Asperger's Syndrome: Diagnostic Criteria, Facts & Treatment

Asperger's Syndrome

A form of neurological disorder named after Viennese physician Hans Asperger, who described a pattern of behaviors in a number of young boys who had average intelligence and language capabilities, yet also exhibited autistic-like behaviors and deficiencies in both social and communication skills. Despite publication of a paper in the 1940's, Asperger syndrome was not added to the DSM-IV until 1944. The syndrome has only been recognized by professionals and parents in the past few years.

Main Document

"Some people with Asperger's are highly successful and were not diagnosed with anything, but were viewed as eccentric, brilliant, socially inept, absent-minded, and a bit physically awkward."

Asperger's syndrome is a developmental disorder that is an autism spectrum disorder (ASD), a part of a distinct group of neurological conditions.

Characteristics of the disorder also include repetitive or restrictive patterns of thought and behavior. Unlike persons with autism, people who have Asperger's syndrome retain their early language skills. Perhaps the most distinguishing symptom of Asperger's syndrome is a child's obsessive interest in a particular object or topic to the point of exclusion of any other. A child with Asperger's desires to know everything about the topic they are interested in; their conversations with other people involve little but their interest in that particular topic.

With a high vocabulary level and expertise on a subject, persons with Asperger's may come across as, 'professorial.' Additional characteristics persons with the disorder have include repetitious rituals or routines, peculiarities in language and speech, emotionally or socially inappropriate behaviors, as well as an inability to interact successfully with others. They may also experience issues with non-verbal communications, or be uncoordinated in their motor movements, appearing clumsy. Children with Asperger's syndrome can experience a sense of isolation due to poor social skills and narrow interests. While they may approach others, their tendency towards either eccentric or inappropriate behavior, or a desire to speak about a single interest might make conversation exceptionally difficult. Children with the disorder commonly have a history of developmental delays related to motor skills where things such as riding a bike, climbing outdoor equipment, or catching a ball are concerned. Their walk can appear stilted or bouncy and they may be awkward or poorly coordinated.

Diagnosing Asperger's Syndrome

At this time medical science is struggling to define exactly where Asperger's syndrome fits in the medical realm. Some professionals believe that it is the same as high-functioning autism, although others believe it is better described as a, 'Non-verbal Learning Disability.' Asperger's has many of the same characteristics of Pervasive Developmental Disorder. Asperger's was relatively unknown not that long ago; many persons with the syndrome were initially diagnosed with Attention Deficit Disorder or ADHD, only to be re-diagnosed with Asperger's syndrome. Some people who were diagnosed with Pervasive Developmental Disorder are now diagnosed with Asperger's, while others have a dual diagnosis of Asperger's and High Functioning Autism.

'Asperger's syndrome,' is a term that is used when either a child or an adult exhibits some features of autism, yet may not have a complete clinical picture. There is disagreement in the medical field regarding where Asperger's fits in the PDD spectrum. Some people with Asperger's are highly successful and were not diagnosed with anything, but were viewed as eccentric, brilliant, socially inept, absent-minded, and a bit physically awkward. While the criteria state no significant delay in development of language, people with the syndrome may exhibit a, 'different,' use of language. Children with the disorder might have an excellent vocabulary, yet not understand the nuances of language and have difficulties with language pragmatics. They may experience weak social pragmatics as well, leading them to appear to be socially, 'different.'

When a medical profession attempts to diagnose Asperger's syndrome, they take into account a number of criteria. The criteria they take into account are as follows:

Diagnostic Criteria For 299.80 Asperger's Disorder

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

1.) Marked impairments in the use of multiple nonverbal 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

B. 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

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

E. 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

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

Treating Asperger's Syndrome

Treating Asperger's syndrome ideally involves therapies which address three core symptoms of the disorder.

• Poor Communication Skills
• Obsessive or Repetitive Routines
• Physical Clumsiness

There is no one, single best treatment, 'package,' for every child or adult with Asperger's syndrome. The majority of professionals agree that the earlier a person with the disorder receives treatment the better. Effective treatment programs build on the person's interests, offer predictable schedules, teach tasks as a series of simple steps, and actively engage the person's attention in structured activities. They also give the person consistent reinforcement regarding their behavior. The program can include cognitive behavioral therapy, social skills training, medication for any co-existing conditions, as well as additional measures.

Pursuit of effective treatment can give persons with Asperger's syndrome the ability to cope with the disability, but they can still find social situations and personal relationships to be difficult. Adults with Asperger's are often able to successfully work in mainstream jobs, even though they may need continued moral support and encouragement in order to maintain an independent lifestyle.

Social Aspects of Asperger's Syndrome

Persons with Asperger's experience difficulty reading nonverbal cues such as body language and often have trouble determining things like appropriate body space. They are often overly sensitive to tastes, smells sounds, and sights. People with Asperger's can prefer things like specific foods, soft clothes, and may be bothered by lights or sound that nobody else appears to see or hear. They perceive the world differently, so it is important to remember that it is their neurological differences that cause these behaviors and not intentional rudeness, bad behavior, a lack of intelligence, or, 'bad parenting.'

Persons with Asperger's syndrome have a regular I.Q. - many people affected by the disorder have exceptional skills or talents related to a specific area. Due to their high degree of functionality and naivete, persons with Asperger's are many times seen as being either odd or eccentric and may become the victims of either bullying or teasing. Persons with Asperger's syndrome tend to be very literal and have a hard time using language in social contexts. During social interactions, persons with Asperger's may avoid the gaze of another person and turn away from them, even as they greet the other person. While they want to interact with others, they have trouble knowing how to do so. They are capable of learning how to interact with others, much in the same way anyone else would learn a new skill. While they may have a more difficult time doing so, adults with Asperger's syndrome can have relationships, families, as well as both happy and productive lives.