Posted by Nessa

In Reply to: Asperger's syndrome posted by Larry

Asperger's Disorder is a milder variant of Autistic Disorder. Both
Asperger's Disorder and Autistic
Disorder are in fact subgroups of a larger diagnostic category. This
larger category is called either
Autistic Spectrum Disorders or Pervasive Developmental Disorders.

In Asperger's Disorder, affected individuals are characterized by
social isolation and eccentric
behavior in childhood. There are impairments in two-sided social
interaction and non-verbal
communication. Though grammatical, their speech is peculiar due to
abnormalities of inflection and a
repetitive pattern. Clumsiness is prominent both in their articulation
and gross motor behavior. They
usually have a circumscribed area of interest which usually leaves no
space for more age
appropriate, common interests. Some examples are cars, trains, French
Literature, door knobs,
hinges, cappucino, meteorology, astronomy or history.

What are the differences between Asperger's Disorder and 'High
Functioning' (i.e. IQ >
70) Autism?

It is believed that in Asperger's Disorder

onset is usually later
outcome is usually more positive
social and communication deficits are less severe
circumscribed interests are more prominent
verbal IQ is usually higher than performance IQ (in autism, the case
is usually the reverse)
clumsiness is more frequently seen
family history is more frequently positive
neurological disorders are less common

What are the diagnostic criteria of Asperger's Disorder?

DSM-IV DIAGNOSTIC CRITERIA FOR ASPERGER'S DISORDER

A.Qualitative impairment in social interaction, as manifested by at
least two of the following:

(1) marked impairment in the use of multiple nonverbal behaviors such
as eye-to-eye gaze, facial
expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental
level
(3) a lack of spontaneous seeking to share enjoyment, interests, or
achievements with other people
(e.g., by a lack of showing, bringing, or pointing out objects of
interest to other people)
(4) lack of social or emotional reciprocity

B.Restricted repetitive and stereotyped patterns of behavior,
interests, and activities, as
manifested by at least one of the following:

(1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest
that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional
routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger
flapping or twisting, or
complex whole-body movements)
(4) persistent preoccupation with parts of objects

C.The disturbance causes clinically significant impairment in social,
occupational, or other
important areas of functioning.

D.There is no clinically significant general delay in language (e.g.,
single words used by age 2
years, communicative phrases used by age 3 years).

E.There is no clinically significant delay in cognitive development or
in the development of
age-appropriate self-help skills, adaptive behavior (other than in
social interaction), and
curiosity about the environment in childhood.

F.Criteria are not met for another specific Pervasive Developmental
Disorder or
Schizophrenia.

GILLBERG'S CRITERIA FOR ASPERGER'S DISORDER

1.Severe impairment in reciprocal social interaction
(at least two of the following)
(a) inability to interact with peers
(b) lack of desire to interact with peers
(c) lack of appreciation of social cues
(d) socially and emotionally inappropriate behavior

2.All-absorbing narrow interest
(at least one of the following)
(a) exclusion of other activities
(b) repetitive adherence
(c) more rote than meaning

3.Imposition of routines and interests
(at least one of the following)
(a) on self, in aspects of life
(b) on others

4.Speech and language problems
(at least three of the following)
(a) delayed development
(b) superficially perfect expressive language
(c) formal, pedantic language
(d) odd prosody, peculiar voice characteristics
(e) impairment of comprehension including misinterpretations of
literal/implied meanings

5.Non-verbal communication problems
(at least one of the following)
(a) limited use of gestures
(b) clumsy/gauche body language
(c) limited facial expression
(d) inappropriate expression
(e) peculiar, stiff gaze

6.Motor clumsiness: poor performance on neurodevelopmental examination

(All six criteria must be met for confirmation of diagnosis.)

hat is the treatment of Asperger's Disorder?

There is no specific treatment or "cure" for Asperger's Disorder. All
the interventions outlined below
are mainly symptomatic and/or rehabilitational.

Psychosocial Interventions

Individual psychotherapy to help the individual to process the
feelings aroused by being socially handicapped
Parent education and training
Behavioral modification
Social skills training
Educational interventions

Psychopharmacological Interventions

For hyperactivity, inattention and impulsivity: Psychostimulants
(methyphenidate, dextroamphetamine, metamphetamine, pemoline),
Clonidine, Tricyclic Antidepressants
(desipramine, nortriptyline)
For irritability and aggression: Mood Stabilizers (valproate,
carbamazepine, lithium), Beta Blockers (nadolol, propranolol),
Clonidine, Naltrexone, Neuroleptics (risperidone, haloperidol)
For preoccupations, rituals and compulsions: SSRIs (fluvoxamine,
fluoxetine), Tricyclic Antidepressants (clomipramine)
For anxiety: SSRIs (sertraline, fluoxetine), Tricyclic Antidepressants
(imipramine, clomipramine, nortriptyline)

Nessa
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