Asperger syndrome AS , also known as Asperger's , is a developmental disorder characterised by significant difficulties in social interaction and nonverbal communication , along with restricted and repetitive patterns of behavior and interests. The exact cause of Asperger's is unknown. There is no single treatment, and the effectiveness of particular interventions is supported by only limited data. In , Asperger's was estimated to affect The World Health Organization WHO defined Asperger syndrome AS as one of the autism spectrum disorders ASD or pervasive developmental disorders PDD , which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual's functioning, and by restricted and repetitive interests and behavior.
Like other psychological development disorders, ASD begins in infancy or childhood, has a steady course without remission or relapse, and has impairments that result from maturation-related changes in various systems of the brain. As a pervasive developmental disorder , Asperger syndrome is distinguished by a pattern of symptoms rather than a single symptom. It is characterized by qualitative impairment in social interaction, by stereotyped and restricted patterns of behavior, activities, and interests, and by no clinically significant delay in cognitive development or general delay in language.
A lack of demonstrated empathy affects aspects of communal living for persons with Asperger syndrome. People with AS may not be as withdrawn around others, compared with those with other, more debilitating forms of autism ; they approach others, even if awkwardly. For example, a person with AS may engage in a one-sided, long-winded speech about a favorite topic, while misunderstanding or not recognizing the listener's feelings or reactions, such as a wish to change the topic of talk or end the interaction.
Some of them may even display selective mutism , not speaking at all to most people and excessively to specific others. Some may choose only to talk to people they like. The cognitive ability of children with AS often allows them to articulate social norms in a laboratory context,  where they may be able to show a theoretical understanding of other people's emotions; however, they typically have difficulty acting on this knowledge in fluid, real-life situations. Childhood desire for companionship can become numbed through a history of failed social encounters.
The hypothesis that individuals with AS are predisposed to violent or criminal behavior has been investigated, but is not supported by data.
A review found that an overwhelming number of reported violent criminals with Asperger syndrome also had other coexisting psychotic psychiatric disorders such as schizoaffective disorder. People with Asperger syndrome can display behavior, interests, and activities that are restricted and repetitive and are sometimes abnormally intense or focused. They may stick to inflexible routines, move in stereotyped and repetitive ways, preoccupy themselves with parts of objects, or engage in compulsive behaviors like lining objects up to form patterns.
Pursuit of specific and narrow areas of interest is one of the most striking among possible features of AS. Because narrow topics often capture the interest of children, this symptom may go unrecognized. According to the Adult Asperger Assessment AAA diagnostic test, a lack of interest in fiction and a positive preference towards non-fiction is common among adults with AS.
Although individuals with Asperger syndrome acquire language skills without significant general delay and their speech typically lacks significant abnormalities, language acquisition and use is often atypical.
Three aspects of communication patterns are of clinical interest: poor prosody, tangential and circumstantial speech , and marked verbosity. Although inflection and intonation may be less rigid or monotonic than in classic autism, people with AS often have a limited range of intonation: speech may be unusually fast, jerky, or loud.
Speech may convey a sense of incoherence ; the conversational style often includes monologues about topics that bore the listener, fails to provide context for comments, or fails to suppress internal thoughts. Individuals with AS may fail to detect whether the listener is interested or engaged in the conversation. The speaker's conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics, are often unsuccessful.
Children with AS may have a sophisticated vocabulary at a young age and such children have often been colloquially called "little professors", but have difficulty understanding figurative language and tend to use language literally.
Although individuals with AS usually understand the cognitive basis of humor , they seem to lack understanding of the intent of humor to share enjoyment with others. Individuals with Asperger syndrome may have signs or symptoms that are independent of the diagnosis, but can affect the individual or the family.
Individuals with AS often have excellent auditory and visual perception. They may be unusually sensitive or insensitive to sound, light, and other stimuli;  these sensory responses are found in other developmental disorders and are not specific to AS or to ASD. There is little support for increased fight-or-flight response or failure of habituation in autism; there is more evidence of decreased responsiveness to sensory stimuli, although several studies show no differences.
Hans Asperger's initial accounts  and other diagnostic schemes  include descriptions of physical clumsiness. Children with AS may be delayed in acquiring skills requiring dexterity , such as riding a bicycle or opening a jar, and may seem to move awkwardly or feel "uncomfortable in their own skin". They may be poorly coordinated or have an odd or bouncy gait or posture, poor handwriting, or problems with motor coordination. There is no evidence that these motor skills problems differentiate AS from other high-functioning ASDs.
Children with AS are more likely to have sleep problems, including difficulty in falling asleep, frequent nocturnal awakenings , and early morning awakenings. Hans Asperger described common traits among his patients' family members, especially fathers, and research supports this observation and suggests a genetic contribution to Asperger syndrome.
Although no specific genetic factor has yet been identified, multiple factors are believed to play a role in the expression of autism, given the variability in symptoms seen in children. A few ASD cases have been linked to exposure to teratogens agents that cause birth defects during the first eight weeks from conception.
Although this does not exclude the possibility that ASD can be initiated or affected later, it is strong evidence that ASD arises very early in development. Asperger syndrome appears to result from developmental factors that affect many or all functional brain systems, as opposed to localized effects. The underconnectivity theory hypothesizes underfunctioning high-level neural connections and synchronization, along with an excess of low-level processes.
