Asperger's Syndrome
Asperger's syndrome is an autism spectrum disorder marked by challenges with social interactions and restricted or repetitive patterns of behavior, interests, and activities.
Individuals with autism have symptoms that fall on a continuum—and since Asperger's syndrome is now a part of the autism spectrum, it is commonly believed that individuals with Asperger's syndrome have high-functioning autism. The term is still used widely, though it is no longer an official diagnosis in the DSM-5.
Asperger's syndrome was delineated in the DSM-IV, and was then folded into the diagnosis of autism spectrum disorder in the DSM-5. (For more on autism, see here.) Symptoms include:
- Atypical verbal and nonverbal communication
- Inability to engage in typical back and forth conversation
- Inability to reciprocate social or emotional feelings
- Not seeking to share enjoyment, interests, or achievements with others
- Failure to develop and maintain peer relationships
- Inflexibility about specific routines or rituals
- Intense preoccupation with a narrow area of interest
- Repetitive finger tapping, twisting, or whole-body movements
- Unusually sensitive to sensory aspects of the environment
A trained mental health professional can diagnose autism by observing a child’s behavior and gathering information from parents and caregivers. Behavioral assessments explore a child’s communication abilities, social skills, and imaginative play. There is currently no biological marker, such as a blood test or brain scan, that can diagnose the condition.
It can be difficult to identify autism or Asperger’s in adulthood, because cases tend to be mild, but the diagnosis can be life-changing for some. Signs that an adult may have Asperger’s syndrome include specific or rigid daily routines, difficulty understanding another person’s perspective or emotions, a preference to avoid eye contact, strong reactions to specific sights, sounds, or textures, and passion for a specific topic such as puzzles or a TV show character.
Although many people colloquially refer to Asperger's syndrome, it is no longer a clinical diagnosis. The DSM-IV contained separate diagnoses for autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified. The current version of the DSM, the DSM-5, combined those diagnoses into the overarching autism spectrum, which is how clinicians now refer to the condition.
Scientists still don't fully understand what gives rise to Asperger's syndrome. There is a genetic component to autism, because the condition tends to run in families. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Research indicates that there may be a common group of genes whose variations or deletions make an individual vulnerable to developing Asperger's syndrome with varying severity and symptoms.
Research also points to brain abnormalities. Scientists have revealed structural and functional differences in specific regions of the brains in children with autism. These differences are most likely caused by the abnormal migration of embryonic cells during fetal development that affects brain structure and goes on to alter the neural circuits that control thought and behavior.
Certain environmental factors also elevate the risk of developing Asperger's syndrome, such as older parental age, exposure to certain drugs or illnesses in utero, and low birth weight.
About 1 in 54 children has autism, according to the Centers for Diseases Control and Prevention. Boys are four times more likely to be diagnosed with autism than girls. Prevalence estimates for Asperger’s syndrome vary, but research suggests that it may affect .06 percent of the population.
The number of people diagnosed with autism has risen over time, from around 1 in 10,000 in the 1960s to about 1 in 54 today. This trend likely has to do with new diagnostic criteria that capture more cases, as well as increased awareness among clinicians and families.
There is currently no cure for Asperger's syndrome—and some debate if a cure should even be a clinical goal. Treatment focuses on developing relevant skills and addressing any co-occurring conditions such as ADHD, anxiety, sleep problems, or gastrointestinal trouble.
An effective treatment program builds on the child's interests, offers a predictable schedule, teaches tasks as a series of simple steps, actively engages the child's attention in highly structured activities, and provides regular reinforcement of behavior. This includes:
- Applied behavior analysis, which focuses on improving communication, relationships and life skills by understanding the components of behaviors and reinforcing those behaviors
- Social skills training, which teaches skills to interact more successfully with others
- Cognitive behavioral therapy, which is a form of talk therapy that helps to manage emotions and reduce obsessive interests and repetitive routines
- Occupational or physical therapy for children with sensory integration problems or poor motor coordination
- Specialized speech or language therapy to help with the pragmatics of speech
- Parental training of behavioral techniques and support
- Medication for co-existing conditions such as depression and anxiety
People with Asperger’s syndrome may need support and accommodations for school, employment, and housing. Although these domains can be challenging to navigate, special education services are available at schools and universities and companies are increasingly implementing programs and services for those with Asperger’s. Housing options include living independently, with family, in an autism community, and in a group home.
Neurodiversity is a movement that accepts and supports neurological differences, such as autism, ADHD, dyslexia, rather than approaching them as diseases that need to be treated or cured. Neurodiversity embraces the benefits that can accompany Asperger’s syndrome, such as thinking differently, approaching problems from a unique lens, attention to detail, and savant abilities.