Asperger's Syndrome
What Is Asperger Syndrome?
By Barbara L. Kirby
Founder of the OASIS Web site (www.aspergersyndrome.org)
Co-author of THE
OASIS GUIDE TO ASPERGER SYNDROME (Crown, 2001, Revised 2005)
Asperger Syndrome or (Asperger's Disorder) is a
neurobiological disorder named for a Viennese physician, Hans Asperger, who in
1944 published a 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. In spite of the publication of his paper in the 1940's, it
wasn't until 1994 that Asperger Syndrome was added to the DSM IV and only in the
past few years has AS been recognized by professionals and parents.
Individuals with AS can exhibit a variety of characteristics and the disorder
can range from mild to severe. Persons with AS show marked deficiencies in
social skills, have difficulties with transitions or changes and prefer
sameness. They often have obsessive routines and may be preoccupied with a
particular subject of interest. They have a great deal of difficulty reading
nonverbal cues (body language) and very often the individual with AS has
difficulty determining proper body space. Often overly sensitive to sounds,
tastes, smells, and sights, the person with AS may prefer soft clothing, certain
foods, and be bothered by sounds or lights no one else seems to hear or see.
It's important to remember that the person with AS perceives the world very
differently. Therefore, many behaviors that seem odd or unusual are due to those
neurological differences and not the result of intentional rudeness or bad
behavior, and most certainly not the result of "improper parenting".
By definition, those with AS have a normal IQ and many individuals (although
not all), exhibit exceptional skill or talent in a specific area. Because of
their high degree of functionality and their naiveté, those with AS are often
viewed as eccentric or odd and can easily become victims of teasing and
bullying. While language development seems, on the surface, normal, individuals
with AS often have deficits in pragmatics and prosody. Vocabularies may be
extraordinarily rich and some children sound like "little professors." However,
persons with AS can be extremely literal and have difficulty using language in a
social context.
At this time there is a great deal of debate as to exactly where AS fits. It
is presently described as an autism spectrum disorder and Uta Frith, in her book
AUTISM AND ASPERGER'S SYNDROME, described AS individuals as "having a dash of
Autism". Some professionals feel that AS is the same as High Functioning Autism,
while others feel that it is better described as a Nonverbal Learning
Disability. AS shares many of the characteristics of PDD-NOS (Pervasive
Developmental Disorder; Not otherwise specified), HFA, and NLD and because it
was virtually unknown until a few years ago, many individuals either received an
incorrect diagnosis or remained undiagnosed. For example, it is not at all
uncommon for a child who was initially diagnosed with ADD or ADHD be
re-diagnosed with AS. In addition, some individuals who were originally
diagnosed with HFA or PDD-NOS are now being given the AS diagnosis and many
individuals have a dual diagnosis of Asperger Syndrome and High Functioning
Autism.
Diagnostic Criteria For 299.80 Asperger's
Disorder
A. Qualitative impairment in social
interaction, as manifested by at least two of the following:
-
marked impairments in the use of multiple nonverbal behaviors such as
eye-to-eye gaze, facial expression, body postures, and gestures to regulate
social interaction
-
failure to develop peer relationships appropriate to developmental level
-
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)
-
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:
-
encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
-
apparently inflexible adherence to specific, nonfunctional routines or
rituals
-
stereotyped and repetitive motor mannerisms (e.g., hand or finger
flapping or twisting, or complex whole-body movements)
-
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 social interaction), and curiosity about the environment in childhood
F. Criteria are not met for another specific Pervasive Developmental Disorder
or Schizophrenia
A More Down-to-Earth Description
by Lois Freisleben-Cook
I saw that someone posted the DSM IV criteria for
Asperger's but I thought it might be good to provide a more down to earth
description. Asperger's Syndrome is a term used when a child or adult has some
features of autism but may not have the full blown clinical picture. There is
some disagreement about where it fits in the PDD spectrum. A few people with
Asperger's syndrome are very successful and until recently were not diagnosed
with anything but were seen as brilliant, eccentric, absent minded, socially
inept, and a little awkward physically.
Although the criteria state no significant delay in the development of
language milestones, what you might see is a "different" way of using language.
A child may have a wonderful vocabulary and even demonstrate
hyperlexia but not truly understand the
nuances of language and have difficulty with language pragmatics. Social
pragmatics also tend be weak, leading the person to appear to be walking to the
beat of a "different drum". Motor dyspraxia can be reflected in a tendency to be
clumsy.
In social interaction, many people with Asperger's syndrome demonstrate gaze
avoidance and may actually turn away at the same moment as greeting another. The
children I have known do desire interaction with others but have trouble knowing
how to make it work. They are, however, able to learn social skills much like
you or I would learn to play the piano.
There is a general impression that Asperger's syndrome carries with it
superior intelligence and a tendency to become very interested in and
preoccupied with a particular subject. Often this preoccupation leads to a
specific career at which the adult is very successful. At younger ages, one
might see the child being a bit more rigid and apprehensive about changes or
about adhering to routines. This can lead to a consideration of OCD but it is
not the same phenomenon
Many of the weaknesses can be remediated with specific types of therapy aimed
at teaching social and pragmatic skills. Anxiety leading to significant rigidity
can be also treated medically. Although it is harder, adults with Asperger's can
have relationships, families, happy and productive lives.
NOTE: Lois Freisleben-Cook's description was originally a post to the
bit.listserv.autism newsgroup/listserv
.
I thought it was an interesting explanation and included it on this site. A
visitor recently pointed out that not all Asperger Syndrome children exhibit
superior intelligence and felt that the post was somewhat misleading. It is my
understanding that the majority of children diagnosed with AS do have at least
an I.Q. in the normal range and that many children do have I.Q.'s in the
superior range. It is important that you take the time to read through several
explanations of AS, many of which are available on O.A.S.I.S. In addition, use
the bibliographies, the libraries, and those professionals working with you to
further your knowledge about Asperger Syndrome.
Barb Kirby
OASIS
The O.A.S.I.S. (Online Asperger Syndrome Information and Support) Web
Page and all O.A.S.I.S. links from the main page and formatting of those links
(http://www.udel.edu/bkirby/asperger/)are © by Barbara L. Kirby For permission
to reprint, please contact
bkirby@udel.edu
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