Asperger Syndrome (AS)

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Asperger Syndrome
Body Parts: Head
Medical Subjects: Children's Health Mental Health
Overview

What Is Asperger's Syndrome

Asperger's syndrome is a nervous system developmental disorder characterized by difficult social interaction, limited and abnormal interest behavior patterns. It is classified as a generalized developmental disorder with autism. This disease was first proposed by Austrian psychiatrist Asperger in 1944, only one year after Kanner discovered autism. The etiology of Asperger's syndrome is unknown, and its incidence may be much higher than that of children with autism, which is very harmful to children's mental health.

Cause

What Is The Cause Of Asperger Syndrome

At present, the etiology of Asperger's syndrome is unclear.

Symptom

What Are The Symptoms Of Asperger Syndrome

The clinical features of Asperger's syndrome are generally described as:

1. Lack of understanding of other people's emotions.

2. Inappropriate and unilateral social interaction, lack of the ability to build friendship, which leads to social isolation.

3. Dull and monotonous language.

4. Poor non-verbal communication.

5. In some limited aspects, such as weather, TV program schedule, train schedule and map, they show strong receptivity, but they only remember mechanically, but they can't understand, giving people an odd impression.

6. Clumsy, uncoordinated movements and strange postures.

Although all cases of this disease were boys when Asperger first reported it, there are cases of girls now. However, boys are obviously more susceptible to this disease. Although most children have normal IQ, there are still a few children with mild developmental retardation. Asperger's syndrome often occurs obviously or at least is discovered later than autism, so language and cognitive ability are preserved. This situation is usually stable. And this higher IQ suggests a better long-term prognosis than autism.

Clinical Picture

1. There is qualitative damage in social interaction. Patients with AS are usually isolated and isolated, and often contact others with some unusual or strange behaviors. Although patients know the existence of others, they are usually self-centered. For example, they will give "speeches" to the audience incessantly, and the contents are generally about his hobbies or, more commonly, some unique and narrow topics. Most patients evaluate themselves as "lonely people", and they often express their interest in making friends and meeting others. However, these wishes often cannot be realized because of their clumsy communication skills and inability to understand other people's feelings and wishes. Repeated failures in communicating with people and making friends gradually make these children feel frustrated, and some people even have depressive symptoms and need medication. In the emotional aspect of social communication, patients often show inappropriate reactions and incorrect explanations in the process of emotional communication, and they are slow to respond to other people's emotional expressions, and even ignore them. Nevertheless, they have the ability to correctly describe other people's emotions in a cognitive and inflexible way.

Patients' behavioral responses strongly depend on formulaic and rigid social behavioral norms and social rules, but cannot understand other people's intentions intuitively and spontaneously, so they often show disjointed responses. This performance leads to AS patients giving people a strong impression that their social behavior is naive and rigid. These behaviors of AS patients at least partially exist in autistic patients. The difference is that autistic patients are withdrawn, and they seem to be not interested in the people around them or unaware of the existence of others. However, AS patients often desire or even try their best to establish contact with others, but lack the skills to do so.

2. There are qualitative defects in language communication. Although there are no obvious functional obstacles in this field in the definition of AS, there are at least three points worthy of attention in the language communication skills of AS.

① Although the patient's voice changes and intonation are not as monotonous and rigid as autism, the rhythm of speech is poor, and there is often a lack of cadence in the representation of facts and humorous comments.

② Words are often beside the point and accidental, giving people a feeling of looseness and lack of internal connection and coherence. Although in some cases, this symptom may suggest some kind of thinking disorder, more often, the lack of coherence and interactivity in this kind of speech is the result of self-centered conversation mode, for example, long monologues about names and numbers that lack feelings, can't provide background information for comments, can't clearly define changes in topics, and can't stop expressing inner thoughts.

③ The most typical feature of patients' communication style is the lengthy expression style, which some authors think is the most obvious feature that distinguishes this disease from others. Patients will keep talking about topics they are interested in, regardless of whether the audience is interested or listening, whether they want to cut in or whether they want to change a topic. Although a lot has been said, there is usually no argument. The other side of the conversation may try to discuss the content or logic of the event, or connect with related topics, but it is usually unsuccessful.

