Asperger
Syndrome is a neurobiological disorder named after the Viennese
physician, Hans Asperger, who in 1944 published a research paper
which described a pattern of behaviors in several young boys
who had normal intelligence and language development, but who
also exhibited autistic-like behaviors and marked deficiencies
in social and communication skills. It wasn't until 1994 that
Asperger Syndrome was recognised a a unique disorder.
Qualitative
impairment in social interaction with at least two demonstrations
of impaired social interaction. The person:
Shows a marked inability to regulate social interaction by using
multiple non-verbal behaviors such as body posture and gestures,
eye contact and facial expression.
Doesn't develop
peer relationships that are appropriate to the developmental
level.
Doesn't seek to
share achievements, interests or pleasure with others.
Lacks social or
emotional reciprocity.
Restricted repetitive
and stereotyped patterns of behavior, interests, and activities,
as manifested by at least one of the following:
Preoccupation
with abnormal (in focus or intensity) interests that are restricted
and stereotyped (such as spinning things).
Rigidly sticks to routines or rituals that don't appear to
have a function.
Has stereotyped, repetitive motor mannerisms (such as hand
flapping).
Persistently preoccupied with parts of objects.
The symptoms cause clinically important impairment in social,
occupational or personal functioning.
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).
There is no clinically
significant delay in cognitive development or in the development
of age-appropriate self-help skills, adaptive behavior (other
than in social interaction), and curiosity about the environment
in childhood.
The patient doesn't
fulfill criteria for Schizophrenia or another specific Pervasive
Developmental Disorder.
Associated
Features:
Associated
features of Asperger's Syndrome which are not required for diagnosis
but are commonly present include delay in motor development
often seen as clumsiness, extreme sensitivities to sensations,
and excessive, but non-interactive, speech when related to areas
of interest. In addition, many children with Asperger's will
have behavior problems due to their difficulty in understanding
the world around them
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise
diagnosis.
Age-appropriate
Behaviors in Active Children.
Mental Retardation.
Under Stimulating Environments.
Oppositional Behavior.
Another Mental Disorder.
Pervasive
Developmental Disorder.
Psychotic Disorder.
Other
Substance-Related Disorder Not Otherwise Specified.
Cause:
Asperger's
Disorder is a milder variant of Autistic
Disorder. Both Asperger's
Disorder and Autistic Disorder
are in fact subgroups of a larger diagnostic category. This
larger category is called either Autistic
Spectrum Disorders or Pervasive
Developmental Disorders. See
Autistic Disorder
Treatment:
There is no specific treatment for Asperger's
Disorder. All the interventions outlined below are mainly
symptomatic and/or rehabilitational.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Individual
psychotherapy to help the individual to process the feelings
aroused by being socially
handicapped.
Parent
education and training.
Behavioral modification.
Social skills training.
Educational interventions.
Pharmacotherapy
[ See
Psychopharmacology Section] :
For hyperactivity,
inattention and impulsivity: Psychostimulants (methyphenidate,
dextroamphetamine, metamphetamine, pemoline), Clonidine, Tricyclic
Antidepressants (desipramine, nortriptyline).
For irritability
and aggression: Mood Stabilizers (valproate, carbamazepine,
lithium), Beta Blockers (nadolol, propranolol), Clonidine,
Naltrexone, Neuroleptics (risperidone, haloperidol).
For preoccupations,
rituals and compulsions: SSRIs (fluvoxamine, fluoxetine),
Tricyclic Antidepressants (clomipramine).
For anxiety:
SSRIs (sertraline, fluoxetine), Tricyclic Antidepressants
(imipramine, clomipramine, nortriptyline)
