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Asperger Syndrome

(Asperger Disorder)
by Debra Wood, RN
Definition

Asperger syndrome is a pervasive developmental disorders resulting in social and behavioral problems. Autism is another condition in this category. Asperger syndrome is viewed by some scientists as a distinct disease; others see it as a less severe type of autism. Children with Asperger syndrome usually have normal intelligence and do not have the language problems typical of autism.

Causes

The cause of Asperger syndrome is unknown. Some experts believe a variety of factors may be responsible for the faulty brain development.

Risk Factors

Asperger syndrome is more common in boys. Family history of autism spectrum disorder may also be a risk factor.

Symptoms

Symptoms usually become noticeable around 2-½ or 3 years of age. Symptoms may range from mild to severe and can include:

  • Ability to read without understanding the words
  • Clumsy movements
  • Difficulty accepting loss or criticism
  • Difficulty imagining things or thinking abstractly
  • Difficulty interacting with others
  • Difficulty with any changes in routine or schedule
  • Few facial expressions, except for anger or unhappiness
  • Focusing on small details and having trouble seeing the bigger picture
  • Following repetitive routines or rituals
  • Good rote memory without understanding the information
  • Hand flapping
  • Impaired body posturing or use of gestures
  • Inappropriate social and emotional responses
  • Inflexibility or trouble accepting change
  • Insensitivity to social cues and facial expressions
  • Intense interest in a few topics
  • Limited interests, usually one or two subjects
  • Limited verbal skills or using words in odd ways
  • Not sharing enjoyment, interests, or achievements with others
  • Obsessive desire to finish any tasks that are started
  • Poor coordination
  • Poor eye contact
  • Poor understanding of other people's feelings
  • Preoccupation with one's own world
  • Problems with nonverbal communication
  • Repeating words or phrases over and over
  • Single mindedness
  • Taking things very literally
  • Trouble making friends
Diagnosis

There are no tests for Asperger syndrome. The diagnosis is based on observations of the child's behavior. Neuropsychological and IQ tests may be given. Medical tests may be ordered to help rule out other conditions. Children and their families can benefit from early intervention. Knowing what is wrong also helps families understand why the child acts differently than other children.

Treatment

There is no treatment to cure Asperger syndrome. Treatments aim to control symptoms and improve social skills. Patients often learn to function independently as adults. However, they usually continue to experience problems with social interaction. They may be at risk for learning disabilities, such as attention deficit disorder (ADD) . They also may develop mental health problems, such as depression and anxiety . Children with Asperger syndrome need love and understanding, as well as a structured schedule.

Therapies include:

Medication

Drugs to help control symptoms may include:

  • Drugs to control seizures
  • Neuroleptics—such as risperidone (eg, Risperdal)
  • Serotonin selective reuptake inhibitors (SSRIs)—such as citalopram (eg, Celexa), sertraline (eg, Zoloft), fluoxetine (eg, Prozac), paroxetine (eg, Paxil CR)
  • Mood-altering drugs
  • Stimulants
Counseling

Behavior modification therapy and training can help children develop social skills. Learning how to make and keep friends is difficult for these children. As they grow up, many find the lack of friends troubling.

Family Care

Caring for a child with Asperger syndrome can be very stressful. Counselors help parents learn how to manage the child's behavior. Suggestions include:

  • Avoid using figures of speech.
  • Do not assume a child with this disorder understands what has been said simply because he can repeat it back to you.
  • Do not make idle threats or promises.
  • Give praise for accomplishments, especially social skills.
  • Give warnings that an activity is about to end and provide ways to "save" the task for later. For instance, a favorite television show may be recorded for later viewing.
  • Keep directions simple.
  • Limit choices to two or three things.
  • Make lists.
  • Set limits on the amount of time the child can spend on a single, obsessive activity.
  • Start explaining at an early age what is appropriate behavior for public and private places.
  • Try to incorporate some flexibility into the day.
  • Use precise words.
Educational Needs

Children with Asperger syndrome usually have a normal IQ but have special educational needs. They often can attend regular schools. They may need extra support in the classroom. Special attention should be paid to building social skills. Teachers should be informed of the child's needs. Children with Asperger's syndrome may be teased or bullied because they seem different.

Prevention

There are no guidelines for preventing Asperger syndrome.

Last reviewed: March 2011 by J. Thomas Megerian, MD, PhD, FAAP.

RESOURCES:
CANADIAN RESOURCES:
References:
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