Although all these manifestations may be explained by the major defects in language practical skills or the lack of insight or awareness of others' expectations, we still need to understand this phenomenon from a developmental perspective in order to facilitate the training of patients' social adaptation skills.

3. Limited, repetitive, fixed patterns of behavior, interests and activities. The most common observation in AS is the total devotion to limited interests. The expression of great devotion to some unusual and very limited topics. They have accumulated a lot of factual knowledge about the topics they are interested in, and they often show these facts in their first social interaction with others. Although the actual topic can change, for example, every other year or two, it may dominate the social interaction and daily activities of patients, and often immerse the whole family in something for a long time. Although this symptom is not easy to be found in childhood, because many children have a strong interest in dinosaurs and popular cartoon characters, it will make the symptoms stand out when the topic becomes unusual and narrow. This kind of behavior is very special because patients often learn a lot of factual information about some limited topics, such as snakes, planet names, maps, TV programs or railway schedules.

4. Clumsy exercise. In addition to the diagnostic bASis mentioned above, there is another symptom as a related manifestation of AS patients rather than the diagnostic basis, that is, delayed motor development and clumsy motor. Patients with AS may have a personal history of backward development of motor skills, such as learning to ride bicycles, catch balls and open cans later than their peers. Usually they are inflexible, rigid in gait, eccentric in posture, poor in operation skills, and have obvious defects in visual-motor coordination ability. Although this performance is contrary to the motor development mode of autism, usually, motor skill is a relatively strong one in autism, but in some respects it is similar to that observed in adult autistic patients. Then, this long-term commonality may be caused by different reasons. For example, AS patients may be caused by psychomotor disorder, while autism may be caused by poor self-image and feeling. This requires us to describe this symptom in the context of development.

Diagnosis of Asperger Syndrome

1. There are obstacles in social interaction, which can be judged qualitatively only by showing at least the following two situations.

① There are obvious defects in the ability to use some nonverbal behaviors for social interaction, such as eye contact, facial expressions, body posture and gestures.

② It is impossible to establish an appropriate partnership commensurate with their age.

③ Lack of desire to find others to share happiness, preferences or success spontaneously.

④ Lack of communicative and emotional reciprocal behaviors.

2. stubbornly adhere to repeated and unchanging patterns in behaviors, preferences and activities, showing at least one of the following situations:

① Always in one or more constant limited interest patterns, and its intensity and interest concentration are abnormal.

② Obvious and stubborn adherence to some special and meaningless procedures and ceremonies.

③ Repeatedly and constantly maintain some special habits formed by yourself.

④ Pay attention to a part of the object for a long time.

3. The above obstacles seriously impair children's functions in social interaction, occupation or other important fields.

4. There is no obvious overall delay of clinical significance in language development, such as speaking a single word before the age of two and using conversational phrases before the age of three.

5. There is no obvious clinical delay in the development of cognitive ability, self-care ability, adaptive behavior and curiosity about the external environment in childhood.

6. It does not meet other definite diagnostic criteria of generalized developmental delay and schizophrenia.

Detect

How To Check For Asperger Syndrome

For patients with Asperger's syndrome, it is impossible to diagnose the disease through examination. It is mainly necessary to observe and accumulate mental behavior in daily life, pay attention to whether there are special manifestations, and make a diagnosis according to six requirements in symptom diagnosis.

Prevention

How To Prevent Asperger Syndrome

Self Support

Although patients with Asperger's syndrome have a strong willingness to make friends and hope to have a more active social life, they usually describe themselves as lonely people. They can promote their social ties by participating in various active group activities, such as church communities, interest clubs and various group organizations. Recent empirical studies have shown that patients with Asperger's syndrome are willing to communicate with other patients with the same problems, and can build relationships through certain activities or sharing interests.

Adaptability

In any intervention plan, giving priority to patients with sufficient abilities in all aspects. Stereotype characteristics of AS patients can be used to cultivate their good habits and improve the quality of life of individuals and family members. Training methods for patients should strictly follow the above guidelines and be carried out routinely in different natural environments, so as to maximize the generalization of skills.

