Understanding Asperger's syndrome
Asperger's syndrome has become a controversial diagnosis to describe children exhibiting various difficulties with social behavior. Like autism it affects an individual's ability to successfully interact with others.
Although children with Asperger's syndrome (or AS) can have normal or above-normal intelligence, when they start school they often experience difficulty functioning in the social world of the classroom. In fact, it's not unusual for these children to remain unidentified as having Asperger's until starting school. The majority of AS children are diagnosed between the ages of 5 and 11.
"As we become more familiar with the variety of differences in our children, a growing number of school-aged children with impairments in complex social behaviors are being referred for assessments and treatment," says Dr. Mariam King of the Pervasive Developmental Disorders Clinic at the University of California, San Francisco.
What are the symptoms of Asperger's syndrome?
Children diagnosed with AS generally show normal development until age 4 in speech, self-help skills and curiosity about the world around them.
A concerned parent should look for many, but not necessarily all, of these signs:
- Repetitive language
- Impairment in the use of nonverbal behaviors, such as making eye-to-eye contact
- Conversation that centers around the self
- A voice that can be emotionless
- Eccentric vocal characteristics
- Dyslexia or other writing problems
- A tendency to think literally rather than abstractly
- Clumsy or awkward motor skills
- Inappropriate or insensitive social behaviors
How common is it?
Although scientists have been studying autism since the 1940s, Asperger's syndrome has only been researched intensively in the past few decades. It was initially described by Viennese pediatrician Hans Asperger in 1944, but it wasn't until the 1990s that the disorder was widely recognized in the English-speaking world. As a result, there's a lack of solid data on the prevalence of Asperger's syndrome.
Our understanding of Asperger's is still unfolding, with diagnostic criteria only recently being established in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) in 1994.
For many years it was thought that one in 166 individuals has an Autism Spectrum Disorder, a range of disorders that includes Asperger's syndrome and the more severe disability, classic autism. In February 2007, new data released by the Centers for Disease Control and Prevention (CDC) indicates that in many areas of the United States the rate of autism in 8-year-olds is as high as one in 150.
What is the difference between autism and AS?
An ongoing debate as to whether Asperger's syndrome is a form of high-functioning autism or a unique disorder altogether indicates the current limited state of our knowledge about the disorder.
One prominent researcher, Dr. Tony Attwood of Australia, believes that AS and autism are much more alike than different, and that the terms Asperger's syndrome and high-functioning autism can be used interchangeably.
Others argue that the term high-functioning autism should apply only to children severely impaired early in their history but who go on to improve. AS children, they claim, are fundamentally different in that they do not have early cognitive delays.
"Within the research and clinical fields," says Dr. King, "AS is a pretty controversial diagnostic category. There are some people who think it should be taken out of the DSM because what it's describing are people with autistic disorder that is mild or people with autistic disorder who aren't mentally retarded. There's a huge amount of controversy about that. There's a lot of research about it and the answer to it is unclear."
