The study of the causes of Asperger syndrome continues to the present and far from its completion. The primary morphological substrate and the pathogenesis of the disease have not yet been identified.
As a working hypothesis, an assumption is made about the autoimmune reaction of the maternal organism, causing brain damage to the fetus. There is much talk about the negative effects of preventive vaccinations, the negative effects of mercury-containing preservatives in vaccines, as well as comprehensive vaccination, allegedly overloading the child’s immune system.
The theory of hormonal disruption in a child (low or high cortisol levels, elevated testosterone levels) has not yet found reliable scientific evidence to date; The relationship between autistic disorders, including Asperger syndrome, and prematurity, attention deficit hyperactivity disorder is being studied.
Genetic predisposition, the male sex, the effects of toxic substances on the developing fetus in the first months of pregnancy, fetal and postnatal viral infections (rubella, toxoplasmosis, cytomegaly, herpes, etc.) are called probable risk factors for the development of Asperger’s syndrome.
Characteristics of Asperger Syndrome
Social difficulties in children with Asperger syndrome
Asperger syndrome is a complex common (pervasive) disorder that affects all aspects of a child’s personality. The structure of the disorder includes the difficulties of socialization, narrow but intense interests; features of the speech profile and behavior. Unlike classic autism, children with Asperger syndrome have moderate (sometimes above average) intelligence and a certain lexicographic base.
Usually characteristic of Asperger syndrome symptoms become noticeable by 2-3 years and can vary from mild to severe. In infancy, Asperger syndrome can manifest itself in a child’s increased calm or, on the contrary, irritability, mobility, sleep disturbance (difficulty falling asleep, frequent waking, sensitive sleep, etc.), selectivity in nutrition. Disorders that are specific to Asperger syndrome early manifest themselves. Children attending kindergarten, hardly part with their parents, poorly adapted to new conditions, do not play with other children, do not enter into friendships, preferring to keep apart.
The difficulties of adaptation make a child vulnerable to infections, so children with Asperger syndrome are often considered to be sick. In turn, this further limits the social interaction of children with their peers, and by the school age, the symptoms of Asperger syndrome become pronounced.
Disorder of social behavior in children with Asperger syndrome is manifested in insensitivity to the emotions and feelings of other people, pronounced facial expressions, gestures, and shades of speech; inability to express their own emotional state. Therefore, children with Asperger syndrome often seem egocentric, callous, emotionally cold, tactless, unpredictable in their behavior. Many of them do not tolerate the touches of other people, practically do not look into the interlocutor’s eyes or look with an unusual fixed gaze (like an inanimate object).
A child with Asperger syndrome experiences the greatest difficulties when dealing with their peers, preferring a society of adults or young children. During interaction with other children (joint games, problem solving) a child with Asperger syndrome tries to impose its own rules on others, does not compromise, cannot cooperate, does not accept other people’s ideas. In turn, the children’s team also begins to reject such a child, which leads to an even greater social isolation of children with Asperger syndrome. Adolescents suffer their loneliness, they may experience depression, suicidal, drug and alcohol addiction.
Features of intelligence and verbal communication in children with Asperger syndrome
IQ in children with Asperger syndrome may be within the age norm or even exceed it. However, when teaching children, an insufficient level of development of abstract thinking and the ability to comprehend, the absence of the skill of independent problem solving are revealed. With phenomenal memory and encyclopedic knowledge, children sometimes cannot adequately apply their knowledge in the right situations. At the same time, children with Aspergers often achieve success in those areas they are enthusiastically interested in: usually it is history, philosophy, geography, mathematics, and programming.
The range of interests of a child with Asperger syndrome is limited, but they are passionately and fanatically given to their hobbies. At the same time, they overly focus on the details, concentrate on the little things, “fixate” on their hobbies, and are constantly in the world of their thoughts and fantasies.
In children with Asperger syndrome, there is no marked delay in the development of speech, and by 5-6 years their speech development is significantly ahead of their peers. The speech of a child with Asperger’s syndrome is grammatically correct, but differs by a slow or accelerated pace, monotony and unnatural timbre of the voice. Excessive academic and book style of speech, the presence of speech patterns contribute to the fact that the child is often called the “little professor.”
Children with Asperger Syndrome can talk about the subject of interest to them for a very long time and in detail, without tracking the interlocutor’s reaction. Often they are not able to start a conversation first and keep the conversation going beyond their area of interest. That is, despite the potentially high speech skills, children are not able to use the language as a means of communication. In children with Asperger syndrome, semantic dyslexia is often encountered – mechanical reading without reading comprehension. At the same time, children may have increased ability to write their thoughts.
