Asperger syndrome: symptoms, causes, therapy
Asperger syndrome (Asperger autism) is an autistic developmental disorder. It is accompanied by, among other things, limited empathy, a lack of social competence and often unusual special interests. With regard to language development and intelligence, however, people with Asperger’s syndrome are generally “normal”. Read more about symptoms, causes and therapies for Asperger’s syndrome here!
Asperger’s syndrome: short overview
- Symptoms: first signs from about 3 years of age, often delayed motor development, clumsiness, stereotypical behaviour, low ability to interact, little facial expression, often talking to oneself. Often striking “special interests”.
- Causes, risk factors: presumably among other things genetic, often higher age of the parents. Infections and diseases as well as medication in pregnancy, premature birth.
- Diagnosis: detailed anamnesis (taking of the previous and family history), external observations, psychiatric and neurological examinations
- Autism tests: Australian Scale for Asperger’s Syndrome (ASAS), Autism Diagnostic Observation Schedule (ADOS), Autism Spectrum Quotient (AQ) and Empathy Quotient (EQ)
- Attention: The tests only allow a rough estimation. Diagnosis difficult, especially in adults.
- Treatment: not curable, but suffering and social interaction can be favourably influenced. Especially behavioral therapy, communication training, supportive occupational therapy, physiotherapy
Asperger’s syndrome: Symptoms
Asperger’s syndrome symptoms usually become noticeable only after the age of three. Before that, the children do not show any abnormalities in their communicative and linguistic skills. They also take their first steps towards independence and are curious about their environment – just like children without Asperger’s syndrome. Only motor development is partly delayed, but not always.
That is why Asperger’s syndrome is often first discovered in children at pre-school or school age. Those affected have problems with social interactions, which can be seen, for example, in playing together with peers. For example, they have difficulty understanding the thoughts and feelings of others and have great difficulty in adapting to other people and social situations. They find it difficult to correctly interpret the facial expressions, gestures and tone of voice of others. They themselves often hardly show any facial expressions.
Often children with Asperger’s syndrome are also unable to have a mutual conversation. They talk when they want and about topics that interest them, without adapting to the audience. They do not understand subtle signals from the other party, for example to change the subject or end the conversation. Often Asperger-Autists also talk to themselves.
Children with Asperger’s syndrome also often do not know how to build friendships. However, some are not interested in social contacts and friendships at all.
Further Asperger’s syndrome symptoms are unusual distinctive interests and knowledge, often in a narrowly defined and partly little practice-relevant area (island talents). This highly specific interest can be in the melting point of metals, batteries or church steeples, for example. Those affected can be so fixated on areas of interest that they have little curiosity and attention for other things (for example at school). Because of this attention deficit disorder, Asperger’s Syndrome children are often bad pupils despite good intelligence.
In addition, Asperger autism sometimes shows disturbances of the sensory perception. For example, some of those affected react very sensitively to certain smells, sounds, surfaces or touch stimuli. In everyday situations, this can become a real stimulus satiation for those affected.
When walking and motor coordination, Asperger autistic people are often quite clumsy. Stereotypical behaviour also occurs.
Despite all the difficulties, people with Asperger’s syndrome often try not to stand out and compensate for their problems of social competence. In the long run this can be very exhausting and overstraining and lead to Asperger autistic people withdrawing from others.
Strengths in Asperger Syndrome
People with Asperger syndrome also have many strengths. This means that language development usually begins at an early stage: The affected children are often able to speak even before they are able to walk freely. Over time, they develop a very sophisticated, versatile language with a large vocabulary.
In addition, people with Asperger’s syndrome usually have good to above-average intelligence. The special interests and island talents mentioned above can be put to good use by some in their professional lives.
In addition, the ability to think is often impressive in Asperger syndrome. Original ideas as well as good skills in logical and abstract thinking are not uncommon.
Honesty, loyalty, reliability and a pronounced sense of justice are often cited as further strengths in Asperger’s syndrome. Children with Asperger’s syndrome often react to praise and recognition with motivation and gratitude.
By the way: The fact that speech development and intelligence are usually normal in Asperger’s syndrome is an important difference to early childhood autism. This is another form of autistic disorder.
Asperger’s syndrome is a subform of autism. “Autism” is more of a behavioral variant and less of a disease. In order to assess and judge the behaviour of a person, lifelong diagnostic support is actually necessary. Therefore, only anamnestic retrospect of the child’s development in the context of a diagnosis in adulthood can be considered.
Many behavioural characteristics specific to this patient group may also offer advantages: For example, people affected by Asperger’s syndrome often have special interests that make them particularly qualified in certain fields. Autistic people are often very conscientious and responsible.
