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Asperger syndrome

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Smiling Autistic Girl Flaps Hands

"Smiling Autistic Girl Flaps Hands" by autistic artist Luna Rose, who was diagnosed with Asperger Syndrome

Asperger syndrome (or Asperger's disorder), also referred to as Asperger's or just AS, is a Pervasive Developmental Disorder on the Autistic spectrum.

Asperger Syndrome was an official diagnosis under the DSM-IV, but has been removed from the DSM-5, which simply uses the term "Autism Spectrum Disorder."

Children and adults with Asperger Syndrome have an intellectual capacity within or above the typical range, but have a distinct profile of abilities that has been apparent since early childhood.

History

Dr. Hans Asperger, an Austrian pediatrician, described what was subsequently named Asperger syndrome in 1944.[1] He observed in the late 1930's and the early 1940's certain peculiar behavior patterns in some of his patients, mostly male children. These children had around average language skills and intelligence levels.

The children exhibited what were seen to be impaired social skills, and had many other unusual behavioral patterns. They struggled with social interactions, had very few facial expressions, and showed many special mannerisms. For instance, they could not tolerate clothes made of certain materials, would be annoyed at light that was normal for others, or would try to cover their ears to stop listening to normal noises. They would look odd and exceptional by the way they would behave.

The children exhibited intense interests, which they loved to share with others around them. Asperger referred to them as "little professors" because of their extensive knowledge of their favorite subjects. They also had incredible attention to detail and deeply valued honesty. Asperger called the condition "autistic psychopathy" and described it as primarily marked by social isolation.[2]

The report was hidden away for decades until it was revealed in 1981 by English psychiatrist Lorna Wing[3] - a year after Asperger's passing. In 1991, Uta Firth published the work in English.[4] The discovery changed the way the medical world saw autism, which up until that point was limited to the work of Leo Kanner.

The syndrome was included in the ICD-10 in 1992 as a pervasive developmental disorder under section V:F84.[5] This led to it's inclusion in the DSM-IV in 1994. The combination of these classifications led to a large increase of prevalence numbers across the Autistic spectrum. It has more recently been classified as an Autistic spectrum disorder in the DSM-5.[6]

Diagnostic Criteria for Asperger's Disorder (DSM-IV)

The profile of abilities includes the following characteristics:

  1. Qualitative impairment in social interaction, as manifested by at least two of the following:
    1. marked impairment in the use of multiple non-verbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction;
    2. failure to develop peer relationships appropriate to developmental level;
    3. a lack of spontaneous seeking to share enjoyment, interests or achievements with other people (e.g.: by a lack of showing, bringing, or pointing out objects of interest to other people);
    4. lack of social or emotional reciprocity.
  2. Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
    1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;
    2. apparently inflexible adherence to specific, nonfunctional routines or rituals;
    3. stereotyped and repetitive motor mannerisms (e.g.: hand or finger flapping or twisting, or complex whole-body movements);
    4. persistent preoccupation with parts of objects
  3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
  4. There is no clinically significant general delay in language (eg: single words used by age 2 years, communicative phrases used by age 3 years).
  5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood.
  6. Criteria are not met for another specific Pervasive Developmental Disorder, or Schizophrenia.[7]

Causes

The exact causes of this condition are not known. However, most researchers believe that there is an underlying genetic element involved in the development of Asperger syndrome. It is also believed to be linked to certain structural differences in the brain, supporting the concept of Neurodiversity.

Other theories involve a connection to immune system dysfunction. Children with autism spectrum disorders demonstrated increased frequency of immunologic abnormalities including signs of elevated innate and humoral immunity. This theory has not been substantiated however, particularly in relation to Asperger syndrome.

Phil Gluyas believes that the behaviors are inherited from parents who have at least one of the behaviors in the criteria but not all, and that all human beings have at least one behavioral trait.[8]

Helping

There are dedicated facilities for children with AS. However, most children affected with AS flourish in a regular education setting with adequate support from parents, teachers, and their classmates through IEP's. Some children with AS attend special schools dedicated to train and teach children with AS, Autism, and other learning disabilities - such as the Village Glen School in Los Angeles, California.[9] However, the current mindset is that the Inclusion Model is a best practice for those with Asperger Syndrome.

There are a variety of ways that parents and caregivers can help children with the condition.

  • Children should be encouraged to learn to develop a self-help attitude. This will help the affected children to face life confidently, and face life with more independence.
  • Parents should explore the possibilities of getting training and counseling from experts to learn about ways to support the child. The work of autistic writers can offer special insights into what their child experiences and how to help.
  • The child should be treated as the part of the family unit, and his/her requirements should also remain in focus alongside the requirements of other family members. This will make the child's position "normal" within the family, and may encourage him/her to participate in the family affairs to the maximum extent possible.
  • The child should be able to express their own social goals, and to speak up if something is hurting or troubling them, and not fear contempt for such speech.
  • No shortcut method or treatment should be selected for the child. It is always better to have treatments and training programs with long term outlook to guide the long term development of the affected child.
  • Apart from the expert advice, it is also necessary for the parents to try to get support, say from members of their community, such as neighbors and friends. There may be support programs available that are sponsored by the local government, hospitals, voluntary organizations and so on. This is also helpful as others may not be aware about the special needs of the affected child. Seeking such support will alert their friends and neighbors about the special needs of the affected child.
  • Parents should realize that they will need to advocate for their child to foster acceptance, tolerance and education to the rest of society.

References

  1. Baskin JH, Sperber M, Price BH "Asperger syndrome revisited" Vol.3 2006
  2. http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm NINDS: Asperger Syndrome Fact Sheet
  3. http://www.mugsy.org/wing2.htm Asperger's syndrome: a clinical account
  4. Asperger H; tr. and annot. Frith U (1991) [1944]. "'Autistic psychopathy' in childhood". In Frith U. Autism and Asperger syndrome. Cambridge University Press. pp. 37–92. ISBN 0-521-38608-X
  5. http://apps.who.int/classifications/icd10/browse/2010/en#/F84.5 ICD-10 Version:2010
  6. https://web.archive.org/web/20101225152454/http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=97 DSM-5 Development. American Psychiatric Association (archive version)
  7. http://www.medterms.com/script/main/art.asp?articlekey=32505 Diagnostic and Statistical Manual of Mental Disorders
  8. http://www.philgluyas.com/as/genetic.htm Article: Autism is Genetic in Origin
  9. http://www.villageglen.org/about/ About Village Glen School

Further reading

  • The OASIS Guide to Asperger Syndrome: Advice, Support, Insight, and Inspiration (ISBN 0609608118) by Patricia Romanowski Bashe and Barbara L. Kirby
  • Mind Apart: Travels in a Neurodiverse World, Antonetta, Susanne, Trade Cloth, Tarcher, 2005 ISBN: 1585423823
  • Asperger's Answer Book: The Top 300 Questions Parents Ask, Ashley, Susan, Trade Paper, Sourcebooks, 2006 ISBN: 1402208073

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