Asperger Syndrome Support Group

Asperger syndrome - also referred to as Asperger's syndrome, Asperger's, Aspergers or just AS - is one of five neurobiological pervasive developmental disorders (PDD), and is characterized by deficiencies in social and communication skills, and normal to above normal intelligence, and standard language development. The diagnosis of AS is complicated by the lack of a standard diagnostic screen, and the use of several different screening instruments and sets of diagnostic criteria. The exact cause of AS is unknown, and the prevalence is not firmly established, due partly to the use of differing sets of diagnostic criteria.

AS is characterized by:

* Limited interests or preoccupation with a subject to the exclusion of other activities;
* Repetitive behaviors or rituals;
* Peculiarities in speech and language;
* Socially and emotionally inappropriate behavior and interpersonal interaction
* Problems with non-verbal communication; and,
* Clumsy and uncoordinated motor movements.

The most common and important characteristics of AS can be divided into several broad categories: social impairments, narrow but intense interests, and peculiarities of speech and language. Other features are commonly associated with this syndrome, but are not always regarded as necessary for diagnosis.

Treatment coordinates therapies that address the core symptoms of AS: poor communication skills, obsessive or repetitive routines, and physical clumsiness.

A typical treatment program generally includes:

* social skills training, to teach the skills to more successfully interact with others;
* cognitive behavioral therapy, to help in better managing emotions that may be explosive or anxious, and to cut back on obsessive interests and repetitive routines;
* medication, for co-existing conditions such as depression and anxiety;
* occupational or physical therapy, to assist with sensory integration problems or poor motor coordination;
* specialized speech therapy, to help with the trouble of the "give and take" in normal conversation; and,
* parent training and support, to teach parents behavioral techniques to use at home.

The prevalence of AS is not well established, but conservative estimates using the DSM-IV criteria indicate that two to three of every 10,000 children have the condition, making it more rare than autistic disorder itself. Three to four times as many boys have AS compared with girls. The universality of AS across races, and validity of epidemiologic studies to date, is questioned.

A 1993 broad-based population study in Sweden found that 36 per 10,000 school-aged children met Gillberg's criteria for AS, rising to 71 per 10,000 if suspected cases are included. The estimate is convincing for Sweden, but the findings may not apply elsewhere because they are based on a homogeneous population. The Sweden study demonstrated that AS may be more common than once thought and may be currently underdiagnosed. Gillberg estimates 30-50% of all persons with AS are undiagnosed. A survey found that 36 per 10,000 adults with an IQ of 100 or above may meet criteria for AS.

Like other autism spectrum disorders, AS prevalence estimates for males are higher than for females, but some clinicians believe that this may not reflect the actual incidence rates. Tony Attwood suggests that females learn to better compensate for their impairments due to gender differences in the handling of socialization. The Ehlers & Gillberg study found a 4:1 male to female ratio in subjects meeting Gillberg's criteria for AS, but a lower 2.3:1 ratio when suspected or borderline cases were included.

The prevalence of AS in adults is not well understood, but Baron-Cohen et al. documented that 2% of adults score higher than 32 in his Autism Spectrum Quotient (AQ) questionnaire, developed in 2001 to measure the extent to which an adult of normal intelligence has the traits associated with autism spectrum conditions. All interviewed high-scorers met at least 3 DSM-IV criteria, and 63% met threshold criteria for an ASD diagnosis; a Japanese study found similar AQ Test results.

Most patients presenting in clinical settings with AS have other comorbid psychiatric disorders. Children are likely to present with attention-deficit hyperactivity disorder (ADHD), while depression is a common diagnosis in adolescents and adults. A study of referred adult patients found that 30% presenting with ADHD had ASD as well.