Asperger’s Syndrome: What It Is, Symptoms, Causes, Treatment and Tips
Sheldon Cooper has helped make this disorder more popular in recent years. This disorder affects the quality of life of children and adults around the world. When he knocks on his neighbor’s door three times in a row and says his name, when he shows a marked interest in trains or in physics, when he can’t understand or express emotions and takes his friend’s humor literally are some examples- sometimes unrealistic -of how people with Asperger’s Syndrome can feel. In this guide you will find, what is Asperger’s syndrome, its characteristics in children and adults, its treatment, causes, diagnosis, and tips.
What is Asperger’s Syndrome?
The definition of the word syndrome implies, in itself, a set of symptoms that appear in a disease or clinical disorder. So, we will mention each of the symptoms that, as a whole, make it possible to diagnose a person with Asperger’s Syndrome.
Asperger’s Syndrome was first described in 1944, by Hans Asperger. Just a year later Leo Kanner described autism symptoms. It is incorporated for the first time in the Diagnostic and Statistical Manual of Mental Disorders, in its fourth edition (DSM-IV), within the developmental disorders. Within this group, in addition to the Asperger’s Syndrome, were also Autism disorder, Rett’s Disorder, Childhood Disintegrative Disorder and Non-specified Generalized Developmental Disorder.
DSM-IV: “Essential features of Asperger’s Disorder are severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behavior, interest, and activity. The disturbance must clinically show significant impairment in social, occupational, and other important areas of functioning.”
Another widely used manual by experts is the International Classification of Diseases (ICD-10). In it, we find the following definition:
ICD-10: Asperger’s syndrome is an autism spectrum disorder, characterized by the same type of qualitative deficit of autism’s own social interaction, as well as by the presence of a restricted, stereotyped and repetitive repertoire of activities and interests. It differs however from autism in that there are no deficits or delays in language or cognitive development. Most of those affected have a normal intelligence but are often very clumsy. It is more common in boys than girls.
The latest published Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM 5) doesn’t include a category of Asperger’s Syndrome itself. It is included within the neurodevelopmental disorders, in the so-called Autistic Spectrum Disorder (ASD) that describes two perfectly differentiated areas: social communication and repetitive behaviors, which in this disorder are altered in three different levels of severity.
We will have to imagine the dimensions as in a continuum as if it were the light spectrum. Here on one end, there is level 1, in which the person requires treatment. The middle, level 2 where the person requires significant treatment and at the other end level 3, in which the person needs continuous treatment. This continuum is used to measure the symptoms as shown below.
People with Asperger’s syndrome usually do not have significant language delays or cognitive development. As a result, they will typically find themselves at less severe levels of the autism spectrum (Level 1).
Asperger’s Syndrome in Adults: Characteristics and Symptoms
Asperger’s syndrome main feature is the persistent alteration in social interaction. That is, the difficulty these people have when relating to others. To the extent that, without adequate therapy, difficulties in social communication cause significant limitations.
They have difficulty, for example, initiating conversations or interactions with other people. Showing unusual responses that are unsuccessful, making it may seem that their interest in social interaction is minimal.
People with Asperger’s Syndrome may be able to engage in communication and intervene in social interaction, but they will fail to hold a conversation or make peculiar and ineffective conversational attempts.
People with Asperger’s syndrome have a relatively independent life, personally and professionally, however, what could be called his social disability, is very severe. This makes it difficult for them to integrate into school, adapt well to the work environment, as well as starting and maintaining friendly relationships with their peers, finding a partner or having a family.
Adults with Asperger’s syndrome acquire adequate formal language, but many have problems using it effectively to communicate. This happens because, neurocognitively, they don’t have the capacity to understand other people’s mental states or empathize. They don’t adequately interpret nonverbal behaviors, especially facial expressions. Since they don’t interpret other people’s intentions correctly, it makes them extremely vulnerable.
In summary, something fundamental in people with autism spectrum disorders, and also people with Asperger’s syndrome, is that they have alterations in the so-called “theory of mind“. This summarized and simplified is the capacity that people, immersed in a social and cultural context, have developed to attribute thoughts and intentions to other people, and that allows them to interact and communicate effectively with other beings of the same species.
Another characteristic of people with Asperger’s syndrome is that their understanding of verbal language is literal. They are not able to fit the language into the context in which it is being used. Nor do they understand colloquial expressions or ironies.
Another affected area in Asperger’s Syndrome is their repetitive or restrictive behaviors. They can, for example, take an interest in one or more subjects in which they become true experts, for example in trains, in astronomy or in quantum physics. However, these interests are always in a repetitive way and in any context or social situation.
They are often rigid and intolerant when changing their habits or routines. Some come to develop rituals or compulsions that are authentic sequences of activities that are not a part of the activity at hand. For example, insisting on placing certain materials in order when you are using them (pens while studying, cutlery while eating), reciting a list which has to be completed to the end, if not the person can develop anxiety symptoms or feel pressured.
Some facts about people with Asperger’s Syndrome:
- 50% goes to higher education.
- 12% achieve full-time work.
- 82% say they have at least two social contacts per month with non-family members.
- 3% live independently.
Asperger’s Syndrome in Adults: Characteristics and Symptoms
The characteristics described in the previous section appear also in children with Asperger’s Syndrome.
According to Lorna Wing, some of the behavioral anomalies begin to manifest in the first year of the child’s life.
