Asperger syndrome (AS) [???????? ????????], also known as Asperger’s, is a developmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior and interests. As a milder Autism Spectrum Disorder (ASD), it differs from other ASDs by relatively normal language and intelligence. Although not required for diagnosis, physical clumsiness and unusual use of language are common. Signs usually begin before two years of age and typically last for a person’s entire life. However, the problem being of permanent nature, it seems quite difficult to overcome this particular problem but Siddha Spirituality of Swami Hardas Life System, a lot of improvement can be achieved. Hence, read how it can be achieved without money and medicines.
Asperger syndrome classification (???????? ???????? ?? ????????)
The extent of the overlap between Asperger Syndrome and High-Functioning Autism (HFA – autism unaccompanied by intellectual disability) is unclear. The ASD classification is to some extent an artifact of how autism was discovered, and may not reflect the true nature of the spectrum; methodological problems have beset Asperger syndrome as a valid diagnosis from the outset.
The World Health Organization (WHO) defined Asperger syndrome (AS) as one of the autism spectrum disorders (ASD) or pervasive developmental disorders (PDD), which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual’s functioning, and by restricted and repetitive interests and behavior.
Like other psychological development disorders, ASD begins in infancy or childhood, has a steady course without remission or relapse, and has impairments that result from maturation-related changes in various systems of the brain.
Of the other four ASD forms, autism is the most similar to Asperger Syndrome in signs and likely causes, but its diagnosis requires impaired communication and allows delay in cognitive development.
Asperger syndrome characteristics (???????? ???????? ?? ?????????)
As a pervasive developmental disorder, Asperger syndrome is distinguished by a pattern of symptoms rather than a single symptom. It is characterized by qualitative impairment in social interaction, by stereotyped and restricted patterns of behavior, activities, and interests, and by no clinically significant delay in cognitive development or general delay in language.
Social interaction (??????? ??????)
Individuals with Asperger syndrome experience difficulties in basic elements of interaction, which may include:
- A failure to develop friendships or to seek shared enjoyments or achievements with others
- A lack of social or emotional reciprocity
- Impaired nonverbal behaviors in areas such as eye contact, facial expression, posture, and gesture
People with AS may not be as withdrawn around others, compared with those with other, more debilitating forms of autism; they approach others, even if awkwardly. For example, a person with Asperger syndrome may engage in a one-sided, long-winded speech about a favorite topic, while misunderstanding or not recognizing the listener’s feelings or reactions, such as a wish to change the topic of talk or end the interaction.
People with AS may analyze and distill their observations of social interaction into rigid behavioral guidelines and apply these rules in awkward ways, such as forced eye contact, resulting in a demeanor that appears rigid or socially naïve. Childhood desire for companionship can become numbed through a history of failed social encounters.
Violent or criminal behavior (????? ?? ??????? ???????)
The hypothesis that individuals with Asperger syndrome are predisposed to violent or criminal behavior has been investigated but is not supported by data. More evidence suggests that children diagnosed with AS are victims rather than offenders.
Restricted, repetitive interests, and behavior (??????????, ????????? ??????? ?? ???????)
People with Asperger syndrome can display behavior, interests, and activities that are restricted and repetitive and are sometimes abnormally intense or focused. They may stick to inflexible routines, move in stereotyped and repetitive ways, preoccupy themselves with parts of objects, or engage in compulsive behaviors like lining objects up to form patterns.
Individuals with AS may collect volumes of detailed information on a relatively narrow topic such as weather data or star names without necessarily having a genuine understanding of the broader topic. For example, a child might memorize camera model numbers while caring little about photography.
Although these special interests may change from time to time, they typically become more unusual and narrowly focused and often dominate social interaction so much that the entire family may become immersed.
Stereotyped and repetitive motor behaviors are a core part of the diagnosis of Asperger syndrome and other ASDs. They include hand movements such as flapping or twisting and complex whole-body movements.
According to the Adult Asperger Assessment (AAA) diagnostic test, a lack of interest in fiction and a positive preference towards non-fiction is common among adults with Asperger syndrome.
Speech and language (??????? ?? ????)
Although individuals with Asperger syndrome acquire language skills without significant general delay and their speech typically lacks: significant abnormalities, language acquisition, and use are often atypical. Abnormalities include:
- Verbosity
- Abrupt transitions
- Literal interpretations and miscomprehension of nuance
- Use of metaphor meaningful only to the speaker
- Auditory perception deficits
- Unusually pedantic
- Formal, or idiosyncratic speech
- Oddities in loudness
- Pitch
- Intonation
- Prosody
- Rhythm
Echolalia has also been observed in individuals with Asperger syndrome.
Motor and sensory perception (???? ?? ?????? ?????)
