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Asperger Syndrome

KidsHealth.org Thu May 12, 8:00 PM ET

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Asperger syndrome (AS) is a neurobiological disorder that is part of a group of diagnoses called "autistic spectrum disorders." The term "autistic spectrum" refers to a range of developmental disabilities that includes autism as well as other disorders with similar characteristics.

They are known as spectrum disorders because the symptoms of each can appear in different combinations and in varying degrees of severity: two children with the same diagnosis, though they may share certain patterns of behavior, can exhibit a wide range of skills and abilities.

As a result, general terms such as "low-functioning," "high- functioning," "autistic tendencies," "pervasive developmental disorder," and others are often used to describe children whose behaviors fall within the spectrum. Children with AS share many of the same symptoms as children with "high-functioning autism."

It's estimated that over 400,000 families are affected by AS. Because milder cases are being identified more frequently, the incidence appears to be increasing. However, like other autistic spectrum disorders, AS is often difficult to diagnose and treat.

What Is Asperger Syndrome?
The disorder is named after Hans Asperger, a Viennese pediatrician who, in 1940, first described a set of behavior patterns apparent in some of his patients, mostly males. Asperger noticed that although these boys had normal intelligence and language development, they had severely impaired social skills, were unable to communicate effectively with others, and had poor coordination.

According to the Asperger Syndrome Coalition of the United States, the onset of AS is later than what is typical in autism - or at least it is recognized later. A large number of children are diagnosed after the age of 3, with most diagnosed between the ages of 5 and 9.

Asperger syndrome is characterized by poor social interactions, obsessions, odd speech patterns, and other peculiar mannerisms. Children with AS often have few facial expressions and have difficulty reading the body language of others; they may engage in obsessive routines and may display an unusual sensitivity to sensory stimuli (for example, they may be bothered by a light that no one else notices or prefer to wear clothing made only of a certain material). Overall, people with AS are quite capable of functioning in everyday life, but they tend to be somewhat socially immature and may be seen by others as odd or eccentric.

Other characteristics of AS include motor delays, clumsiness, limited interests, and peculiar preoccupations. Adults with AS have trouble demonstrating empathy for others, and social interactions continue to be difficult. Experts say that AS follows a continuous course and usually lasts a lifetime. However, symptoms can wax and wane over the course of time, and early intervention services can be helpful.

Signs and Symptoms
Because the symptoms of AS are often hard to differentiate from other behavioral problems, it's best to let your child's doctor or other health professional make evaluate your child's symptoms. It's not uncommon for a child to be diagnosed with attention deficit hyperactivity disorder (AD/HD) before the diagnosis of AS is made later on.

The following are a number of signs and symptoms that might be present in a child with AS:

    * inappropriate or minimal social interactions
    * conversations almost always revolving around self rather than others
    * stilted or repetitive speech
    * lack of "common sense"
    * problems with reading, math or writing skills
    * obsession with complex topics such as patterns or music
    * average to above-average verbal cognitive abilities
    * average to below-average nonverbal cognitive abilities
    * awkward movements
    * odd behaviors or mannerisms

It's important to note that, unlike children with autism, children with AS may show no delays in language development; they usually have good grammatical skills and an advanced vocabulary at an early age. However, they typically do exhibit a language disorder; they may be very literal, and they may have trouble using language in a social context. Often there are no obvious delays in cognitive development or in age-appropriate self-help skills such as feeding and dressing themselves. Although individuals with AS may have problems with attention span, problems with organization, and skills that seem well developed in some areas and lacking in others, they usually have average and sometimes above average intelligence.

What Causes Asperger Syndrome?
Researchers and mental health experts are still investigating the causes of autism and AS. Many believe that the pattern of behavior that characterizes AS may have many causes. There seems to be a hereditary component to AS, and research indicates that in some cases AS may be associated wih other mental health disorders such as depression and bipolar disorder. Researchers are also looking into whether environmental factors that affect brain development might play a role in the condition.

Does anyone know anything about the Asperger Syndrome Coalition of the United States, mentioned in the article?

Lili Marlene Wrote:
Does anyone know anything about the Asperger Syndrome Coalition of the United States, mentioned in the article?


           That organization went bellyup two years ago. It was founded in 1997 and originally called ASPEN. It had to change its name after it was forced to by ASPEN of New Jersey, a coalition of local chapters founded by a woman who dropped out of the national organization once she realized, as I did, how insular and self-serving they were.

         The underground code name for the ASC-US original board was
"Eight jewish mothers from hell."  That hit it on the head perfectly.

       I was on the advisory board of ASC-US and offered a board position. I didn't accept it. I was eventually kicked off the advisory board after I complained about a conflict of interest situation. Karma is sweet. ASPEN took four years to have a national conference. The first one was pretty good. The second one, after I left, bombed and they had to fold their tent.

         They saved face by claiming to "merge" with MAAP but the truth is they were dead in the water. Hearing that made my day. I don't like being screwed by anyone.

                                     Jerry Newport

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* average to above-average verbal cognitive abilities
* average to below-average nonverbal cognitive abilities

Shouldn't that be the other way round?

Everything that I've read about comparing verbal and non-verbal cognitive abilities in Aspergers and/or HFA is confusing and contradictory. The current fad in academia seems to be to lump all forms of autism into the category of "ASD" or "Autism spectrum disorders" and then the academics feel free to make sweeping generalisations about all of us. I personally the researchers should try comparing NVLDs and other kinds of autistics for sub-test scores. I suspect that might show up a genuine difference in cognitive type.

