Definition of Asperger’s Syndrome (“AS”)
Asperger’s syndrome refers to individuals that show an average, or above average, level of intelligence and learning abilities, but face social communication issues that affect their lives in a non-neglectable way.
The Asperger’s syndrome was diagnosed, until 2013 (DSM 4), in people that struggled with:
- socialization, communication, friendships and, more in general, interaction with the external world;
- non-verbal communication (challenges to recognize and classify signals like gestures, facial expressions, tone of the voice, eyes expressions and the emotional patterns of others)
- emotional intelligence (failure to understand if other persons were happy or angry, or if someone was talking normally, sadly, or in an engaging way)
- management of sensory inputs (like loud sounds)
- narrow span of interests, and an obsessive focus on very few topics
Asperger’s vs. Level 1 Autism (Difference DSM 4 and DSM 5)
Until 2013 and according to DSM IV, Asperger’s syndrome was classified as one of the five 自閉症の種類 (a mild type, otherwise called, “high-functioning autism”).
In 2013, the American Psychiatric Association released the DSM-5 directive that, among other innovations, unified the symptoms of autism under the umbrella of a single pathology, called “Autism Spectrum Disorder” (ASD) with three levels of severity.
Therefore, Asperger’s disorder is no longer mentioned as a type of autism under DSM V, even if the symptomatology of “Level 1 ASD” matches “Asperger’s” quite closely.
Asperger’s in girls and women
The diagnosis of Asperger’s disorder for girls and women is more challenging than men, due to women’s superior ability to camouflage social and communication deficiencies in the quest to be perceived as “normal”.
This may explain why Asperger’s disorder shows a remarkably higher incidence in men than women (figures may hide undiagnosed women).
The Asperger’s symptoms
a) Asperger’s symptoms in toddlers and children
The typical symptoms of Asperger’s syndrome in toddlers and children are:
- lack of eye contact
- lack of response to stimuli (child does not smile, doesn’t look at people talking or smiling, and shows signs of anxiety when touched, hugged or cuddled)
- inability to read other people’s emotions (child doesn’t seem to understand the difference between an angry and a happy expression for instance)
- flat tone of voice, lack of laughter, display of a cold (even robotic) personality
- over interest in few topics and stereotyped behavior
- distress in case of changes in routine (meals at the same time every day, things ordered in the same way, same way back and forth from school)
- lack of mental retard (Asperger’s score average or above-average IQ)
b) Asperger’s symptoms in adults
A frequent question is “What are the signs of Asperger’s in adults”? The answer is: basically, the same listed for children. Of course, adults may have learned to cope with Asperger’s during the course of life, and the symptoms may show up in a mild, sometimes difficult to diagnose, way.
Asperger’s diagnoses have been made by psychologists, pediatric neurologists, psychiatrists, development pediatricians. Diagnoses involved multidisciplinary teams and were executed partly at the doctor’s facility, partly at school or outdoor, where the symptoms could be better observed.
Asperger’s syndrome, like other types of autism, seems caused by genetic mutations affecting the brain (specifically, its neural connections), that have quite interesting impacts also on the sensorial abilities of the affected individuals (as shown in the image below).
With the correct intervention strategy, several children with Asperger’s managed to cope with their social and communication disabilities and become very successful later in life.
There are few examples of highly successful Asperger’s, like Bill Gates, Steve Jobs, and many others (success rate is high in professions where attention to detail and introversion are assets, like programming or engineering, and architecture).
The most frequently used therapies for Asperger’s are/were:
- Speech therapy: the goal of this therapy is to give the child a more intense way of communicating, fighting the tendency to talk in a flat, boring and unemotional way, or to entertain two-ways conversations with other people (talk, listen, respond)
- Social skills therapy: these therapies, executed 1:1 or in a group, aimed at improving the child’s ability to deal with other people, keep eye contact, use and understand the non-verbal communication and express her/his emotional intelligence.
- ABA therapy (applied behavior analysis): the ABA therapy is based on a “positive reinforcement” playful approach, i.e. the child is rewarded in case of a positive development of her/his social and communication skills (and discouraged in case of dysfunctional behavior);
- Family therapies: these are all the therapies that parents learn with specialized professionals and have to apply at home
- CBT therapy (cognitive behavioral therapy): the goal of these therapies is to increase the child’s ability to control her/his emotional outbursts, changing the mood, and control repetitive behaviors. The child is stimulated with subjects beyond her/his monomaniac field of interest and helped to minimize obsessive behaviors.
- Medicaments: as for any other disorder on the spectrum of autism, there is no specific medicine to treat the Asperger’s syndrome yet; some conventional medicines are used to relieve some symptoms associated with the core pathology, such as anti-depressants, stimulants, serotonin reuptake inhibitors (SSRIs), psychoactive drugs, sleeping pills to fight possible chronic sleep disorders.
What is the difference between Asperger’s and autism?
Simply said, the Asperger’s syndrome was/is as a mild type of autism. Asperger’s and autism share the same 症状, with different intensity and impairment. After the publication of DSM V in 2013, children that would have been diagnosed as Asperger’s according to DSM IV are now diagnosed as level 1 ASD.
Some checklists have been developed in the past to diagnose Asperger’s syndrome.
Even if a number of checklists to diagnose Asperger’s are available, they all seem to revolve around similar questions:
- Does your child seem inflexible, i.e. does she/he show distress and anxiety anytime a routine is changed?
- Does your child struggle to develop close friendships and tends to isolate himself, not looking for companionship with peers and family members?
- Does your child avoid eye contact when talking with others, or when you talk to her/him?
- Does your child struggle to communicate with others, i.e. her/his conversations seem dry and not a real exchange of opinions?
- Does your child seem to lack emotional intelligence, i.e. understand own’s and other people’s emotions?
- Does your child explode at times, with uncontrolled anger and fear, over-reacting to stimuli that could be managed differently?
- Does your child talk obsessively about a few topics, repeating her/his arguments indefinitely and not accepting different viewpoints?
- Does your child focus on himself exclusively, not caring for the needs and the emotions of others?
- Can you observe stereotyped body movements and behaviors like hand flapping, strange ways to play with games, twirling?
- Does your child struggle to do things that are normal for her/his peers and are connected to motor skills (for example riding a bike or playing at soccer)?
What is the Autism Quotient test?
の Autism Quotient Test (or AQ Test), developed by Simon Baron-Cohen of the Cambridge Autism Research Center, is one of the most known Asperger’s checklists. The test is articulated in a number of questions and a final score in points (Asperger’s get scores above 32 points).
Even if the Autism Quotient test cannot replace an in-depth expert examination, it can be used to have a first rough indication of the likelihood of being Asperger’s.