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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.
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment 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 in social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia .
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:
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:
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).
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