If you want to get confused good and proper about the whole subtest score question, I recommend you read this paper:

Barnhill G, Hagiwara T, Myles B S, Simpson R L. (2000) Asperger syndrome: a study of the cognitive profiles of 37 children and adolescents. Focus on autism and other developmental disabilities. 2000: 15(3):146-153.

Lili Marlene Wrote:
Everything that I've read about comparing verbal and non-verbal cognitive abilities in Aspergers and/or HFA is confusing and contradictory.

Bingo!

It seems that *most* trends observed in such studies are caused mainly by the criteria by which the participants are "divided" into sub-groups in the first place (circular arguments).

I mean, what do they expect to find if they put people with language delay in one group and people with fewer motor problems in the other? That they are the same?  :lol:

Raeth Wrote:

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* average to above-average verbal cognitive abilities
* average to below-average nonverbal cognitive abilities

Shouldn't that be the other way round?


No.
People with Aspergers are often verbally precocious - hence the "little professor" label for AS kids. There are lots of studies to support this, particularly differentiating HFA/AD and AS, although not so much information differentiating AS from NT's.

Here are some articles you might want to chase up, if you are interested in this.

Cederlund, Mats; Gillberg, Christopher(Oct 2004) One hundred males with Asperger syndrome: A clinical study of background and associated factors.  Developmental Medicine & Child Neurology, Vol 46(10), . pp. 652-660.

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Quote from the abstract:
" There was a high rate (51%) of non-verbal learning disability (denned as Verbal IQ more than 15 points higher than Performance IQ), but otherwise there was little or no support for the notion of right-hemisphere brain dysfunction being at the core of the syndrome. "



Ghaziuddin, Mohammad; Mountain-Kimchi, Kimberly (Jun 2004) Defining the intellectual profile of Asperger syndrome: Comparison with high-functioning autism.  Journal of Autism & Developmental Disorders, Vol 34(3). pp. 279-284.

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Quote from the abstract
" As a group, subjects with AS showed a higher verbal IQ and higher scores on information and vocabulary subtests than those with HFA."


Miller, Judith N.; Ozonoff, Sally (May 2000) The External Validity of Asperger Disorder: Lack of Evidence From the Domain of Neuropsychology. By: ; Source: Journal of Abnormal Psychology. Vol. 109 (2) , pp. 227-238

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Quote from the abstract:
"The present study compared individuals with high-functioning autism (HFA) and Asperger disorder (AD) in intellectual, motor, visuospatial, and executive function domains. Participants with AD demonstrated significantly higher Verbal and Full Scale IQ scores, significantly larger Verbal-Performance IQ discrepancies, and significantly better visual-perceptual skills than those with HFA."



Grossman, James B.; Klin, Ami; Carter, Alice S. (Mar 2000) Verbal bias in recognition of facial emotions in children with Asperger syndrome. Journal of Child Psychology & Psychiatry, Vol 41(3), . pp. 369-379

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From the abstract
"When presented with a more demanding affective processing task, Ss with AS showed a bias towards visual-verbal over visual-affective information (i.e., words over faces). Thus, children with AS may be using compensatory strategies, such as verbal mediation, to process facial expressions of emotion. "



Ene, Michaela (Oct 1999) High-functioning autism or Asperger Syndrome? A comparison of emotion perception abilities and neurocognitive functioning. ; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 60(4-B), . pp. 1849.

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From the abstract
"Consistent with previous research studies, a comparison of HFA and AS neurocognitive profiles as measured by the WISC-III, revealed significant differences between these two groups with respect to overall verbal skills. HFA individuals were significantly more impaired in their verbal comprehension abilities compared to AS individuals. Although HFA and AS groups were matched on overall Performance IQ, a significant and important dissociation between HFA and AS groups with respect to their non-verbal intellectual abilities was evident when examining specific subtests of the WISC-III. Results indicated that HFA performed significantly better than AS on tasks involving abstract visual-spatial skills (Block Design and Object Assembly), while AS individuals performed significantly better than HFA participants on tasks requiring the visual integration of more meaningful, contextually relevant information (Picture Completion and Picture Arrangement)"


Manjiviona, Janine; Prior, Margot (Dec 1999)  Neuropsychological profiles of children with Asperger syndrome and autism. Autism, Vol 3(4), . pp. 327-356.

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Quote from abstract
" Clinically diagnosed children with Asperger syndrome and autism were not differentiated on the basis of their neuropsychological profiles. The major difference between them was the overall higher IQ in Asperger syndrome, which was largely due to superior verbal abilities."



Ramberg, Chris; Ehlers, Stephan; Nydén, Agneta (1996.) Language and pragmatic functions in school-age children on the autism spectrum. ; European Journal of Disorders of Communication, Vol 31(4),  pp. 387-413.

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From the abstract:
" Ss completed tests of vocabulary, differentiation between comprehension of language and expression or production of language, grammar, memory and attentional skills, and conversational structure, non-verbal communication skills, and prosody. AS is associated with higher full-scale and verbal IQ than AU "


I guess it depends what you are reading, but there have been quite a lot of studies supporting AS as having higher verbal abilities than HFA or autistic disorder.

Well, as the main difference between definitions of AS and HFA is that AS doesn't have delay in speech, it seems reasonable to expect that generally the language skills in AS will be stronger. It's a circular argument type-situation.

I'd like to point out that being late to speak is not necessarily an indication of weakness in language skills. We have an aspie child in our family who, buy some definitions of language delay, was a late speaker, but at a young age showed precocious and advanced talents in reading and writing and vocabulary, and these skills have been recogised by the education system as being in the gifted category. So I'm of the opinion that IQ testing is a much better indicator of deficits or abilities than developmental history.

What does the research tell us about writing abilities in AS and HFA? We all know that there can be a big difference between a person's ability to express themself in print and verbally.
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