Inadaptive Behavior

Patients are usually trained in the form of oral instructions to teach them special problem-solving methods to solve frequently occurring and troublesome problems, such as novelty, strong social demands or setbacks in this respect. Training in this area is very necessary for patients to know the occurrence of problems and choose the best solution.

Social and Communication Skills

This skill may be best trained by social experts interested in pragmatics. However, if social training institutions can provide enough opportunities for patients to contact trainers and practice special skills, they can also receive training in them. Training courses should include the following aspects:

1. Appropriate nonverbal behaviors, such as gazing and learning and imitating tone changes in people's communication, including imitating training in front of a mirror, and so on.

2. Explain other people's nonverbal behavior with language.

3. Processing visual and auditory information at the same time, so as to cultivate the ability to integrate various stimuli and reduce the difficulty of establishing appropriate social relationships.

4. At the same time, cultivate and train patients' social cognition and perspecive-talking skill ability, and correct their ambiguous expressions, such as non-written language.

School Curriculum

The course content should be compiled according to the long-term goal, so that the effectiveness of each project can be evaluated according to its long-term effect on patients' social skills, career potential and quality of life. Emphasis should be placed on those skills that are closely related to patients and those that are regarded as closely related to people's professional life, such as writing skills, computing skills, scientific experiments and so on. If a patient has a special interest in some aspect, it is better to make use of it for seeking a career in the future than to restrict it and treat it as unusual. This kind of interest and talent should be cultivated in a systematic way to help patients learn how to study in a planned way, such as how to use libraries, computers, internet, etc. Special subjects should be set up to enable patients to get more credits. Special educational methods can be established through the communication between members and patients in the community. It is often useful to emphasize the use of computer resources, which can be regarded as:

1. The compensation of typical descriptive motor skill difficulties.

2. Stimulate patients' interest in self-learning skills, including using online resources.

3. Establishing contact with other people with common interests through e-mail, a non-threatening social relationship is more conducive to developing contact, including personal contact.

Vocational Training

Generally speaking, adults with AS can't meet the job requirements when looking for a job, or they can't carry out a certain job for a long time because of poor interview skills, social skills, eccentric behavior and anxious aggression. Being unable to do skilled work, these patients may find physical work with the help of kind friends and relatives. However, due to their poor visual or motor abilities, they will often fail again, resulting in destructive emotional cues. It is very important to train patients with AS and let them work in an environment that can be supported and protected to a certain extent, and this work must not be restricted by their neuropsychological damage. At the same time, these jobs can't have higher requirements for social skills.

Treatment

How To Treat Asperger Syndrome

The main treatment of Asperger is understanding, support, sympathy and tolerance. Special education service is necessary. The acquisition of basic social skills and adaptability in other areas should be encouraged. It is usually difficult for Asperger patients to participate in intensive insight cooperative psychotherapy, but supportive psychotherapy focusing on sympathy, social difficulties and depression syndrome is also useful. Accompanying conditions such as depression can be treated with drugs.

Before starting every treatment and intervention plan, it is necessary to make a comprehensive and thorough assessment to understand the children's deficiencies and abilities. A comprehensive and extensive assessment includes an assessment of past and present behaviors or spirits, neurobiological functions, communication patterns, especially the ability to use language to achieve some social goals, or pragmatics, and adaptive behaviors, so as to tap one's own potential and solve problems encountered in daily life. The final report should describe in detail the children's deficiencies and abilities in these different aspects. Making a correct diagnosis is the last step in this assessment. Every child is different. If you look at a group of children with Asperger, you will probably be more impressed by their differences than their similarities. Therefore, it is very important that the intervention plan based on comprehensive and extensive evaluation must meet the unique needs and abilities of the given children.

A set of individualized education and treatment programs should be established after a thoughtful discussion of a child. This detailed guideline should be used as a set of recommendations for reference when setting up education, treatment and vocational training programs for individual cases. In a word, don't take the diagnosis of AS for granted, ask some detailed and personalized things of your child, don't accept some arguments about your child's ability not to be applied in intervention, and don't accept an intervention plan based solely on diagnosis, such as asking about the progress of the appropriate plan based on your child's current situation, study plan and living conditions, and realistic short-term and long-term goals.

