Asperger’s
Syndrome Defined
Asperger’s Syndrome (also known as Asperger’s Disorder)
is a neurodevelopmental condition defined by social competence difficulties
and restricted areas of interest and/or stereotyped behaviors and
activities. It is considered to be one of five pervasive developmental
disorders within the “autistic spectrum” (the other four
being Autistic Disorder, Pervasive Developmental Disorder –
Not Otherwise Specified, and the much rarer Rett’s Disorder
and Childhood Disintegrative Disorder). Unlike in autism, in Asperger’s
both language and cognitive ability are generally intact from an early
age. Individuals with Asperger’s often have trouble deciphering
nonverbal cues and behavior such as tone of voice, gestures, facial
expressions, sarcasm, jokes, social nuances, and body language. They
also may have frequent trouble learning from new experiences, become
anxious with change in routine, and have difficulty with flexibility.
For example, a child with Asperger’s may become upset if an
exception is made in a classroom rule or schedule. For this reason,
children with Asperger's Syndrome have been referred to as “little professors
without social skills” and are often considered strange or weird
by their peers. Many have difficulty making friends and may be frequently
teased by others.
Although not part of official diagnostic criteria, a number of
secondary characteristics are frequently associated with Asperger’s,
including egocentric and idiosyncratic behavior, motor clumsiness,
attention difficulties, inappropriate expression, pedantic speech,
impaired use of social language, advanced vocabulary, odd eye contact,
difficulty demonstrating empathy and taking another’s perspective
(“theory of mind” difficulties), and auditory processing
difficulties. These characteristics vary in intensity, and may be
present in some individuals but not in others.
Individuals with Asperger’s may seem to gaze off or stare
through others when conversing, and not respond appropriately in
conversation. They may also have some sensory dysfunction, such
as an extreme sensitivity to touch or sound. Many children and adults
with Asperger’s also meet the criteria for intellectual giftedness.
In recent years, many people have come to view Asperger’s
Syndrome not as a disorder, but simply as a different and unique
way of being. As Hans Asperger said in 1938, “Not everything
that steps out of line, and thus “abnormal”, must necessarily
be “inferior.” In fact, many people with Asperger’s
make significant contributions to society and lead happy lives using
their particular interests and talents to become successful.
High Functioning Autism Defined
Autism is a neurodevelopmental disorder affecting an individual's
ability to communicate, form relationships with others, and respond
appropriately to environmental cues. Autism is usually considered
“high functioning” when average to above average intelligence
and verbal ability are present. Like Asperger’s Syndrome,
high functioning autism is characterized by difficulties with social
competence and stereotyped or restricted behaviors/activities. In
addition, children and adults with high functioning autism have
difficulty reading nonverbal cues, adjusting to changes in routine
and taking another’s perspective. Frequently, they also have
attention difficulties and sensory integration difficulties. However,
unlike Asperger’s Syndrome, autism is diagnosed when significant
deficits or delays in communication are present (i.e., single words
not produced by 2 years, or phrases by 3 years). Also, symptoms
must be present before the age of 3 and usually begin in infancy.
Other Differences between Asperger’s
Syndrome and High Functioning Autism
Many practitioners have difficulty distinguishing Asperger’s
Syndrome from high functioning autism. In fact, there is an ongoing
debate in the literature about where the differences lie. Although
the following observations are not currently included in accepted
diagnostic criteria, recent research suggests several differences.
In addition to later onset for Asperger’s, there appears to
be a different pattern of strengths and weaknesses between the two
conditions. Whereas individuals with Asperger’s tend to have
stronger verbal ability and weaker visual-spatial ability, individuals
with high functioning autism often have the opposite profile. Social
competence and communication difficulties are more pervasive and
severe in high functioning autism. Also, imaginative play and a
sense of humor (albeit unusual) are more commonly seen in Asperger’s
Syndrome.
Benefits of an Assessment for Asperger’s
Syndrome or High Functioning Autism
The psychologist you work with will help:
Identify specific strengths and weaknesses unique to each individual
Recommend appropriate interventions to compensate for difficulties
Rule out other difficulties that may be contributing to symptoms
Help obtain appropriate school/college services
Obtain greater self-understanding and validation of experiences
Asperger’s
Syndrome and High Functioning Autism (HFA) Assessments
Although there is no single standardized test that can diagnose
an autism spectrum disorder, a number of autism rating scales and
structured interviews now exist that are helpful in determining
the likelihood of such disorders. While assessments look for the
main characteristics of an autism spectrum disorder (social impairment,
communication difficulties, reliance on repetitive routines/ narrowness
of interests), a comprehensive evaluation will assess the following
areas of functioning through a combination of individualized standardized
testing, self-report measures, behavioral checklists, interviews,
and observations:
- Developmental and medical history
- Cognitive abilities and academic achievement
- Social competence and social perception
- Emotional and behavioral functioning
- Communication and language skills
- Perceptual-motor/visual-spatial ability
- Assessment of attention and memory as indicated
The ApaCenter may also recommend a full medical evaluation to rule
out other medical conditions that may be causing symptoms (e.g.,
hearing loss). Diagnosis of an autism spectrum disorder takes particular
care, because the presentations of these disorders vary from person to person,
and symptoms often change with development. More often than not,
clients with Asperger’s or HFA also experience other related
difficulties such as ADD/ADHD, depression, and learning disabilities
that confound diagnosis. In addition, many times individuals who
have characteristics that fit an Asperger’s profile are actually
experiencing other difficulties. For example, it is sometimes challenging
to distinguish Asperger’s Syndrome from symptoms experienced
by a shy, depressed child who is verbally gifted. Symptoms common
to autism spectrum disorders also need to be distinguished from
symptoms that result from trauma. For this reason, the consideration
of current life stressors is extremely important for a reliable
diagnosis. Finally, an awareness and sensitivity to cultural factors
that may confound accurate diagnosis is essential (e.g., the norms
for respectful eye contact and communication vary from culture to
culture).
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