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)