Drug Treatment

Although there is little information about drug treatment for patients with Asperger's syndrome, conservative treatment based on autism is likely to be adopted. Generally speaking, children should be prevented from drug intervention as much as possible, and special drug treatment can be given when patients have weak depression symptoms, serious delusions, compulsions or confusion of thinking. Parents should know clearly that drug treatment is only for special accompanying symptoms, but not for the disease itself.

Psychotherapy

Although the existing psychotherapy has not shown much curative effect on AS, the centralized and structured counseling service to a certain extent is of great help to AS patients, especially those who are sad, suffering from resistance, anxiety, abnormal family function or suffer setbacks in finding a career and adapting to society.

Identify

How To Identify Asperger Syndrome

Schizophrenic Personality Disorder In Children

Some similar diagnostic concepts, which are derived from adult psychiatry, neuropsychology, neurology and other interdisciplinary subjects, have a common performance with AS to a certain extent. For example, Wolff and his colleagues describe a group of people who have abnormal behavior patterns and are characterized by social isolation, rigid thinking habits and abnormal communication methods. This disease is named as schizophrenic personality disorder in children. Unfortunately, there is no further progress in the research of this subject, so it is difficult to determine how many cases described here show autism-like symptoms at an early age. More generally, if you understand AS as a fixed personality trait, you can't fully understand the new research direction of this disorder, but these research advances play an important role in differential diagnosis.

Non-Verbal Learning Disorder (NLD)

In neuropsychology, a large number of studies focus on the Non-verbal Learning Disorder (NLD) proposed by Rourke's. The main contribution of this research is to try to describe the meaning of children's social emotional development from the perspective of neuropsychology by studying the soundness and defects of neuropsychology which have adverse effects on people's socialization ability and communication style. The neuropsychological characteristics of NLD patients include tactile sensation, neuromuscular coordination, visual/spatial structure defects, non-verbal problem-solving ability defects, and discrimination and understanding obstacles between incongruous things and humor.

There are many aspects of NLD patients, including:

1. Good mechanical language ability and verbal memory.

2. It is difficult to adapt to the new or complex environment.

3. Over-reliance on mechanical behavior to cope with the new environment.

4. Compared with the skilled reading ability of single words, the mechanical computing ability is relatively poor.

5. Poor use and rhythm of language expression.

6. Obvious defects in social cognition, social judgment and social skills.

There are obvious defects in the understanding of some subtle and obvious nonverbal communication, so that they are often discriminated and excluded by others. The results show that NLD patients have a significant tendency of social withdrawal, and the risk of developing serious emotional disorder is very high.

Right Brain Syndrome

Many clinical features commonly manifested in NLD have been described by neurological works as a state of developmental learning difficulties in the right hemisphere of the brain. Children with these conditions are also taken as examples of "great interference in expression and communication and some basic interpersonal skills". It is not clear that these two concepts describe two completely different diseases or, more likely, provide different kinds of observation and analysis methods. However, these two diseases overlap, and some individuals have at least some common symptoms.

Autism

There are many similarities between AS and autism, especially high functional autism. Some researchers can't explain the research results of others. Clinicians make the diagnosis of AS at will based on their own understanding or misunderstanding of AS. Parents and schools can't do anything about this diagnostic name. What is even more worrying is that no one knows how to treat them, and there are almost no publicly released information about education and treatment for parents and clinicians. Until AS was officially defined in DSM-IV, this chaotic situation was improved to some extent. This definition is based on a large-scale international experiment. The subjects of this experiment include more than 1,000 children and adolescents with autism or related disorders. This experiment reveals some evidence that AS is a diagnostic category independent of autism, and it belongs to extensive developmental disorder with autism. More importantly, it establishes a unified definition of AS, which should be regarded as the reference basis for diagnosis. However, the problem is far from being solved. Except for some new research progress, our understanding of AS is still very limited. For example, we don't have exact figures to show how common it is, and what is the prevalence rate between men and women. Also, the disease is linked with heredity, which increases the possibility of similar situations among family members, and so on.

Complication

What Are The Complications Of Asperger's Syndrome

Patients with Asperger's syndrome, because of their lack of social skills, may suffer from depression after suffering many times and need medication.

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