In children with Asperger’s syndrome, it is common to see a lack of socialization with their peers in settings such as school or park. The problem is not so much that they do not want to try to relate to their peers, but more that they don’t have the skills to do so.
This “lack of empathy” often translates into school isolation because other children view their interactions or responses as strange. As for the language of children with Asperger’s syndrome, it is often mechanical, because of the tone or volume of speech. They also sometimes sound pedantic and interpret language literally.
As in adults, children with this disorder often have areas and objects for which they show a special interest. For example, they play with the same toys or are only passionate about one thing, almost in an obsessive way.
They also show repetitive patterns of behavior or rituals, such as wanting to always go the same way to school. If routines or rituals are interrupted or change it can cause great discomfort.
Finally, children with Asperger’s Syndrome often have motor clumsiness. That is, motor development can be delayed in comparison with their peers, as well as movement coordination difficulties.
Asperger’s Syndrome: Causes
At present, the prevalence of Asperger’s Syndrome in the population is between 20 and 25 people affected for every 10,000. It is 8 times more frequent in men than in women.
The origin of autism spectrum disorders, or Asperger’s syndrome, is not exactly known. Although research points to a more biological origin.
Differences in children’s brain structures and regions with autism spectrum disorder have been found compared to their peers without autistic spectrum disorder. These differences appear, for example, in certain brain areas where abnormal migration of cells has occurred during fetal development.
An increase in neural connections between the frontal lobes of the brain, the limbic system, and temporal zones have also been observed. These areas are the basis for cognitive development and adequate acquisition of the higher functions.
Genetic factors also appear to be important in Autism Spectrum Disorders including Asperger’s Syndrome. For example, the hereditary factor is observed between 37% and 90% of the people affected by this disorder. It has been discovered that up to 15% of cases are associated with a genetic mutation.
When we talk about causes of autism spectrum disorders, risk factors such as parental advanced age or low birth weight are taken into account. It should be mentioned here, that it is a totally false myth, that autistic spectrum disorder is related to the MMR vaccine. Child Vaccinations have proven to have NO RISK in the development of autism.
Early manifestations of autistic spectrum disorders have been investigated and reviewed from a variety of sources and provide support for psychological explanations that place the emphasis on a developmental disorder. This disorder affects the constitution of social skills, which in normal development can be observed from the last trimester of the first year of life.
Asperger’s Syndrome: Diagnosis
Asperger’s syndrome diagnosis is more complicated than autism detection. In other words, more serious levels of autism are detected easier than those with a language development relatively normal and no intellectual disability.
It should be done by specialists in this area, by observing behavior, assessing psychological skills and a medical assessment must be performed.
The psychological aspects that are generally evaluated are intelligence, conceptual, social and practical adaptive skills, language and developmental history of the child or adult.
Early detection is important, so treatments can be put in place strategies to provide appropriate therapies and support systems, such as psychological therapies, pharmacological treatment, school support or financial aid.
Asperger’s Syndrome: Treatment
Treatment of Asperger’s Syndrome should always be based on the child’s or adult’s characteristics.
The sooner you intervene and implement techniques and strategies in different environments, the more effective the treatment will have.
Treatments are usually behavioral control techniques, emotional support, activities aimed at improving social and communicative skills, for example, to improve understanding facial expressions or colloquial language.
How to live with Asperger’s Syndrome? Tips and strategies
- People with Asperger’s syndrome have difficulty interpreting language or expressions. That is why, when possible, avoid using abstract concepts. Be as specific as you can and use visual cues such as drawings or written words to clarify the meaning of abstract concepts. For example, instead of asking the person with Asperger’s Syndrome “why did you do this?” Say “I don’t like it when you slammed the door when I said it was time to go to school. Next time you can tell me that you do not feel like going and close the door softly”.
- Avoid using idioms or phrases such as “penny for your thoughts”, “ball is in your court” or “best of both worlds”. Same goes for double meaning sentences, sarcasm or jokes. If you use them, you have to explain them later.
- People with Asperger’s syndrome make continuous efforts to adapt to the environment or integrate into social groups. They may have strange behaviors and on occasions seem egocentric. We should not take this as intentional or on purpose.
- Remember that sometimes they may not understand facial expressions or other expressions of nonverbal language. Be careful when you use them.
- Occasionally, unusual behaviors may be frowned upon in different settings. Even people around people with Asperger’s syndrome may react poorly to their behaviors. Therefore, it is useful for these people to always have a “safe place” or “person they trust” available.
- If a child with Asperger’s syndrome repetitively asks questions or verbal arguments in an environment such as the school, the teacher or us, we should try to interrupt the behavior without scolding. Ask, for example, to put in writing or drawing. At school, due to the communicative difficulties, important activities or tasks are best delivered in writing to parents or guardians.
- Finally, do not treat them differently. Although they have difficulties in social interaction or communication, if you support them and treat them normal it can improve their quality of life greatly.
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This article is originally written in Spanish by Rosa Calderon Vicente, translated by Alejandra Salazar.
Alejandra is a clinical and health psychologist. She is a child specialist with a diploma in evaluation and intervention in autism. She has worked in different schools with young children and private practice for over 6 years. She is interested in early childhood intervention, emotional intelligence, and attachment styles. As a brain and human behavior enthusiast, she is more than happy to answer your questions and share her experience.