Asperger's Syndrome

What is Asperger’s Syndrome?

Austrian pediatrician Hans Asperger first defined Asperger’s Syndrome in the 1940s. These days it is widely characterized as a developmental disorder and “subtype of autism spectrum disorder (ASD) characterized by major problems in social and nonverbal communication, together with limited and repetitive forms of behavior and interests.” ^[1]

In addition to the symptoms mentioned above, people with Asperger’s can be particularly stubborn in defending an opinion or belief and exhibit an almost obsessive adherence to rules and routines.

Asperger’s Syndrome is no longer an official diagnosis and is instead on the autism spectrum, often referred to as “high-functioning autism”. This is not a diagnosis; it is simply because people with Asperger’s typically need less support than others on the autism spectrum.

The condition disproportionately affects more males than females by a ratio of about 9 to 1 ^[2].

Due to the lack of impairment in cognitive or language ability (and unlike more severe ASDs), people with Asperger’s are generally able to perform daily tasks on their own. This also means they can often be educated in an average classroom and maintain employment in later life.

What is the difference between Asperger’s Syndrome and Autism?

In 2013, the American Psychiatric Association (APA) revised the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) to reclass Asperger Syndrome as an autism spectrum disorder (ASD), along with other changes and reclassifications. As a result, the symptoms of Asperger’s are now generally attributed to ASD, a term encompassing a wide range of autistic disorders. In short, people previously thought of as having Asperger’s are now considered to be on the spectrum of autism.

The severity of symptoms is the most visible difference between what would be defined as autism and what used to be diagnosed as Asperger’s. People with autism struggle with speech and language skills and have a noticeable cognitive delay. However, people diagnosed with Asperger’s tend to exhibit developed (or even highly developed) grammatical and intellectual capabilities.

Another significant difference between autism and Asperger’s is the average age of diagnosis. In 2010, the average age of diagnosis for children with autism was around 3.1 years, whereas for Asperger’s Syndrome, the average age was 7.2 ^[4]. However, a child with Asperger-like symptoms may not receive a diagnosis until early adulthood due to the lack of language delays and a higher IQ. Therefore, it may not be until the child starts school and is forced into more social interactions that parents recognize a developmental delay.

Symptoms of Asperger’s Syndrome

In 2011, before the 2013 DSM-5 reclassification, Asperger’s was defined as a neurobiological disorder that causes obvious deficiencies in social skills such as difficulty in communication and changing routines ^[5]. However, this can be broadened to include more specific symptoms such as abnormal speech patterns, restricted facial expressions, and other unusual behavior.

Even though all children with Asperger’s are individuals with unique traits and characteristics, a lack of social aptitude and obsessive interests tend to set them apart. If your child has Asperger’s Syndrome, they may display one or more of the following symptoms or characteristics:

• Constantly talking about themselves or one of their interests instead of taking an interest in others
• Minimal social interaction or impoliteness
• Minimal facial expressions, lack of eye contact, and trouble understanding emotions
• Speaking quietly, loudly, or in other unusual ways
• Trouble picking up nonverbal communication like body language
• Difficulties understanding descriptions, explanations, and jokes
• Over-precise or extremely literal use of language
• Inability to think in an abstract way instead of factually
• Obsessive interest in a hobby or activity
• Finding a change in routine stressful or upsetting
• Failure to understand the feelings or opinions of others
• Impaired motor skills including awkward and clumsy movements
• Hypersensitivities to things in their environment, like sound or light

Diagnosing Asperger’s Syndrome

Because Asperger’s itself is no longer a diagnosable condition, it is now diagnosed as a form of autism spectrum disorder (ASD).

However, if you notice your child exhibiting any of the symptoms previously mentioned, a pediatrician should be the first port of call. They can then assess your child and advise whether you should see a mental health professional such as a psychologist or another clinician specializing in ASD.

The diagnosis usually involves an assessment in which medical professionals will ask the parents of the child questions about the child’s developmental history and social communication skills. The medical professionals will also observe the child and conduct tests to evaluate the child’s linguistic and cognitive abilities. 

The Center for Disease Control and Prevention (CDC) recommends developmental monitoring. This is where parents monitor a child as they develop from a young age and ensure they meet the typical developmental milestones for average children. This includes everything to do with how they interact with their surroundings, such as speaking, moving, behavior etc. This will help identify any symptoms of Asperger’s/ASD early on and help ensure early treatment for your child, which ensure higher chances of the condition having less of an impact later in their life.

It should be noted that “caution is required when diagnosing ASD because of non-specific manifestations in different age groups and individual abilities in intelligence and verbal domains.” ^[3] Certain behaviors could be typical of that child’s age group, such as “irritability, passivity… followed by delays in language and social engagement.” ^[3] It is also important not to confuse symptoms of ASD with other mental health conditions, such as attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD).

Causes of Asperger’s Syndrome

The exact cause of Asperger’s is not fully understood. It is widely agreed that abnormalities in the brain are responsible for most ASD diagnoses. However, the primary reasons for these changes in the brain are also unknown. Genetic abnormalities are also thought to play a part in the likelihood of being diagnosed with Asperger’s/ASD.

It’s important to stress that Asperger’s/ASD is NOT a consequence of a child’s upbringing or bad parenting.

Treatment for Asperger’s Syndrome

Treatment of Asperger’s revolves around therapy that addresses the three core symptoms of the condition: trouble communicating, obsessive interest or routines, and clumsiness. The following treatments are some of the most used:

• Social skills training: This method aims to improve the patients’ social skills by making them more aware of social and nonverbal cues such as body language.
• Speech therapy: A speech therapist will discuss and evaluate the patients’ language and verbal communication skills.
• Cognitive behavioral therapy: This is a form of psychotherapy that is used to treat a range of diagnoses, including depression, anxiety, alcohol/drug problems, and other negative thoughts and patterns of behavior. This helps people with Asperger’s deal with the day-to-day challenges they experience because of having the condition.
• Medication: There is no medication that “cures” Asperger’s. But healthcare providers can prescribe medication to ease symptoms of medical conditions that can occur alongside ASD diagnoses, such as depression and anxiety. Medicines used often include antidepressants (amitriptyline), anti-anxiety (alprazolam), and anti-psychotic (clozapin) medications.

There are also other ways to help make daily life easier for people with Asperger’s. This includes music and art therapy, acupuncture, and support groups.

Most experts agree that the earlier Asperger’s is diagnosed, the earlier the child can start therapy, increasing the likelihood that the child will go on to lead a successful and independent life.

Frequently asked questions about Asperger's

What are the characteristics of a person with Asperger’s?

People with Asperger’s Syndrome tend to have the following:

• Poor social skills (e.g., inability to talk about anything other than themselves or their interests, rudeness/discourtesy)
• An intense obsession over one or two things (which could be mundane things such as rail timetables or the height of a tower)
• Abnormal speech patterns (e.g., an inability to control the volume or tone of their voice)
• Limited facial expressions

When was Asperger’s discovered?

Hans Asperger first described Asperger’s Syndrome in 1944. Still, it did not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1994, then removed from the fifth edition in 2013 (DSM-5) ^[6].

Asperger observed that his patients displayed symptoms similar to those of autism, such as impaired social interaction and repetitive behaviors and interests ^[6]. However, what set them apart was an adequate grasp of language and developed cognitive ability.

What is high-functioning Asperger’s?

“High-functioning Asperger’s,” or more accurately “high-functioning autism,” is an informal term used to describe people on the autism spectrum who can speak, read, write and perform daily tasks such as eating and getting dressed independently without the need for assistance.

High-functioning Asperger’s is not a medical or official term.