AS typically becomes fixated on a narrow range of topics - something those around him/her may find tiresome. There are hundreds of subjects, sports and other activities to choose from.
Exposing the child to a wide range of options, and a certain amount of your own involvement, may help him/her select something useful and productive for which they eventually have a passion.
Recent developments on Asperger's syndrome from MNT news
In what is deemed the first large-scale clinical study of its kind, researchers from the University of Cambridge in the UK suggest that adults who have Asperger's syndrome are at much higher risk of experiencing suicidal thoughts than the general population.