Asperger's Syndrome

What is Asperger's syndrome?
Asperger's syndrome (also known as Asperger's Disorder) was first described in the 1940s by Viennese pediatrician Hans Asperger, who observed autism-like behaviours and difficulties with social and communication skills in boys who had normal intelligence and language development. Many professionals felt Asperger's syndrome was simply a milder form of autism and used the term "high-functioning autism" to describe these individuals.

Asperger's syndrome was a unique diagnosis listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) until 2013, when all forms of autism were combined under one umbrella diagnosis, autism spectrum disorder (ASD).

People with Asperger's syndrome may have high intelligence and better than average verbal skills. Asperger's is considered a high-functioning form of autism.

How common is Asperger syndrome?

Autism, including Asperger syndrome, is much more common than most people think. People with Asperger syndrome come from all nationalities and cultural, religious and social backgrounds, although it appears to affect more men than women.

How do people with Asperger syndrome see the world?

Some people with Asperger syndrome say the world feels overwhelming and this can cause them considerable anxiety. In particular, understanding and relating to other people, and taking part in everyday family, school, work and social life, can be harder. People with Asperger syndrome may wonder why they are 'different' and feel their social differences mean people don't understand them.

Emotional and behavioural symptoms

• Repetitive behaviours: Engaging in repetitive behaviour is a common symptom of ASD. This may include doing the same thing every morning before work, spinning something a certain number of times, or opening a door a certain way.
• Inability to understand emotional issues: People with AS may have difficulties when asked to interpret social or emotional issues, such as grief or frustration.
• First-person focus: Adults with AS may struggle to see the world from another person's perspective, and may have a hard time reacting with empathy or concern.
• Exaggerated emotional response: Adults with AS may struggle to cope with emotional situations, feelings of frustration, or changes in pattern, which may lead to emotional outbursts.
• Abnormal response to sensory stimuli: This can be hypersensitivity or hyposensitivity to sensations — for example, excessively touching people or objects, preferring the dark, or deliberately smelling objects.

Communication symptoms

• Social difficulties: People with AS may struggle with social interactions and may not be able to carry on "small talk".
• Speech difficulties: It's not unusual for adults with AS to have "stiff" or repetitive speech, and difficulty moderating their voice for different environments.
• Exceptional verbal skills: Adults with AS may have strong verbal skills and a greater vocabulary, especially in areas of interest.
• Below-average nonverbal skills: They may not pick up on nonverbal cues such as hand gestures, facial expressions, or body language.
• Lack of eye contact: When talking to another person, they may not make eye contact.

Other symptoms

• Clumsiness: Motor coordination difficulties are significantly more common in adults with ASD, showing up as difficulty with tasks like sitting or walking correctly, or fine motor skills like tying shoes.
• Obsession: It's not uncommon to have hyperfocus toward a specific topic, with a deep understanding and vast vocabulary related to it, and an insistence on talking about it.

How to diagnose

The characteristics of Asperger syndrome vary from one person to another, although there are some key traits autistic people share. These are:

• persistent difficulties with, or differences in, social communication and social interaction;
• restricted and repetitive patterns of behaviours, activities or interests since early childhood, to the extent that these impact negatively on day-to-day life.

The diagnosis process usually involves a multi-disciplinary team — often including a speech and language therapist, paediatrician, psychiatrist and/or psychologist. Because Asperger syndrome varies widely from person to person, making a diagnosis can be difficult, and symptoms may sometimes not be recognised until adulthood.

How is Asperger's treated in adults?

There's no cure for Asperger's syndrome. However, these treatments may help adults cope with symptoms and difficulties:

• Cognitive behavioural therapy: A therapist can help you cope with some of the emotional effects, such as social isolation and anxiety, and learn new social skills.
• Speech therapy: A speech pathologist can help you learn voice control and modulation.
• Vocational therapy: A vocational therapist can help you find solutions to the issues you face at work so that you can continue to be successful.
• Medications: Prescription drugs may be used to treat individual symptoms, such as anxiety or hyperactivity — including stimulants, antipsychotics, and serotonin reuptake inhibitors (SSRIs).

At present, there is no "cure." By learning to cope with the symptoms and pick up on social cues, a person can overcome many of the challenges they face. With help, parents can learn how best to support their child. People with Asperger's syndrome can do well in school and go on to be contributing members of their community.