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What causes autism spectrum disorders?
The exact causes of autism spectrum disorders are unknown. However,
there is widely accepted evidence that there is a hereditary factor
to these disorders since they run in families. Certain brain imaging
studies have found a number of structural abnormalities in individuals
on the autism spectrum that may affect development. Some researchers
have posited theories that environmental factors may cause or exacerbate
symptoms of autism spectrum disorders. Hypothesized environmental
influences include: the mercury preservatives contained in some
childhood vaccines, heavy metal toxicity from industrial emissions,
and digestive sensitivities (specifically to yeast, gluten, and
casein, which is a milk protein). Other researchers suggest that
there may be a gene/environment interaction that determines whether
or not an autism spectrum disorder will develop. Although vigorous
debate continues within the scientific community, there is currently
no definitive evidence that environmental factors cause autism spectrum
disorders. It should be noted that no existing evidence suggests
that autism spectrum disorders are caused by ineffective parenting.
How common is Asperger’s Syndrome?
Although Asperger’s Syndrome was originally identified in
1944 by Hans Asperger, it was not regularly diagnosed until the
1980s. Currently, prevalence estimates of Asperger’s Syndrome
(also known as Asperger’s Disorder) vary due to differences
in diagnostic criteria used across studies. Initial estimates indicated
that it was found in 3 per 1,000 children, affecting boys to girls
with a ratio of approximately 4:1. A more recent estimate, based
on a study conducted in Sweden, indicates that it may affect at
least 1 in 300 children, affecting boys to girls with a ratio of
10:1.
Why is the incidence of autism and
Asperger’s increasing?
This is also a subject of debate. Many researchers believe,
and some research has corroborated, that the incidence of autism
and Asperger’s is increasing due to a rise in awareness about
these disorders and a broadening of diagnostic criteria. In other
words, the actual prevalence of the disorder might not be increasing
as much as it appears. Rather, individuals with autism/Asperger’s
who were not diagnosed previously are now receiving a diagnosis.
This is a common phenomenon with psychological and neurological
conditions. As more is understood about a disorder, professionals
are better equipped to correctly identify when individual experience
those symptoms. However, some scientists and professionals contend
that the incidence of autism is increasing due to environmental
causes. For example, certain studies have shown a correlation between
autism spectrum diagnoses and areas of the country with high exposure
to environmental toxins. Please refer to the “What causes
autism spectrum disorders?” question above for more information
on this debate.
My child has Asperger’s/autism.
What should I look for in a teacher?
If you child has Asperger’s/autism, you might wish to seek
special education support services and accommodations for him/her.
Within special education, you should gain access to teachers who
have training and experience in working with children who have Asperger’s/autism.
In general, a teacher who is patient, organized, and encouraging
will generally be a good fit for your child. Moreover, a teacher
who receives practical support from the school administration will
be more prepared to meet the needs of your child. A classroom environment
that is structured, organized, quiet, and encouraging is likely
to prove beneficial for a child with Asperger’s/autism. Many
school districts also provide specific support and resources for
children with autism spectrum disorders, such as regular social
skills training groups, occupational therapy, counseling, and speech
therapy services. Although some children with autism spectrum disorders
are better served within special education, others are well served
through the regular education or gifted and talented curriculum.
The most appropriate placement for your child will likely depend
upon their specific strengths and weaknesses.
Is there a difference between Asperger’s
Syndrome and Asperger’s Disorder?
The terms “Asperger’s Syndrome” and “Asperger’s
Disorder” are used interchangeably; there is no difference
between them. Although the condition was first known as “Asperger’s
Syndrome,” it is listed in the most current edition of the
Diagnostic and Statistical Manual for Mental Disorders, 4th Edition
(DSM-IV), as “Asperger’s Disorder.” However, it
is still referred to as “Asperger’s Syndrome”
in much of the literature and in common usage. The ApaCenter generally
uses the term “Asperger’s Syndrome” rather than
“Asperger’s Disorder.”
Is Asperger’s Syndrome really
a disorder, or just another personality type?
There is much debate in the literature about whether Asperger’s
is a psychological disorder or simply a different type of personality.
In fact, many individuals now diagnosed with Asperger’s would
have likely been viewed in the past as highly intelligent, yet socially
awkward people with some unusual traits and eccentricities. Clearly,
there is no firm dividing line between what differentiates a personality
type from an abnormality, but a useful guideline might be, as DSM-IV
criteria states, that for a diagnosis of Asperger’s Disorder,
the disturbance must cause “clinically significant impairment
in social, occupational, or other areas of functioning.” Of
course, this begs the question of what constitutes “clinically
significant impairment,” and this is at the heart of the difficulty
in making diagnostic decisions.
Does Asperger’s Syndrome look
different in boys and girls?
Girls and boys with Asperger’s have the same core symptoms.
However, boys and girls may display these symptoms somewhat differently.
A girl with Asperger’s may be more likely to withdraw or display
internalizing symptoms, whereas a boy with Asperger’s might
"act up” and display his frustrations more outwardly.
In general, girls tend to develop more sophisticated language skills
at an earlier age than boys. This early advantage in language development
for girls appears to compensate for their difficulties and, as a
result, the symptoms of Asperger’s tend to be less noticeable
in girls than in boys. However, the unique social deficits associated
with Asperger’s have been found to be particularly challenging
for girls, especially since girls in our society are known to be
more relationally-oriented. That is, girls’ identity development
places more emphasis on the strength of their relationships, whereas
boys’ identity is typically more achievement-oriented. The
impact of Asperger’s on social functioning and relationships
can be extremely difficult and lonely for girls, particularly during
and after adolescence.
