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Asperger Syndrome (sometimes called Aspergers) is an Autism Spectrum Disorder, but individuals with Asperger Syndrome (AS) may display different symptoms from other individuals on the autistic spectrum, because they often have above average intelligence and reasonable language skills (no clinically significant delay in spoken or receptive language). Single words may have developed by 2 years of age and simple communicative phrases by three years. However, children with this syndrome have difficulties with social interaction, and reading social cues and body language. They are also likely to have a narrow range of interests and activities, and some individuals also have delayed motor skills.
The previous edition of the Diagnostic and Statistical Manual – DSM IV-TR (developed by the American Psychiatric Association to provide the criteria by which clinicians define and diagnose various psychiatric and developmental conditions, including autism spectrum disorders), divides Asperger Syndrome into 2 clusters of impairments:
1. Qualitative impairment of social interactions – this presents with difficulties in understanding non-verbal behaviour, establishing peer relationships, and social reciprocity.
2. Restricted areas of interest – this presents with stereotypic behaviours, and narrow range of interests.
However in 2013 the updated version of the Diagnostic and Statistical Manual-DSM-V refined the term Asperger Syndrome:
The diagnostic labels Autistic Disorder, Asperger’s Disorder, PDD-NOS and Childhood Disintegrative Disorder that were in the previous DSM edition under the heading Pervasive Developmental Disorders will no longer be used. These subcategories have been merged into the single broader diagnostic category of Autism Spectrum Disorder (ASD). A diagnosis of ASD may be considered for girls with Rett Syndrome if they present with behaviours that meet the ASD diagnostic criteria. Despite the new guidelines from the American Psychiatric Association, it is likely that many of the previous terms will continue to be used for some time.
Other Behaviours and symptoms
Individuals with Asperger’s Syndrome may also display verbosity, have difficulty regulating their voice volume, suffer from attention difficulties and motor clumsiness. Although there is no cure for AS, the fact that these individuals have average to above average intelligence and reasonable language skills, allows a lot of scope to teach new skills and for the individuals to make good progress in learning about social interaction and social norms. The general long term outlook can be favourable for most individuals, with many progressing into the work place following schooling.
Speech and Language
Although individuals with Asperger Syndrome can use and understand language, there may be several subtle differences when compared to a neuro-typical individual’s language. Their intonation and pitch may be different, often sounding quite flat, and sometimes they will not monitor their volume, and talk loudly. They may have difficulty understanding abstract language such as metaphor, idioms and sarcasm, and are unlikely to use this type of language (see “Avoiding Abstract Language”). They may have difficulty making inferences from information they read or hear. An individual with Aspergers may also have a very literal understanding of language. Time and maths concepts may also be very difficult for these individuals to comprehend.
Individuals with Aspergers Syndrome may also have difficulties with social skills. Skills such as turntaking, initiating conversation, asking appropriate questions, and responding appropriately in context can sometimes be a difficulty. An individual with Asperger’s may also like to talk at length about their own interests and show little enthusiasm to listen to a conversation about other people’s interests. There may also be inappropriate physical contact with touching, pushing past, or not respecting other people’s personal space.
A lack of empathy is often a trait that individuals with AS display, they may be insensitive to other peoples distress or react inappropriately at the wrong times (e.g. laugh when someone is crying). Language may be used unintentionally that hurts peoples feelings, such as telling someone they are fat.
Individuals with Asperger Syndrome may also have difficulty with rules, often not being able to generalise the same rule across environments. Their disregard for authority may be due to their lack of understanding people’s roles and status. Some individuals may have sensory sensitivities or have things that trigger tantrums or inappropriate behaviour (such as sudden changes to a routine). People working with individuals on the autism spectrum must be aware of behavioural triggers and also prepare individuals when there are changes to their routine. Other individuals may also have obsessive or ritualistic behaviours, which they may find calming or stimulating.
Evidence shows that children with AS may be more motivated to learn about a subject if it is incorporated with a special interest. Students may also respond well to treatment involving visual supports and social stories to help them understand and organise. Awareness of sensory difficulties should also be paramount, with the use of things such as earplugs (to avoid loud noises or distractions), or keyboards (when writing is difficult due to poor fine-motor difficulties).
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