Diseases & Conditions


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Asperger syndrome (Asperger’s disorder)


A condition characterized by sustained problems with social interactions and social relatedness, and the development of restricted, repetitive patterns of interests, activities, and behaviors. The disorder is named after Hans Asperger, a Viennese pediatrician who first documented this cluster of characteristics in the 1940s. One type of AUTISM SPECTRUM DISORDER, Asperger’s is a milder form of AUTISM but without the delays in cognitive or language development. In 1994 Asperger’s was first classified as a pervasive developmental disorder, a designation that also includes autistic disorder. Many children with pervasive developmental disorders such as Asperger’s disorder also meet the diagnostic criteria for ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD). However, ADHD should not be diagnosed when there is Asperger’s, since all the ADHD symptoms can be attributed to the other condition. Clinicians who overlook other symptoms of Asperger’s tend to diagnose these children as having ADHD. Like many learning disorders, Asperger’s is believed to be more common in boys, although more research needs to be done to understand its genetic origins. According to the National Institutes of Health, Asperger’s disorder occurs in one out of every 500 Americans—more often than multiple sclerosis, DOWN SYNDROME, or CYSTIC FIBROSIS. It is estimated that more than 400,000 families are affected by this condition. Symptoms Often there are no obvious delays in language or cognitive development or in age-appropriate selfhelp skills. While these individuals possess attention deficits, problems with organization, and an uneven profile of skills, they usually have average and sometimes gifted intelligence. Individuals with Asperger’s syndrome may have problems with social situations and in developing peer relationships. They may have noticeable difficulty with nonverbal communication, impaired use of social gestures, facial expressions, and eye contact. There may be certain repetitive behaviors or rituals. Though grammatical, speech is peculiar due to abnormal inflection and repetition. Clumsiness (and a lack of motor planning) is prominent both in speech and physical movements. Individuals with this disorder usually have a limited area of interest that usually excludes more ageappropriate, common interests. Some examples of these single-minded obsessions may include cars, trains, Russian literature, doorknobs, hinges, astronomy, or history. Asperger’s vs. Autism Clumsiness and single-minded interests are more common in Asperger’s, and verbal IQ is usually higher than performance IQ. In autism, the reverse is usually true. The outcome is usually more positive for Asperger’s than for autism. Cause Biological factors are of crucial importance in the etiology of autism, and frontal lobe abnormalities have been found. Associated medical conditions such as FRAGILE X SYNDROME, tuberous sclerosis, neurofibromatosis, and hypothyroidism (sluggish thyroid) are less common in Asperger’s disorder than in classical autism. Therefore, scientists suspect there may be fewer major physical brain problems associated with Asperger’s than with autism. Treatment While there is no cure, early intervention has been proven to be effective. The need for academic and social supports increase through the school years, and by adolescence many children develop symptoms of depression and anxiety. It is important to continue supports into adulthood to ensure that affected adults can lead productive lives. Symptoms can be managed using social skills training and individual psychotherapy to help the individual to process the feelings aroused by being socially handicapped. Other treatments may include parent education and training, behavioral modification, educational interventions, and medication. For treating hyperactivity, inattention, and impulsivity, stimulants such as methlyphenidate, dextroamphetamine, metamphetamine, pemoline, clonidine, desipramine and nortriptyline may be used. For irritability and aggression, mood stabilizers (valproate, carbamazepine, lithium), beta blockers (nadolol, propranolol), and neuroleptics (risperidone, haloperidol) are effective. To treat preoccupations, rituals, and compulsions doctors may prescribe antidepressants such as fluvoxamine, fluoxetine, or clomipramine. To treat anxiety doctors may prescribe antidepressants (sertraline, fluoxetine, imipramine, clomipramine, or nortriptyline).