Asperger’s disorder was first described in the 1940s by Viennese pediatrician Hans Asperger who observed autistic-like behaviors and difficulties with social and communication skills in boys who had normal intelligence and language development. Many professionals felt Asperger’s disorder was simply a milder form of autism and used the term “high-functioning autism” to describe these individuals. Professor Uta Frith, with the Institute of Cognitive Neuroscience of University College London describes individuals with Asperger’s disorder as “having a dash of autism.” Asperger’s disorder was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994 as a separate disorder from autism. However, there are still many professionals who consider Asperger’s disorder a less severe form of autism.
Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism. Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors, such as viral infections, metabolic imbalances, and exposure to environmental chemicals.
What distinguishes Asperger’s disorder from autism disorder is the severity of the symptoms and the absence of language delays. Children with Asperger’s disorder may be only mildly affected and frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s disorder may just seem like a normal child behaving differently.
Children with autism are frequently seen as aloof and uninterested in others. This is not the case with Asperger’s disorder. Individuals with Asperger’s disorder usually want to fit in and have interaction with others; they simply don’t know how to do it. They may be socially awkward, not understanding of conventional social rules, or show a lack of empathy. They may have limited eye contact, seem to be unengaged in a conversation, and not understand the use of gestures.
Interests in a particular subject may border on the obsessive. Children with Asperger’s disorder frequently like to collect categories of things, such as rocks or bottle caps. They may be proficient in knowing categories of information, such as baseball statistics or Latin names of flowers. While they may have good rote memory skills, they have difficulty with abstract concepts.
One of the major differences between Asperger’s disorder and autism is that, by definition, there is no speech delay in Asperger’s disorder. In fact, children with Asperger’s disorder frequently have good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection or have a rhythmic nature, or it may be formal, but too loud or high pitched. Children with Asperger’s disorder may not understand the subtleties of language, such as irony and humor, or they may not understand the give-and-take nature of a conversation.
Another distinction between Asperger’s disorder and autism concerns cognitive ability. While some individuals with autism experience mental retardation, by definition a person with Asperger’s disorder cannot possess a “clinically significant” cognitive delay and most possess average to above average intelligence.
While motor difficulties are not a specific criteria for Asperger, children with Asperger’s disorder frequently have motor skill delays and may appear clumsy or awkward.
Diagnosis of Asperger’s disorder is on the increase, although it is unclear whether it is more prevalent or whether more professionals are detecting it. The symptoms for Asperger’s disorder are the same as those listed for autism in the DSM-IV; however, children with Asperger’s disorder do not have delays in the area of communication and language. In fact, to be diagnosed with Asperger’s disorder, a child must have normal language development as well as normal intelligence. The DSM-IV criteria for Asperger’s disorder specifies that the individual must have “severe and sustained impairment in social interaction, and the development of restricted, repetitive patterns of behavior, interests and activities that must cause clinically significant impairment in social, occupational or other important areas of functioning.”
The first step to diagnosis is an assessment, including a developmental history and observation. This should be done by medical professionals experienced with autism and other PDDs. If Asperger’s disorder or high-functioning autism is suspected, the diagnosis of autism will generally be ruled out first. Early diagnosis is also important as children with Asperger’s disorder who are diagnosed and treated early in life have an increased chance of being successful in school and eventually living independently.
For information on Asperger resources, including support groups and websites, click here.