What Is Asperger’s Syndrome: Everything You Need To Know
In 2013, the diagnosis of Asperger Syndrome (AS) was removed from the 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V), published by the American Psychiatric Association. Officially, Asperger's has been folded into the more general diagnosis of autism spectrum disorder, but unofficially, the Asperger's profile still rings true for many children and adults who have received or may have received an Asperger's diagnosis in the past.
AS is part of the autism spectrum, but it's not consistent with some stereotypes about autism. For example, people with Asperger's don't have trouble with verbal communication. In fact, many have been gifted with extraordinary verbal skills, some do well in school, and many have above-average IQs.
(Asperger Syndrome, also known as Asperger's, is sometimes incorrectly referred to Asperger Disease, Aspergers Disease, or Asperger's Disorder.)
A Short History of Asperger's
Dr. Hans Asperger, an Austrian physician, first described Asperger Syndrome in 1944, unaware that the first papers about autism were being written at the same time. He described children who were socially isolated and clumsy, didn't respond normally during social interactions, and had very narrow and unusual interests, and above-average language skills with subtle abnormalities in the way they communicated.
At the same time Dr. Leo Kanner, another Austrian physician, was describing autism for the first time in a paper that would be published in 1943. His work was quickly translated into other languages, and "autism," a label used for the first time by both Asperger and Kanner, became well-known. Autism, as Kanner described it, was first included as a diagnosis in the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders published in 1980. By comparison, Dr. Asperger's work wasn't even translated into English for the first time until 1991, and wasn't considered a separate diagnosis until 1994.
So is Asperger's autism? There was debate at one time about whether or not Asperger's should be a separate diagnosis from autism, but even from the beginning, there have been many voices insisting that AS is part of the autism spectrum. Almost all clinicians today agree that it is, and when AS gained status as its own disorder in 1994, it was included under the heading of autism. It was only removed from DSM-V because of evidence that the diagnosis was difficult to consistently apply and that almost all people with symptoms of AS would be diagnosed with high-functioning autism, instead of under the diagnostic guidelines. Despite its classification as a form of autism, Asperger's has several distinguishing features.
What is Asperger's?
So what is Asperger's Syndrome? It's difficult to define Aspergers in a single sentence, but the Merriam-Webster dictionary has made a good, if not very readable, attempt at an Asperger's Syndrome definition: "an autism spectrum disorder that is characterized by impaired social interaction, by repetitive patterns of behavior and restricted interests, by normal language and cognitive development but poor conversational skills and difficulty with nonverbal communication, and often by above average performance in a narrow field against a general background of impaired functioning." This definition is a good starting point, but let's break Asperger's down into its symptoms and look at them in more detail.
People with Asperger's are often uncoordinated. This has never been part of the official diagnostic criteria for autism or Asperger's, but it's been noticed by physicians and families of children with Asperger's. It's not clear why people with Asperger's tend to have poor motor skills, but one theory is that they have a poorly developed sense of where their bodies are in space and how they're moving. This can result in an odd gait and jerky movements and, in children, trouble with sports or group games.
Lack of Interest in Social Interaction
Social issues seem to be at the heart of autism, and one of the first signs of AS in children can be a disinterest in social interaction. This is also one of the signs that tend to manifest a little differently in those with autism than those with Asperger's. People with severe autism often have no desire to socialize, but people with AS usually desire relationships even though they struggle with social skills. They often feel empathy and care about the people in their lives the same way neurologically-typical people do, but may find it difficult to show these feelings.
Poor Social Skills
Poor social skills include lack of adequate eye contact, unusual body language, one-sided conversations, and an inability to read nonverbal cues and to understand non-literal communication. For example, they may take sarcasm and idioms literally, struggling with requests like "take a seat" instead of the more literal "sit down." These social deficits can make living independently with Asperger's difficult, since appropriate social interactions are an important aspect of work and personal relationships.
Repetitive behaviors are another very early sign of autism and are also present in children with Asperger's. These repetitive motions can begin as early as 2 years old and are one of the best predictors for whether or not a child with concerning symptoms will go on to be diagnosed with autism or Asperger's. A popular theory is that these motions are comforting for children on the autism spectrum, but new research indicates that repetitive motions and focused interests may activate their reward systems in ways that social interaction doesn't.
Focused or Unusual Interests
People with Asperger's Syndrome have obsessive and focused interests. Consuming interests are common in children, but it's unusual for one interest to entirely dominate a child's attention and time. In adults, who usually have a variety of interests, this symptom can be even more obvious. An interest that is usually general like stamp collecting, trains, or dolls, may be very specific in a child or adult with Asperger's - an interest in collecting blue stamps, a fascination with remembering which numbers he or she has seen on passenger trains, or an interest in collecting dolls with short, blond hair.
Odd Speech Patterns
People with AS can be oblivious to the subtle vocal and rhythm changes that allow most of us to interpret someone's tone, and they often don't include these variations in their own speech, creating a monotonous, robotic way of speaking. They may also have above-average vocabularies and choose unusual words instead of common ones.
Treatment for Asperger's
Most treatment plans for Asperger's involve working with a therapist to identify areas in which the symptoms of AS are interfering with an individual's ability to function and be happy, and working to improve those areas.
Speech therapy isn't just for children who have delayed speech or pronunciation difficulties. A therapist can help people with AS use the pitch fluctuations of everyday speech to avoid monotonous or flat-sounding speech patterns. Therapy can also help with understanding nonverbal cues, like facial expressions, hand motions, and body language.
Honing social skills is a lifelong process for people with and without Asperger's, but adults and children with Asperger's often benefit from extra help when learning to imitate typical social interactions. Social skills training is either approached in groups or one-on-one, and it focuses on helping children and adults with Asperger's interact with others in ways that are considered appropriate.
Cognitive behavioral therapy (CBT) helps people be aware of and control their thought patterns, helping them to identify and change ways of thinking that are problematic. Cognitive behavioral therapy can help with emotional outbursts and obsessive thoughts and interests. CBT is also a common depression treatment and can be used to treat depression in people with AS, since some research indicates that people with Asperger's are at higher risk for depression.
In applied behavior analysis, therapists use positive incentives or praise to encourage positive behavior and discourage behavior that is difficult or isolating.
There are no medications that have been approved for the treatment of autism or Asperger's, but sometimes medication is used to treat conditions that can occur simultaneously with AS, like depression and anxiety.
Parent education is a vital part of therapy for children with Asperger's and their families. Parents need to know what their children are working on so that they can help reinforce new skills at home on a daily basis, and parents often benefit from speaking to a licensed therapist about the challenges that come with raising a child on the autism spectrum.
It's important for people with Asperger's and their families to be encouraged by the benefits that can come with Asperger's. Many people with Asperger's are unusually successful in their chosen profession, often, but not always, being drawn to math-based or research-based careers. Their unusual ability to focus on tasks and retain information can set their work apart.
And a disregard for social expectations can attract people looking for honest and straightforward friendships. Though they may feel isolated at times, adolescents and young adults with Asperger's often avoid the many pitfalls that can come with seeking peer approval.
Facts about Asperger Syndrome
A few fascinating and little-known Aspergers facts:
Asperger's may affect as many as 1 in 250 children.
Asperger's is much more likely to affect boys, and girls sometimes have less obvious symptoms.
Service dogs can be used to help people with Asperger's manage their emotions.
Celebrities Susan Boyle and Dan Aykroyd have been diagnosed with Asperger's.
Einstein, Mozart, and Newton are all historical figures who showed signs of mild autism.
An adult with Asperger's (Dr. Vernon Smith) has won a Nobel Prize.