Autism

Asperger Syndrome Symptoms and Treatment

An Overview of Asperger Syndrome

Asperger syndrome, one of five diagnoses within a category called pervasive developmental disorders, was officially added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. It described people with a very high-functioning form of autism. 

Asperger syndrome was officially removed from the next version of the manual, the DSM-V, in 2013. Today, people with the symptoms of what would have been called Asperger syndrome are now diagnosed as having level one autism spectrum disorder (although the original name for the condition is still used widely by many non-health professionals, and so is used here).

Asperger syndrome is different from other disorders on the autism spectrum in part because it was often diagnosed in older children and adults, as opposed to very young children. Many children with very high-functioning autism pass their earliest milestones with flying colors—that is until they reach an age when they are expected to manage complex social relationships, conversations, or sensory challenges (often around grade three, but sometimes much later).

 

The DSM-IV did describe distinct differences between Asperger syndrome and other autism spectrum disorders, stating that:

  • "The essential features of Asperger's Disorder are severe and sustained impairment in social interaction...and the development of restricted, repetitive patterns of behavior, interests, and activities...The disturbance must cause clinically significant impairment in social, occupational, or other important areas of functioning. In contrast to Autistic Disorder, there are no clinically significant delays or deviances in language acquisition (e.g., single non-echoed words are used communicatively by age 2 years, and spontaneous communicative phrases are used by age 3 years)...although more subtle aspects of social communication (e.g., typical give and take in conversation) may be affected."

    While these sound like significant differences in diagnosis, the truth is that—in the words of Asperger syndrome expert Dr. Tony Attwood—"the difference between high-functioning autism and Asperger syndrome is mostly in the spelling."

    This is particularly the case as children grow up and differences in language ability at the age of three become irrelevant. By the time people with Asperger syndrome or high-functioning autism are teens, those distinctions have essentially disappeared, making it very difficult to distinguish between the two diagnoses.

    The History of Asperger Syndrome

    Hans Asperger was a Viennese child psychologist who worked with a group of boys, all of whom had similar developmental differences. While they were all intelligent and had normal language skills, they also had a set of autism-like symptoms.

    As a result of the second world war, Asperger’s work disappeared for a number of years. When it reappeared in the late 1980s, it garnered a good deal of interest. Today, Asperger’s syndrome—despite the fact that is no longer an official diagnostic category—is in the news virtually every day.

    What Are the Symptoms of Asperger Syndrome (Level 1 Autism Spectrum Disorder)?

    Most people with very high-functioning autism have no problem with basic speech, and they may be very intelligent and capable. The issues that emerge for people diagnosed with Asperger's (level 1 autism) include:

    • Difficulty with social and communication skills (the ability to "read" body language, understand sarcasm, etc.)
    • Sensitivity to loud noise, bright lights, and other sensory input

    Individuals may also have difficulty with:

    • Changes in routines
    • Talking/thinking about topics that are not of particular interest
    • Imagining what other people are thinking or feeling

    It's important to note that people with high-functioning autism are not lacking in emotions and can be very empathetic. In fact, they can sometimes be extremely emotional, highly sensitive, and easily moved to joy, anger, frustration, enthusiasm, etc. 

    In some cases, they may be creative and innovative (though in others, they may prefer a regular routine).

    Difficulties arise, however, when folks at the high end of the autism spectrum run up against social conventions or expectations that are complex and require a high level of social thinking skills.

    If this sounds like it describes an awful lot of people, it's especially important to note that a person who has the traits described, but is able to function comfortably in his daily life, would not be diagnosed with Asperger syndrome. In other words, many people have some or all of the symptoms of Asperger syndrome, but because they are able to hold down a job or function in school, interact appropriately with others, and take care of their own daily needs, they are not diagnosable as having the condition.

    Could I (or Someone I Know) Have Asperger Syndrome?

    Setting aside the fact that no one can receive an Asperger's diagnosis anymore, could you or someone you know have the same symptoms and, thus, qualify for an autism spectrum diagnosis? It's certainly possible, and several self-tests have been designed to provide a clue as to whether an evaluation might be a good idea.

    The Cambridge Lifespan Asperger Syndrome Service (CLASS), an organization in the United Kingdom that works with adults with Asperger's, has developed a simple 10-question checklist to help with a preliminary self-diagnosis:

    • I find social situations confusing.
    • I find it hard to make small talk.
    • I did not enjoy imaginative storywriting at school.
    • I am good at picking up details and facts.
    • I find it hard to work out what other people are thinking and feeling.
    • I can focus on certain things for very long periods.
    • People often say I was rude even when I didn't intend to be.
    • I have unusually strong, narrow interests.
    • I do certain things in an inflexible, repetitive way.
    • I have always had difficulty making friends.

    If you do answer “yes” to many of these questions relative to yourself or a loved one, you may have uncovered an undiagnosed case of Asperger syndrome/level 1 autism spectrum disorder. (Of course, a discussion with a healthcare professional is in order before jumping to any conclusions, however.) For some teens and adults, this is a tremendous relief: It puts a name on a set of issues that has troubled them throughout their lives. It also opens the door to support, treatment, and community.

    A Word From Verywell

    There are psychologists, psychiatrists, and other practitioners with specific experience diagnosing high-functioning autism in teens and adults. These same practitioners may be able to recommend therapies such as social skills coaching, speech therapy, occupational therapy, etc. They may also be able to recommend you to local support and self-advocacy groups.

    But know that there is no obligation to do anything at all about Asperger syndrome. In fact, many adults feel that being an “aspie,” as some people call it, is a point of pride. These are unique, often successful individuals who are simply...themselves.

    Sources:

    American Psychiatric Association. (2000). Diagnostic criteria for Asperger’s disorder. In Diagnostic and statistical manual of mental disorders (Fourth edition---text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 84.

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

    Autism Research Centre, Department of Developmental Psychiatry, University of Cambridge. Website. 2016.

    Interview with Dr. Tony Attwood, May, 2007.

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