Asperger syndrome

Asperger syndrome: short overview

• symptoms: first signs about the age of 3, often delayed motor development, awkwardness, stereotypical behavior, low ability to interact, little facial expressions, often self-talk. Often conspicuous “special interests”.
• Causes, risk factors: probably u.a. genetically, often higher age of the parents. Infections and diseases as well as medicines in pregnancy, premature birth.
• Diagnosis: detailed medical history (survey of family and family history), foreign 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 Ratio (EQ)
• Watch out: The tests only allow a rough assessment. Diagnosis difficult especially in adults.
• Treatment: not curable, but suffering and social interaction can be favorably influenced. V. a. Behavior therapy, communication training, supportive occupational therapy, physiotherapy

Asperger syndrome: symptoms

Asperger syndromeSymptoms usually become apparent after the third year of life. Previously, the children show no abnormalities in terms of their communicative and language skills. They also take their first steps towards self-employment and are curious about their environment – as well as children without Asperger’s Syndrome. Only the motor development is partly delayed, but not always.

Therefore, Asperger’s Syndrome is often discovered in children only at pre-school or school age. The sufferers have Problems with social interactions, which is shown for example in the joint game with peers. For example, they can misunderstand the thoughts and feelings of their fellow human beings and have great difficulty adjusting to other people and social situations. It is difficult for them to correctly interpret the facial expression, the gestures and the tone of others. They themselves often show hardly any facial expressions.

Often children with Asperger syndrome can also no mutual conversation to lead. They talk when they want and on issues that interest them, without adapting to the audience. Subtle signals of the other person, for example to change the subject or to end the conversation, they do not understand. Often, Asperger Autists also talk to themselves.

Children with Asperger syndrome often do not know how to build friendships. Some, however, have no interest in social contacts and friendships.

Other Asperger syndrome symptoms are unusual pronounced interests and knowledge, often in a narrow and sometimes less practical area (island talents). This high specific interest may, for example, apply to the melting point of metals, batteries or church towers. Those affected can be so focused on interest that they (eg at school) little curiosity and attention for others. Based on these attention Deficit disorder Asperger syndrome children are often bad students despite good intelligence.

In addition, Asperger autism sometimes shows Disorders of sensory perception, Thus, some of those affected are very sensitive to certain smells, sounds, surfaces or touch stimuli. In everyday situations, this can become a veritable overstimulation of the afflicted.

Aspergers are often right in walking and in motor coordination clumsy, Also stereotypical behaviors come forward.

Despite all the difficulties, people with Asperger’s Syndrome often try not to attract attention and compensate for their social skills issues. In the long run, this can be very exhausting and overwhelming and cause Asperger Autists to become different withdraw.

Strengths in Asperger’s Syndrome

People with Asperger’s syndrome also have many strengths. So sets with them the Speech development usually early a: The affected children can often speak before running free. Over time, they develop a very sophisticated, versatile language with a large vocabulary.

In addition, people with Asperger syndrome usually have one good to above average intelligence, The special interests and island talents mentioned above can be used by some in their professional life.

In addition, Asperger syndrome is the Thinking ability often impressive, Original ideas as well as good skills in logical and abstract thinking are not uncommon.

Sincerity, loyalty, reliability and a well-developed sense of justice are often cited as further strengths in Asperger’s Syndrome. In praise and recognition, children with Asperger’s Syndrome often respond with motivation and gratitude.

By the way: That language development and intelligence in Asperger’s syndrome are usually normal is an important difference to early childhood autism. That’s another form of autistic disorder.

Asperger syndrome: symptoms in adults

The problematic behaviors of Asperger’s autism are often less apparent in adult patients than in childhood. However, even adults usually have a grammatically correct, polished style of speech and a detailed narrative style that hardly distinguishes between important and unimportant. As with children, Asperger’s Syndrome in adults can lead to frozen facial expressions and the avoidance of eye contact. On a smile or a humorous remark, many sufferers hardly or not at all respond.

The lack of empathy in Asperger syndrome also influences the subject partnership, Those affected often feel cool and selfish. Many find it difficult to make contact with potential partners. If it works with a relationship, many find it difficult to meet the partner’s requirements for intense communication and empathy.

Also on the sex life Asperger’s Syndrome Can Affect: Some sufferers have little need for physical closeness or even aversion to it. Others have a desire for sex, but are very unsure in specific situations because sexual intimacy is the result of intense mutual empathy. Nonetheless, Asperger’s Syndrome in adults does not mean that a stable partnership and starting a family of one’s own would not be possible.