The mirror neuron system MNS theory hypothesizes that alterations to the development of the MNS interfere with imitation and lead to Asperger's core feature of social impairment. Changes in brain neurotransmitter activity have been found. There is increased dopaminergic activity, whereas there is reduced serotonin due to reduced tryptophan. Standard diagnostic criteria require impairment in social interaction and repetitive and stereotyped patterns of behavior, activities, and interests, without significant delay in language or cognitive development.
Unlike the international standard,  the DSM-IV-TR criteria also required significant impairment in day-to-day functioning;  DSM-5 eliminated AS as a separate diagnosis in , and folded it into the umbrella of autism spectrum disorders. Diagnosis is most commonly made between the ages of four and eleven. Underdiagnosis and overdiagnosis may be problems.
The cost and difficulty of screening and assessment can delay diagnosis. Conversely, the increasing popularity of drug treatment options and the expansion of benefits has motivated providers to overdiagnose ASD.
There are questions about the external validity of the AS diagnosis. Conditions that must be considered in a differential diagnosis along with ADHD include other ASDs, the schizophrenia spectrum , personality disorders , obsessive—compulsive disorder , major depressive disorder , semantic pragmatic disorder , nonverbal learning disorder , social anxiety disorder ,   Tourette syndrome ,  stereotypic movement disorder , bipolar disorder ,  social-cognitive deficits due to brain damage from alcohol abuse ,  and obsessive—compulsive personality disorder OCPD.
Parents of children with Asperger syndrome can typically trace differences in their children's development to as early as 30 months of age. Asperger syndrome treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication, and vocational skills that are not naturally acquired during development,  with intervention tailored to the needs of the individual based on multidisciplinary assessment. Managing AS ideally involves multiple therapies that address core symptoms of the disorder.
While most professionals agree that the earlier the intervention, the better, there is no treatment combination that is recommended above others. Of the many studies on behavior-based early intervention programs, most are case reports of up to five participants and typically examine a few problem behaviors such as self-injury , aggression , noncompliance, stereotypies , or spontaneous language; unintended side effects are largely ignored.
No medications directly treat the core symptoms of AS. The selective serotonin reuptake inhibitors SSRIs fluoxetine , fluvoxamine , and sertraline have been effective in treating restricted and repetitive interests and behaviors,    while stimulant medication, such as methylphenidate , can reduce inattention.
Care must be taken with medications, as side effects may be more common and harder to evaluate in individuals with AS, and tests of drugs' effectiveness against comorbid conditions routinely exclude individuals from the autism spectrum.
Individuals with AS may be unable to identify and communicate their internal moods and emotions or to tolerate side effects that for most people would not be problematic. Although many attend regular education classes, some children with AS may utilize special education services because of their social and behavioral difficulties. Despite high cognitive potential, most young adults with AS remain at home, yet some do marry and work independently.
Education of families is critical in developing strategies for understanding strengths and weaknesses;  helping the family to cope improves outcomes in children. Frequency estimates vary enormously. In , it was estimated that For example, a relatively small study of 5, eight-year-old children in Finland found 2. Boys seem to be more likely to have AS than girls; estimates of the sex ratio range from 1.
Named after the Austrian pediatrician Hans Asperger — , Asperger syndrome is a relatively new diagnosis in the field of autism,  though a syndrome like it was described as early as by Grunya Sukhareva — They also lacked nonverbal communication skills and were physically clumsy. Asperger described this "autistic psychopathy" as social isolation.
Unlike today's AS, autistic psychopathy could be found in people of all levels of intelligence, including those with intellectual disability. They fulfill their role well, perhaps better than anyone else could, and we are talking of people who as children had the greatest difficulties and caused untold worries to their care-givers. Asperger's paper was published during World War II and in German, so it was not widely read elsewhere.
Lorna Wing used the term Asperger syndrome in ,  and popularized it to the English-speaking medical community in her February publication    of case studies of children showing the symptoms described by Asperger,  and Uta Frith translated his paper to English in Hundreds of books, articles and websites now describe AS and prevalence estimates have increased dramatically for ASD, with AS recognized as an important subgroup. People identifying with Asperger syndrome may refer to themselves in casual conversation as aspies a term first used in print by Liane Holliday Willey in Proponents of this view reject the notion that there is an "ideal" brain configuration and that any deviation from the norm is pathological ; they promote tolerance for what they call neurodiversity.
Some researchers have argued that AS can be viewed as a different cognitive style, not a disorder,  and that it should be removed from the standard Diagnostic and Statistical Manual , much as homosexuality was removed. By contrast, Pier Jaarsma and Welin wrote in that the "broad version of the neurodiversity claim, covering low-functioning as well as high-functioning autism, is problematic.
Only a narrow conception of neurodiversity, referring exclusively to high-functioning autists, is reasonable. The narrow conception of the neurodiversity claim should be accepted but the broader claim should not. It's given me bad fine motor coordination problems where I can hardly write. I have an impaired ability to relate to people. I can't concentrate or get things done. From Wikipedia, the free encyclopedia.
Neurodevelopmental disorder affecting social interaction. For other uses, see Asperger's disambiguation. Further information: Asperger syndrome and interpersonal relationships.
Further information: Causes of autism. Main article: Diagnosis of Asperger syndrome. Further information: Autism therapies. Further information: Conditions comorbid to autism spectrum disorders. Main article: History of Asperger syndrome. See also: Societal and cultural aspects of autism.