Asperger Syndrome: genetic causes, diagnostic methods, and characteristics

Asperger Syndrome: Causes, Diagnosis, Characteristics Treatment

Causes

Asperger Syndrome (as) is classified as an autistic spectrum disorder, and its causes, as with all forms of autism, remain controversial and hotly debated within the scientific community as well as in the popular media. Most research indicates that it is a developmental disorder and its symptoms manifest themselves either at birth or shortly afterwards. There seems to be a strong hereditary component to as (Tatum 2009). There is a family history of autism spectrum disorder in about 50% of the as population and pre -- and perinatal risk factors in about 25% of as cases (Toth & King 2008). Morphologically, the regions affected in the brain are fronto-striatal in nature and more insight is needed on the role of networks in the brain and on how networks are formed during embryogenesis so scientists can determine when the impairment occurs (Tatum 2009). As it is a disorder of non-verbal communication, the brains of people with as have been compared to controls with neuroimaging to identify which areas of the brain are concerned with the functions lacking in as suffers such as communication, executive functions, and empathy (Tatum 2009).

Diagnosis

The average age at diagnosis of as is about 11 years, compared with 5.5 years for autism (Toth & King 2008). A comprehensive assessment for as involves a review of the child's developmental history and current level of social, communication, and behavioral development. Most clinicians use a standardized assessment tool such as the Autism Diagnostic Interview-Revised test. Review of school records and previous testing and interventions, as well as consultation with the child's teachers for their observations, particularly of peer interactions, is important to inform diagnosis and treatment planning for the child.

One question that may arise during the diagnostic phase is if the individual has Asperger Syndrome or high-functioning autism. A significant minority of the scientific community believes that the neuropsychological and behavioral profiles of as and high-functioning autism differ significantly and should be treated as distinct disorders and not merely as spectrum disorders, while others have argued that there is little empirical evidence for a distinction between these two disorders (Toth & King 2008). Individuals with as outperformed those classified as having high-functioning autism on the comprehension subtest of the WISC-III and showed greater creativity, imagination, and expressive language abilities, but there were no differences on measures of executive functions like flexibility and planning. Individuals with as had more circumscribed interests, while high-functioning autism showed a greater insistence on sameness of routines (Toth & King 2008).

To a layperson Asperger Syndrome manifests itself in low social awareness and executive function. As individuals may fail to pick up on social cues that are clear to others, such as yawning as a sign of inattention. Often they are obsessed with a few narrow subject areas, and may talk on these subjects at length, despite the listener's obvious lack of interest in such minutiae. As children seem to have difficulty empathizing with others, even if other cognitive functions may be impaired or even enhanced. Some may even be gifted in their intelligence and may excel in school, if their special needs are met with understanding and patience by their teachers (Asperger Syndrome, 2009, Mental Health Weekly Digest). This may or may not include special resource room and tutoring support.

Treatment

Most forms of treatment for as individuals involve explicitly teaching them how to behave specific social situations in ways that others might take for granted. "While social skills instruction is an important strategy for promoting social success, some critics argue that it merely teaches individuals 'how to' act in specific social situations, but not how to generate any kind of 'social thinking' or problem-solving about how to act in novel or unexpected situations" and merely reinforces the rote behaviors of as (Blacher & Howell 2008). The approach may often develop on the degree of impairment. Role-plays, story-telling and 'what if' situations are common methods of instruction, as well as breaking down social skills into subskills, "such as greeting others, initiating topics, staying on topic, maintaining reciprocity, using nonverbal communication (eye contact, facial expressions, gestures) appropriately, checking in to see if the listener is still interested, and appropriately ending conversations (i.e., saying goodbye). Higher-level skills can include accepting suggestions, handling criticism, resolving conflicts, and showing empathy" (Toth & King 2008).

Regardless, of the approach, the consensus is that early intervention is necessary for all as individuals. Left untreated, a lack of social skills can have a profound impact on social and academic performance. Children with as may be teased more than their peers, and this can cause profound emotional distress, and the challenges increase with age as communication grows more subtle. "For individuals with autism, developing peer relationships and grappling with the emotional, physical, sociosexual facets of adolescence and adulthood can be especially difficult (Sullivan & Caterino 2008). The most common comorbid diagnosis in individuals with as and high-functioning autism is depression, occurring in as many as 41%" of cases (Toth & King 2008). Depression and alienation can affect enjoyment of school and school performance, even of the highly gifted as student.

AS individuals may find that their lack of social skills inhibits their ability to find a job, retain employment and receive promotions. Routine steps that often involve social communication, such as completing a job application, participating in a job interview, adapting to new work routines, and interacting with co-workers are among their perceived obstacles to job success" but can be dealt with through therapeutic interventions (Blacher & Howell 2008).