For the professional life Asperger’s Syndrome can have two consequences: some patients are easily overwhelmed when dealing with colleagues or customers, they are easily challenged with their very direct, rude-looking manner and can hardly adapt flexibly to different requirements.

In other cases, Asperger’s Syndrome in adults has a beneficial effect on career development. Namely, when those concerned can profitably use their special interest (for example in the computer science sector) that accompanies the disturbance in their work. In addition, many Asperger autistic individuals, with their often high cognitive abilities, are able to make good career and personal goals.

Comorbidities (comorbidities)

People with Asperger’s Syndrome can also develop other illnesses or disorders, especially in times of crisis such as relocation, retraining, puberty, childbirth or death in the family. The most common are ADHD, motor disorders, obsessive-compulsive symptoms, mood disorders (such as depression, anxiety), personality disorders, aggressive behavior, and sleep disorders. Tics / Tourett syndrome, eating disorders, dumbness (mutism), self-injurious behavior, and schizophrenia may also accompany Asperger’s autism.

Asperger syndrome: causes and risk factors

Autism – Asperger’s Syndrome (Asperger’s Autism) is one of them. What causes it is not yet known. Experts suggest that the interaction of multiple factors is responsible for someone developing Asperger’s Syndrome.

So it is believed that in the onset of Asperger’s syndrome genetic factors play. Many sufferers have close relatives with Asperger’s autism or similar behaviors. There are now several genetic changes that increase the risk of developing an autistic disorder such as Asperger’s Syndrome.

Studies also suggest that a higher age of father or mother Increased the likelihood of Asperger autism and other autism spectrum disorders.

Proven risk factors are maternal Infections during pregnancy (like rubella). Maybe also increase (strong) preterm birth, maternal diabetes such as Hypoglycaemia and lung function problems in newborns the risk of autistic disorders such as Asperger’s Syndrome.

Another risk factor discussed is the intake of certain Medicines during pregnancy, Suspected, for example, are agents for epilepsy (antiepileptics, especially valproate).

In addition, also seem neurological and biochemical abnormalities to play a role. These include, for example, irregularities in the electrical brain waves, deviations in the structure of various brain regions, and an altered proportional composition of the nerve messengers (neurotransmitters).

Parents and vaccines are not to blame

The old hypothesis that autistic disorders such as Asperger’s Syndrome are due to lack of parent love is wrong. The nature of parenting and attachment to parents also does not increase the risk of autism. The same applies to alcohol consumption and a strong psychosocial burden on the mother during pregnancy.

Likewise, there was no evidence for the thesis that autism is caused by vaccines or their preservatives.

Asperger syndrome: examinations and diagnosis

Asperger syndrome is often difficult to distinguish from other abnormalities, such as deep developmental disorders, obsessive-compulsive disorder, obsessive-compulsive disorder, schizotypal or schizophrenic disorders. Therefore, a detailed medical examination is necessary for the diagnosis. For the Asperger syndrome in children, a physician is responsible for child and adolescent psychiatry. The expert in adult Asperger syndrome is a specialist in psychiatry or psychotherapy.

For a detailed examination of suspected Asperger syndrome include:

• Conversation with patient and relatives
• Information about past or current illnesses
• Reports and findings from other doctors
• Information from other people who know the patient (teachers, friends, educators, therapists etc.)
• Thorough physical, psychiatric, neurological and laboratory medical examinations

In conversation and during examinations, the doctor pays attention to typical signs of Asperger’s autism. For example, children with Asperger’s Syndrome often play less imaginatively than their peers. Mimic and speech melody are monotone, the style is polished and sophisticated. The children can tell in great detail about experiences, but do not separate the important from the unimportant. Children with Asperger’s autism respond less frequently to smiles or emotional remarks. Direct eye contact and body contact often avoid them.

Asperger Syndrome Test

Various screening questionnaires and assessment scales support the diagnosis of Asperger’s syndrome. For example, there are the Australian Scale for Asperger’s Syndrome (ASAS) and the Autism Diagnostic Observation Schedule (ADOS). The ASAS is a questionnaire intended for primary school children. It is designed to capture the behaviors and skills typical of Asperger’s Syndrome at this age. In ADOS, on the other hand, different situations are created for the child, which invite social interaction. The assessor estimates to what extent the child complies with this request.