What does Asperger’s Syndrome look like in a teenager?
Teenagers with Asperger's Syndrome may experience anxiety or rejection by their peers in social situations. These youths have difficulty navigating their social world due to deficits in interpreting social cues and reading the body language and facial expressions of others. Some youths with Asperger's Syndrome have difficulty demonstrating empathy or “putting themselves in others' shoes.” As a result, they may not respond appropriately, or at all, in situations calling for an empathetic response. Their peers may view them as odd or different. Social rejection can cause them to experience feelings of loneliness or depression. In addition, young people with Asperger's Syndrome have difficulty responding flexibly to changes in routine and spontaneous events. They have a tendency to become visibly distressed when unexpected events or changes in routine occur. For this reason, it is important to notify them in advance of impending changes in routine, when possible, and respond patiently to your teen with Asperger's Syndrome when they demonstrate resistance to change.
What is the biology of Asperger’s
Syndrome?
The neuropsychological basis of the autism spectrum, which includes
Asperger’s, continues to be explored. With the advent of newer
imaging techniques such as functional magnetic resonance imaging
(fMRI), researchers are beginning to map the complex circuitry that
may underlie these disorders. Scientists know relatively little
about the neurological abnormalities that are correlated with Asperger’s.
However, a number of abnormalities in the structure and function
of the brain have been specifically linked to Asperger’s Syndrome
in various studies. Traditionally, the role of the brain’s
left hemisphere has been emphasized in classic autism, whereas Asperger’s
has been hypothesized to be a right hemisphere disorder. One study
suggests that the developmental period in which dominance shifts
from the right to left hemisphere might determine whether autism
or Asperger’s emerges. There is also some evidence of frontal
lobe dysfunction in autism spectrum disorders, which is consistent
with observed deficits in executive function. Still, other studies
have found abnormalities in structure or function of various areas
of the brain including: the temporal lobe, amygdala, fusiform gyrus,
operculum, parietal cortex, and cerebellum. Such diverse findings
are not surprising when one considers that Asperger’s Syndrome
consists of a cluster of varied symptoms. Researchers caution against
mapping Asperger’s to any one area, and stress that much more
research is needed to better understand its neurobiology, particularly
research utilizing brain imaging studies with larger sample sizes.
What are the other psychological
problems that can coexist with Asperger’s Syndrome?
A number of other difficulties may co-exist with Asperger’s
Syndrome, including but not limited to the following: ADD/ADHD,
learning disabilities (particularly dysgraphia, or difficulty with
writing), Tourette’s Syndrome/tic disorders, depression, anxiety,
bipolar disorder, fine and gross motor difficulties, oppositional
defiant disorder (ODD), obsessive compulsive disorder (OCD), sensory
integration dysfunction and central auditory processing difficulties.
There is a particularly high comorbidity (co-occurring rate) with
ADD/ADHD, anxiety, and depression. Mood difficulties, such as anxiety
or depression, are very commonly seen as secondary difficulties
that result from the isolation or social difficulties that individuals
with Asperger’s experience.
I think my child might be showing
some symptoms of Asperger’s Syndrome. How old does my child
have to be before he or she can be diagnosed?
Many individuals with Asperger’s Syndrome can function well
in most aspects of life, but difficulties often surface within social
relationships and after language development. As a result, diagnoses
are rarely made prior to a child reaching school age. It should
also be noted that in children under the age of five, symptoms of
Asperger’s can often be mistakenly attributed to other neurobiological
disorders or over-looked due to the presence of comorbid (co-occurring)
disorders. For example, many children who are later diagnosed with
Asperger’s are first diagnosed with Attention-Deficit/Hyperactivity
Disorder (ADHD or ADD). However, reaching an accurate diagnosis
as early as possible can prove to be highly beneficial. It has been
found that early intervention is very important to children’s
progress. In short, Asperger’s is typically diagnosed after
a child has reached school age; however, signs of this condition
can be seen earlier than that. It is becoming more common for parents
to seek an assessment to diagnose Asperger’s as early as preschool
so they can take advantage of early intervention opportunities.
What services might be available
at my school for a child with Asperger’s?
If you child has Asperger’s/autism, you might wish to seek
special education support services and accommodations for him/her.
Parents should contact school personnel to find out what specific
services are available at that school and in that district, as it
often varies. Standard services provided by schools include a combination
of speech and language therapy, occupational and physical therapy,
counseling, vocational education, and assistive technology, such
as special computer software. Within the special education program,
parents and school staff will meet together and develop an Individualized
Education Plan (IEP) for the student. Children with Asperger’s
often do best in structured learning situations in which they learn
problem-solving and social skills in conjunction with academic subjects.
Often the most important needs deal with social development. Students
with Asperger’s often require individualized or group training
that targets social and emotional competency. Although many children
with autism spectrum disorders are served within special education,
others are well served through the regular education or gifted and
talented curriculum, depending on their specific strengths and weaknesses.
In general, a teacher who is patient, organized, and encouraging
will generally be a good fit for your child. Moreover, a teacher
who receives practical support from the school administration will
be more prepared to meet the needs of your child. A classroom environment
that is structured, organized, quiet, and encouraging is likely
to prove beneficial for a child with Asperger’s/autism.
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