Gilli Long '03

Asperger's Disorder is the term for a specific type of pervasive developmental disorder.  It has many similarities autism although there are several distinct differences.  Asperger’s Disorder got its name from Hans Asperger, who was the Austrian physician that first described this condition in 1944. He described the behaviors of several young boys who had normal intelligence and language development, but also displayed several autistic characteristics and had noticeable problems with social and communication skills.   People with this disorder are characterized by social isolation and eccentric behavior in childhood (http://www.aspergers.com/aspclin.htm)

In the past, many children with Asperger’s Disorder were diagnosed with having autism.  In general, children with Asperger’s Disorder function at a higher level than children with autism.  While many children with autism do not develop language or have language delays, most children with Asperger’s Disorder are using words by the age of two.  However the speech patterns of children with Asperger’s Disorder may be somewhat unusual.  (http://www.aacap.org/publications/factsfam/69.htm) 

The DSM-IV diagnostic criteria for Asperger’s Disorder state that there must be impairment in social interaction that is displayed in at least two out of four ways.  The first way is that the child will have marked impairment in the use of multiple nonverbal behaviors.  The second social interaction impairment is that the child has failed to have peer relationships that are appropriate to his stage in development.  The third possible impairment is a lack or interest in seeking to share enjoyment, interests, or achievements with other people.  The fourth impairment is a lack of social or emotional reciprocity.  (http://www.aspergers.com/aspclin.htm)  The DSM-IV states that the child must also have restricted or repetitive patterns of behavior or activities.  The child must also have no significant general language delay.  (http://web.syr.edu/~rjkopp/data/as_diag_list.html)

As children with Asperger’s Disorder develop, they may be faced with different problems at each stage.  A preschool aged child might show difficulty understanding the basics of social interaction. Children at this age may have trouble identifying social cues. Children with Asperger’s Disorder may want friends but may be unable to make or keep any friends (http://www.baltimorepsych.com/aspergers.htm).  Elementary school age children may not be able to use the right tone and volume of speech. They may stand too close or make poor eye contact with other people.  Frequently children with Asperger’s Disorder will have either subtle or severe learning difficulties.  The child may fixate on a particular topic and then has difficulty changing the subject even when other children have given clear signals that they are bored with the topic.  Some children with Asperger’s Disorder have problems adjusting to changes in their daily routine and so change must be added gradually (http://www.baltimorepsych.com/aspergers.htm). 

Currently, the most effective treatment for Asperger’s Disorder involves a combination of psychotherapy, special education, behavior modification, and support for families (http://www.aacap.org/publications/factsfam/69.htm).  There are no specific medicines for Asperger’s however, some medications are used to treat specific target symptoms.  SSRI’s are used to help with obsessions and also to treat associated depression and anxiety.  In addition to any medication a child might be on, social skills training is a very important part of treating Asperger’s Disorder.  Children with Asperger’s Disorder must learn concrete rules for eye contact and social distance.  Social skills are best practiced within a small group setting.  This allows the child to practice the skills he has learned and also to meet and associate with other children with Asperger’s Disorder (http://www.baltimorepsych.com/aspergers.htm). Educational interventions are also used to help the child deal with the educational environment.  Teachers need to be aware that the student refuse to look them in the eye and they should also notify the student prior to changing the school routine.  Students should have a private place to escape to if they become overstimulated (http://www.baltimorepsych.com/aspergers.htm).  Parents also play an important role in helping their child deal with Asperger’s Disorder.  It is important for the parent to recognize the difference between willful disobedience and simple misunderstandings of social cues.  Parents can help their child deal with their daily routine and can help the child with any changes to that routine (http://www.baltimorepsych.com/aspergers.htm). 

The outcome for children with Asperger's Disorder is more promising than for those with autism. Many children with Asperger’s Disorder finish high school and attend college. Although they may have problems with social interactions, they are also capable of developing long lasting relationships with family and friends. 

References

Asperger’s Disorder (1999). http://www.aacap.org/publications/factsfam/69.htm.  American Academy of Child and Adolescent Psychiatry. 

Asperger’s Disorder: DSM-IV diagnostic criteria.  http://web.syr.edu/~rjkopp/data/as_diag_list.html.

Ozbayrak, R. (2002) What is Asperger’s Disorder.  http://www.aspergers.com/index.htm

Watkins, C. (2000) Asperger’s Disorder.  http://www.baltimorepsych.com/aspergers.htm.  Northern County Psychiatric Associates.