Features of the sensory and motor sphere of children with Asperger syndrome
Children with Asperger Syndrome are characterized by a sensory sensitivity disorder, which manifests itself in increased susceptibility to various visual, sound, and tactile stimuli (bright light, sound of dripping water, street noise, touching the body, head, etc.). Since childhood, Aspergers have been distinguished by excessive pedantry and stereotyped behavior. Children follow daily rituals day after day, and any change in the conditions or order of actions causes them to become confused, alarming and disturbing. Very often, children with Asperger syndrome have strictly defined gastronomic tastes and categorically deny any new dishes.
A child with Asperger Syndrome may have unusual obsessive fears (fear of rain, wind, etc.) that are different from the fears of children of their age. However, in dangerous situations, they may lack the instinct of self-preservation and the necessary caution.
As a rule, a child with Asperger syndrome has impaired motor skills and coordination of movements. They can no longer learn how to button buttons and tie shoelaces longer than peers; the school has an uneven, sloppy handwriting, because of which they receive constant comments. Asperger children may experience stereotypical obsessive movements, clumsiness, poor posture and gait.
Diagnosis of Asperger Syndrome
The features of Asperger syndrome in a child can be detected by parents, educators, teachers, doctors of various specialties who monitor the development of children (pediatrician, pediatric neurologist, speech therapist, child psychologist, etc.). However, the final right to confirm the diagnosis remains for a child or adolescent psychiatrist.
In the diagnosis of Asperger syndrome, methods of questioning, interviewing parents and teachers, observation of the child, and neuropsychological tests are widely used. Criteria for the diagnosis of Asperger syndrome developed by WHO and allow you to assess the ability of the child to various types of social contacts.
To exclude organic brain diseases, neurological diagnosis (EEG, MRI of the brain) may be required.
Treatment with Asperger Syndrome
There is no specific treatment for Asperger Syndrome. Psychotropic drugs (neuroleptics, psychostimulants, antidepressants) can be prescribed individually as pharmacological support. Non-drug therapy includes training in social skills, exercise therapy, speech therapy, cognitive-behavioral psychotherapy.
The success of social adaptation of children with Asperger syndrome largely depends on the organization of the correct psychological and pedagogical support of the “special” child at various stages of his life. Despite the fact that children with Asperger syndrome can attend secondary school, they need individualized learning conditions (organizing a stable environment, creating motivation conducive to academic success, accompanied by a tutor, etc.).
Developmental impairment is not completely overcome, so a child with Asperger syndrome grows up in an adult with the same problems. In adulthood, a third of patients with Asperger syndrome are able to live independently, start a family, and work in regular work. In 5% of individuals, problems of social adaptation are fully compensated and can only be identified through neuropsychological testing. Particularly successful are people who find themselves in areas of interest, where they show a high level of competence.
Asperger syndrome is an autism spectrum disorder characterized by the specific difficulties of social interaction. Children with Asperger Syndrome have problems with non-verbal communication, establishing and maintaining friendly contacts; prone to the same type of behavior and actions; have inhibited motor skills, stereotyped speech, narrowly focused and at the same time deep interests. The diagnosis of Asperger syndrome is established on the basis of data from a psychiatric, clinical, neurological examination. Children with Asperger Syndrome need to develop social interaction skills, psychological and pedagogical support, medical correction of the main symptoms.
Asperger’s Syndrome is a common developmental disorder belonging to highly functional autism, in which the ability to socialize remains relatively intact. According to the modern psychiatric classification, Asperger syndrome is one of the five autistic spectrum disorders, along with early childhood autism (Kanner syndrome), childhood disintegrative disorder, Rett syndrome, non-specific pervasive developmental disorder (atypical autism). According to foreign authors, signs that meet the criteria for Asperger syndrome are found in 0.36–0.71% of schoolchildren, while in 30–50% of children, this syndrome is not diagnosed. Asperger syndrome is 2–3 times more common in the male population.
The syndrome was named for Austrian pediatrician Hans Asperger, who observed a group of children with similar symptoms, which he himself described as “autistic psychopathy”. Since 1981, the name “Asperger syndrome” has been assigned to this disorder in psychiatry. Children with Asperger syndrome have poorly developed abilities to social interaction, behavioral problems, learning difficulties, and therefore require increased attention from teachers, child psychologists and psychiatrists.