For example, adults use the autism spectrum quotient (AQ) and the empathy quotient (EQ) to help diagnose Asperger’s syndrome. These are self-assessment instruments – the person concerned completes the questionnaires himself. However, there are also foreign assessment instruments such as the “Marburg assessment scale for Asperger syndrome” (MBAS).

Important: Each Asperger syndrome test is just a rough estimate. On the basis of the test result alone, no diagnosis can be made.

Asperger syndrome: difficult diagnosis in adults

Diagnosing Asperger’s Syndrome in adults is much more difficult than in children. The problematic behaviors are usually more pronounced in childhood and often change with growing up. In addition, many sufferers can not remember the difficulties in childhood.

In addition, many adults with Asperger’s Syndrome develop coping strategies to appear as “normal” as possible. As a result, they can often lead an inconspicuous life, pursue a profession and have a partner and children. Usually they go to the doctor only because of complications, for example because of depression, anxiety, obsessive-compulsive disorder or eating disorders. However, if the symptoms are well understood, the doctor may diagnose Asperger’s syndrome in adults as the underlying cause of the disease.

Asperger syndrome: treatment

Asperger syndrome has not healed so far. One can only try to support those affected in their everyday lives with the right support and, for example, help them to improve their social skills. However, not every Asperger syndrome has “disease value” and needs to be treated. Crucial for this are the extent of the symptoms and the suffering of the affected person.

Asperger Syndrome Therapy is composed of various building blocks. It is adapted to the individual needs of the patient. In particular, the age of the person affected, the severity of Asperger’s autism with the individual symptoms and any concomitant diseases or disorders play a role.

Generally recognized behavioral procedures in Asperger syndrome. Such were developed especially for children. Ideal is an early intervention, so an individually adapted behavioral therapy at a young age.

Other therapies can also help, for example Train social and communication skills in the group, The affected persons can train social rules, practice the conduct of the interview and generally make social experiences.

Occasionally, procedures such as occupational Therapy and physical therapy make sense. Some parents also report that their Asperger syndrome child benefits from riding therapy or active (possibly supported) recreational activities. The latter can be, for example, membership in a chess club, sports training, music making or dancing.

A psychotherapy can help with concomitant diseases or disorders, such as anxiety or obsessive-compulsive disorder. In such comorbidities sometimes the gift of drugs be displayed. These may be, for example, antidepressant agents, agents for hyperactivity or against compulsive acts. The medication must always be part of a comprehensive therapy concept.

Asperger syndrome: Other measures

For the Asperger syndrome and all other autistic disorders applies: The victims need a manageable, predictable environmentto feel safe. Clear and lasting structures as well as routines in everyday life are therefore important.

The older a child with Asperger’s Syndrome, the more important is the understanding of their own weaknesses and problems: The child should be informed by the attending physician or therapist about his autistic disorder (psychoeducation).

In adolescents and adults with Asperger syndrome is also the Career finding or professional adaptation important for the success of therapy and the quality of life. Occupations with intensive social contact are usually not advisable. Adapted to the individual possibilities, however, suitable occupations can be found or their own special abilities can be specifically used in a profession.

Asperger syndrome: disease course and prognosis

It is difficult to predict how Asperger’s Syndrome develops individually. Existing studies indicate that the disease is stable. For most sufferers, contact and social behavior will show a slight improvement over time. The basic disturbances remain however. Some Asperger autists can not lead an independent life. Others, on the other hand, have a stable partnership and a profession, where they may even be able to take advantage of their special interests. However, contact with colleagues can sometimes be difficult.

A big impact on the prognosis Asperger syndrome have any comorbidities or disorders. They can significantly affect the further course and development possibilities of the person concerned. Therefore, they should be treated early and properly.

Additional information

Book recommendations:

• A Life with Asperger’s Syndrome: From Childhood to Adulthood – Anything That Can Help (Tony Attwood, 2012, TRIAS)
• Asperger’s Syndrome: The Successful Practice Guide for Parents and Therapists (Tony Attwood, 2016, TRIAS)
• Hedgehog Children – Understanding Children and Adolescents with Asperger Syndrome (Reiner Bahr, 2013, Patmos Verlag)
• Asperger: Living in two worlds: Affected reports: That helps me in my job, partnership and everyday life (Christine Preißmann, 2013, TRIAS)

Guideline:

• S3 Guideline “Autism Spectrum Disorders in Child, Youth and Adulthood” of the Association of Scientific Medical Societies e.V. (as of 2016)

Support group:

Autism Germany e.V. – Federal Association for the Advancement of People with Autism

www.autismus.de