Asperger Disorder

WHAT IS ASPERGER DISORDER?

IT IS A PERVASIVE DEVELOPMENTAL DISORDER WITHIN THE AUTISTIC SPECTRUM, BUT IT IS QUALITATIVELY DIFFERENT THAN AUTISTIC DISORDER.

Asperger disorder stems from the work of Hans Asperger, a German pediatrician, who identified a sample of children with a peculiar set of characteristics that he referred to as "autistic".
Asperger disorder shares some of the symptomatology of autism or autistic disorder (DSM; APA, 1994) but has some important differences and is thus considered to belong to the autism spectrum of disorders. Autistic disorder, however, is generally more severe and has been associated with another group of children described by Leo Kanner (1943).
Both Asperger and Kanner worked with children whom they labeled as autistic at roughly the same time in history (WWII) but were unaware of each other's work. Most likely due to the war, Asperger's work (in Germany) remained relatively unknown (Frith, 1991), but Kanner's work somehow led to the eventual recognition of autistic disorder.
The term "autistic" refers to the tendency to become egocentric and isolated from other people.
Asperger's work was later rediscovered (Wing, 1981), and the differences between Asperger's and Kanner's children eventually led to a differentiation in diagnoses between autistic disorder and Asperger disorder.

HOW IS ASPERGER DISORDER DIAGNOSED?

(For clinical criteria, see DSM, APA, 1994, p. 77).

IN LAY TERMS, CLINICIANS LOOK FOR THE FOLLOWING SYMPTOMS WHICH NEED NOT ALL BE PRESENT (DSM; APA, 1994):
Difficulty maintaining eye contact
Either an expressionless gaze or exaggerated facial expressions
Unusual body postures and gestures
A lack of friends from among their peer group
Little or no spontaneous sharing of interests
Difficulty with the mutual give and take of relationships
Intense interest in a narrow range of subjects which are often outside of the norm
Rigid adherence to rituals which can appear as obsessive/compulsive
Repetitive movements such as finger twisting or hand flapping
Preoccupation with parts of objects without consideration for the function of the whole
Significant social or occupational difficulty due to these behaviors and mannerisms
No developmental delays other than social and possibly fine motor skills

THERE IS SOME CONTROVERSY OVER THE DIAGNOSTIC CRITERIA FOR ASPERGER DISORDER.

ONE AREA OF CONTROVERSY IS OVER THESE LAST 3 SYMPTOMS WHICH ARE NOT INCLUDED IN THE DIAGNOSTIC CRITERIA WITHIN THE DSM.

ANOTHER AREA OF CONTROVERSY IS WHETHER "NO SIGNIFICANT DELAYS IN LANGUAGE DEVELOPMENT" IS RELEVANT.

Although "no significant delays in language" is included in the diagnostic criteria for Asperger disorder, it is important to note that significant delays in language are part of the diagnostic criteria for autistic disorder. Nonverbal children who eventually are able to speak and whose IQ is near or above normal are often considered to be high-functioning.
Some of these children are then diagnosed as having Asperger disorder instead of autism.
Is high-functioning autism the same as Asperger Disorder? Only further empirical research can provide the answer.

BASED ON THESE CRITERIA, ASPERGER DISORDER IS CLEARLY A DISORDER INVOLVING A SIGNIFICANT AMOUNT OF SOCIAL AWKWARDNESS.

IT SEEMS AS THOUGH PEOPLE WITH ASPERGER JUST NEED TO BE TAUGHT APPROPRIATE SOCIAL SKILLS.

This comment raises a good question: "Are poor social skills in disorders such as these the result of a lack of opportunity for learning appropriate social skills?" OR "Is there a faulty brain system underlying these disorders that makes it extremely difficult for individuals to develop appropriate social skills?"

WHAT ELSE DO WE KNOW ABOUT ASPERGER DISORDER?
PREVALENCE: 26-36 cases per 10,000 children (Ehlers & Gillberg, 1993)
POSSIBLE ETIOLOGIES UNDER INVESTIGATION:
Genetics (see Gillberg, 1991; Volkmar, Klin, & Pauls, 1998) Case studies and family studies reveal an increased incidence of both autistic disorder and Asperger disorder in the relatives of people with Asperger disorder.

Secretin (see Beck & Rimland, 1998; Rimland, 1999) Secretin is a hormone of the upper small intestine involved in the digestive process. In the case of a child named Parker Beck, injection of this hormone was followed by marked improvement in autistic and other symptoms. Although it is unclear whether this hormone is responsible for Parker's improvement, it is currently under study.

THERE IS ALSO A NEUROPSYCHOLOGICAL PERSPECTIVE TO BE CONSIDERED IN THE ETIOLOGY OF ASPERGER DISORDER.

DEFICITS IN EXECUTIVE FUNCTIONS, THE BRAIN SYSTEM WHICH IS BELIEVED TO BE RESPONSIBLE FOR GOAL ATTAINMENT (see Pennington, 1991), MAY PLAN AN INTEGRAL ROLE IN IMPAIRMENTS OF SOCIAL ABILITIES SUCH AS ASPERGER DISORDER.