It is best to give these people the space to use their specific skills in a socially adequate way. On the one hand, this requires rest and retreat possibilities, but also social integration specifically tailored to them.
Asperger’s syndrome: symptoms in adults
The problematic behaviors in Asperger autism are often not as noticeable in adult patients as in childhood. However, even adults usually have a grammatically correct, polished linguistic style and a detailed narrative style, which hardly distinguishes between important and unimportant things. Just like in children, Asperger’s syndrome can lead to a stiffened facial expression and the avoidance of eye contact in adults. Many affected people react little or not at all to a smile or a humorous remark.
The lack of empathy in Asperger’s syndrome also influences the topic of partnership. Those affected often seem cool and selfish. Many find it difficult to establish contacts with potential partners. If a relationship works out, many find it difficult to meet the partner’s requirements for intensive communication and compassion.
Asperger’s syndrome can also have an impact on sexual life: Some of those affected have only a slight need for physical closeness or even an aversion to it. Others may well have a desire for sex, but are very insecure in concrete situations, because sexual intimacy results from an intense mutual empathy. Nevertheless, Asperger’s syndrome in adults does not mean that a stable partnership and starting a family is not possible.
Asperger’s syndrome can have two different consequences for professional life: Some patients are quickly overwhelmed when dealing with colleagues or customers, get easily upset with their very direct, seemingly impolite manner and can hardly adapt flexibly to different requirements.
In other cases, however, Asperger’s syndrome in adults has a beneficial effect on professional development. Namely, when those affected can use their special interest in the disruption (for example in the field of information technology) in their work. In addition, many Asperger autistic people are able to achieve professional and private goals thanks to their often high cognitive abilities.
Accompanying diseases (comorbidities)
People with Asperger’s syndrome can also develop other diseases or disorders, especially in times of crisis such as moving house, retraining, puberty, birth or death in the family. The most common are ADHD, motor disorders, obsessive-compulsive symptoms, affective disorders (such as depression, anxiety), personality disorders, aggressive behaviour and sleep disorders. Tics / Tourett’s syndrome, eating disorders, dumbness (mutism), self-injuring behaviour and schizophrenia can also accompany Asperger’s autism.
Asperger’s syndrome: causes and risk factors
There are different forms of profound developmental disorder autism – Asperger’s syndrome (Asperger autism) is one of them. What causes it is not yet known. Experts suspect that the interaction of several factors is responsible for when someone develops Asperger’s syndrome.
It is assumed that genetic factors play a role in the development of the Asperger syndrome. Many affected people have close relatives with Asperger autism or similar behaviour. Several genetic changes are now known to increase the risk of developing an autistic disorder like Asperger’s syndrome.
Research suggests that a higher age of the father or mother also increases the likelihood of Asperger autism and other autism spectrum disorders.
Proven risk factors are maternal infections during pregnancy (such as rubella). It is also possible that (severe) premature birth, maternal diabetes, hypoglycaemia and lung function problems in newborns increase the risk of autistic disorders such as Asperger’s syndrome.
Taking certain drugs during pregnancy is also discussed as a risk factor. Epilepsy drugs (antiepileptic drugs, especially valproate) are suspected, for example.
In addition, neurological and biochemical abnormalities also seem to play a role. These include irregularities in the electrical brain waves, deviations in the structure of various brain regions and a changed proportional composition of nerve messengers (neurotransmitters).
Parents and vaccines are not to blame
The old hypothesis that autistic disorders such as Asperger’s syndrome are due to a lack of parental love is wrong. Neither does the type of upbringing nor the attachment to the parents increase the risk of autism. The same applies to alcohol consumption and a strong psychosocial burden on the mother during pregnancy.
Similarly, no evidence was found for the thesis that autism is caused by vaccines or their preservatives.
Asperger syndrome: examinations and diagnosis
Asperger’s syndrome is often difficult to distinguish from other abnormalities, such as profound developmental disorders, obsessive-compulsive disorders, obsessive-compulsive personality disorders, schizotypic or schizophrenic disorders. A detailed medical examination is therefore necessary for the diagnosis. For Asperger’s syndrome in children, a doctor for child and adolescent psychiatry is responsible. The expert for Asperger’s syndrome in adults is a specialist in psychiatry or psychotherapy.
A detailed examination in case of suspicion of Asperger’s Syndrome should be included:
- Conversation with patient and relatives
- Information on past or present diseases
- Reports and findings of other doctors
- Information from other people who know the patient (teachers, friends, educators, therapists etc.)
