Asperger syndrome

Definition

Asperger syndrome is often considered a high functioning form of autism. People with this syndrome have difficulty interacting socially, repeat behaviors, and often are clumsy. Motor milestones may be delayed.

Alternative Names

Pervasive developmental disorder - Asperger syndrome

Causes, incidence, and risk factors

Hans Asperger labeled this disorder "autistic psychopathy" in 1944. The cause is unknown.

There is a possible link to autism, and genetic factors may play a role. The condition appears to be more common in boys than in girls.

Although people with Asperger syndrome often have difficulty socially, many have above-average intelligence. They may excel in fields such as computer programming and science. There is no delay in their cognitive development, ability to take care of themselves, or curiosity about their environment.

Symptoms

People with Asperger have problems with language in a social setting.

• It may be difficult to choose a topic of conversation, their body language may be off, and it may be difficult for them to recognize that the other person has lost interest in the topic.
• They may speak in a monotone, and may not respond to other people's comments or emotions.
• They may have difficulty understanding sarcasm or humor.

Other symptoms may include:

• Problems with eye contact, facial expressions, body postures, or gestures (nonverbal communication)
• Singled out by other children as "weird" or "strange"
• Difficulty developing relationships with children their own age
• Inability to respond emotionally in normal social interactions
• Not flexible about routines or rituals
• Lack of showing, bringing, or pointing out objects of interest to other people
• Do not express pleasure at other people's happiness
• Preoccupied with parts of whole objects
• Repetitive behaviors, including repetitive behavior that injures themselves
• Repetitive finger flapping, twisting, or whole body movements
• Unusually intense preoccupation with narrow areas of interest, such as obsession with train schedules, phone books, or collections of objects

Signs and tests

Physical, emotional, and mental tests are usually done to rule out other causes.

Treatment

Treatment depends on the patient's level of function. People with a high IQ will have a better outlook than those with a below-average IQ. Because the patient may have average or above average intelligence, improvements in social function are particularly important.

For patients with severe impairment, treatment is similar to autism therapy.

Treatment strategy is based on using the person's strengths (such as intelligence or memory) to help compensate for their social or behavioral difficulties. It is also important for them to have the right living and social environment with as much support as possible.

Medications such as selective serotonin reuptake inhibitors (SSRIs), antipsychotics, and stimulants may be used to treat problems such as anxiety, depression, and aggression.

Expectations (prognosis)

The long-term outcome is based on the underlying problem and therapies used.

Calling your health care provider

Call for an appointment with your health care provider if your child:

• Does not respond to people
• Has odd or peculiar speech
• Has behavior that may lead to self-harm

References

Shah PE, Dalton R, Boris NW. Pervasive developmental disorders and childhood psychosis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 29.