- thorough physical, psychiatric, neurological and laboratory medical examinations
During the conversation and during the examinations, the physician pays attention to typical signs of Asperger autism in the patient. Children with Asperger’s syndrome often play less imaginatively than their peers. Facial expression and speech melody are monotonous, the style of speech is polished and polished. The children can tell about their experiences in great detail, but do not separate the important from the unimportant. Children with Asperger’s autism are less likely to respond to a smile or emotional comments. They often avoid direct eye contact and also physical contact.
Asperger’s syndrome test
Various screening questionnaires and assessment scales support the diagnosis of Asperger’s syndrome. For children, for example, there is the “Australian Scale for Asperger’s Syndrome” (ASAS) and the “Autism Diagnostic Observation Schedule” (ADOS). The ASAS is a questionnaire intended for children of primary school age. It is used to record behaviours and skills that are typical of Asperger’s syndrome at this age. ADOS, on the other hand, creates various situations for the child that call for social interaction. The assessor shall assess the extent to which the child complies with this request.
In adults, for example, the “Autism Spectrum Quotient” (AQ) and the “Empathy Quotient” (EQ) are used to support the diagnosis of Asperger’s Syndrome. These are self-assessment tools – the person concerned therefore completes the questionnaires himself. However, there are also external assessment instruments such as the “Marburg Assessment Scale for Asperger’s Syndrome” (MBAS).
Important: Each Asperger’s syndrome test is only a rough estimate. No diagnosis can be made based on the test result alone.
Asperger Syndrome: Diagnosis in adults difficult
Diagnosing Asperger’s syndrome in adults is much more difficult than in children. The problematic behaviours are usually more pronounced in childhood and often change as the child grows up. In addition, many of those affected cannot remember the difficulties they experienced during childhood.
In addition, many adults with Asperger’s syndrome develop coping strategies to appear as “normal” as possible. This often allows them to lead an inconspicuous life, have a job, a partner and children. They usually only go to the doctor for secondary diseases, such as depression, anxiety, obsessive-compulsive or eating disorders. With good knowledge of the symptoms, however, the doctor can also then diagnose Asperger’s syndrome in adults as the causative underlying disease.
Asperger’s Syndrome: Treatment
The Asperger’s syndrome cannot be cured so far. One can only try to support those affected in their everyday life with the right support and help them, for example, to improve social skills. However, not every Asperger syndrome has “disease value” and must be treated. The extent of the symptoms and the degree of suffering of the person concerned are decisive in this respect.
The Asperger’s syndrome therapy consists of different components. It is adapted to the individual needs of the patient. The age of the affected person, the severity of the Asperger autism with the individual symptoms as well as possible accompanying diseases or disorders play a role.
Behavioural therapy methods for Asperger’s syndrome are generally recognised. These were developed especially for children. The ideal is early support, i.e. individually adapted behavioural therapy from an early age.
Other therapeutic measures can also be helpful, such as training social and communication skills in the group. The people concerned can train social rules, practise how to conduct conversations and generally make social experiences.
Occasionally, procedures such as occupational therapy and physiotherapy can also be useful. Some parents also report that their Asperger’s syndrome child benefits from riding therapy or active (possibly supported) leisure activities. The latter can be, for example, membership in a chess club, sports training, making music or dancing.
Psychotherapy can help with accompanying illnesses or disorders, such as anxiety or obsessive-compulsive disorder. In such comorbidities, sometimes the administration of medication may be indicated. These can be, for example, antidepressants, remedies against hyperactivity or against compulsive acts. However, the medication must always be part of a comprehensive therapy concept.
Asperger’s syndrome: Other measures
For Asperger’s syndrome and all other autistic disorders the following applies: The affected persons need a manageable, predictable environment to feel safe. Clear and permanent structures and routines in everyday life are therefore important.
The older a child with Asperger’s syndrome is, the more important it is to understand their own weaknesses and problems: The child should be educated about his autistic disorder by the attending physician or therapist (psychoeducation).
For adolescents and adults with Asperger’s syndrome, finding a job or adapting to a career is also important for the success of the therapy and quality of life. Professions with intensive social contact are usually not advisable. Adapted to the individual possibilities, however, suitable professions can be found or one’s own special skills can be used in a specific profession.
Asperger’s syndrome: course of disease and prognosis
It is difficult to predict how Asperger’s syndrome develops individually. Existing studies indicate that the disease has a stable course. For most of those affected, contact and social behaviour show a slight improvement over time. However, the fundamental disturbances remain. Some Asperger autistic people cannot lead an independent life. Others, on the other hand, have a stable partnership and a profession where they may even be able to bring their special interest to bear. However, contact with colleagues remains difficult at times.
Possible accompanying diseases or disorders have a great influence on the prognosis for Asperger’s syndrome. They can have a significant impact on the further course and developmental opportunities of the affected person. They should therefore be treated professionally and at an early stage.