Individuals with Asperger syndrome may have signs or symptoms that are independent of the diagnosis but can affect the individual or the family. These include:
- Differences in perception and problems with motor skills
- Sleep
- Emotions
Individuals with AS often have excellent auditory and visual perception. Children with ASD often demonstrate enhanced the perception of small changes in patterns such as arrangements of objects or well-known images; typically this is domain-specific and involves the processing of fine-grained features. Conversely, compared with individuals with high-functioning autism, individuals with AS have deficits in some tasks involving visual-spatial perception, auditory perception, or visual memory.
Many accounts of individuals with AS and ASD report other unusual sensory and perceptual skills and experiences. They may be unusually sensitive or insensitive to sound, light, and other stimuli; these sensory responses are found in other developmental disorders and are not specific to AS or to ASD.
Children with Asperger syndrome are more likely to have sleep problems, including:
- Difficulty in falling asleep
- Frequent nocturnal awakenings
- Early morning awakenings
AS is also associated with high levels of alexithymia, which is difficulty in identifying and describing one’s emotions. Although AS, lower sleep quality, and alexithymia are associated with each other, their causal relationship is unclear.
Asperger syndrome Causes (???????? ???????? ?? ????)
Hans Asperger described common symptoms among his patients’ family members, especially fathers, and research supports this observation and suggests a genetic contribution to Asperger syndrome. Although no specific genetic factor has yet been identified, multiple factors are believed to play a role in the expression of autism, given the variability in symptoms seen in children.
Evidence for a genetic link is the tendency for AS to run in families and an observed higher incidence of family members who have behavioral symptoms similar to AS but in a more limited form, for example:
- Slight difficulties with social interaction
- Language
- Reading
Most behavioral genetic research suggests that all Autism Spectrum Disorders have shared genetic mechanisms, but AS may have a stronger genetic component than autism. There is probably a common group of genes where particular alleles render an individual vulnerable to developing AS.
Asperger syndrome Diagnosis (???????? ???????? ?? ?????)
Diagnosis is most commonly made between the ages of 4 and 11. A comprehensive assessment involves a multidisciplinary team that observes across multiple settings and includes a neurological and genetic assessment as well as tests for cognition:
- Psychomotor function
- Verbal and nonverbal strengths and weaknesses
- Style of learning
- Skills for independent living
The gold standard in diagnosing ASD combines clinical judgment with the Autism Diagnostic Interview-Revised (ADI-R), a semi-structured parent interview; and the Autism Diagnostic Observation Schedule (ADOS), a conversation and play-based interview with the child. Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior.
Underdiagnosis and overdiagnosis may be problems. The cost and difficulty of screening and assessment can delay diagnosis. Conversely, the increasing popularity of drug treatment options and the expansion of benefits has motivated providers to overdiagnose ASD.
There are questions about the external validity of the Asperger syndrome diagnosis. That is, it is unclear whether there is a practical benefit in distinguishing AS from HFA and from PDD-NOS; the same child can receive different diagnoses depending on the screening tool.
Differential diagnosis (?????? ?????)
Many children with AS are initially misdiagnosed with attention deficit hyperactivity disorder (ADHD). Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age. Adult diagnosis requires painstaking clinical examination and thorough medical history gained from both the individual and other people who know the person, focusing on childhood behavior.
Conditions that must be considered in a differential diagnosis along with ADHD include:
- Other ASDs
- The schizophrenia spectrum
- Personality disorders
- Obsessive-compulsive disorder
- Major depressive disorder
- Semantic pragmatic disorder
- Nonverbal learning disorder
- Social anxiety disorder
- Tourette syndrome
- Stereotypic movement disorder
- Bipolar disorder
- Social-cognitive deficits due to brain damage from alcohol abuse
- Obsessive-compulsive personality disorder (OCPD)
Asperger syndrome Screening (???????? ???????? ?? ????)
Parents of children with Asperger syndrome can typically trace differences in their children’s development to as early as 30 months of age. Developmental screening during a routine check-up by a general practitioner or pediatrician may identify signs that warrant further investigation.
The diagnosis of AS is complicated by the use of several different screening instruments, including the:
- Asperger Syndrome Diagnostic Scale (ASDS)
- Autism Spectrum Screening Questionnaire (ASSQ)
- Childhood Autism Spectrum Test (CAST)
- Childhood Asperger Syndrome Test
- Gilliam Asperger’s Disorder Scale (GADS)
- Krug Asperger’s Disorder Index (KADI)
- The Autism-spectrum Quotient (AQ)
Asperger syndrome Management (???????? ???????? ?? ???????)
AS treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication, and vocational skills that are not naturally acquired during development. Although progress has been made, data supporting the efficacy of particular interventions are limited.
Therapies (????????)
The ideal treatment for Asperger syndrome coordinates therapies that address core symptoms of the disorder, including poor communication skills and obsessive or repetitive routines. While most professionals agree that the earlier the intervention, the better, there is no single best treatment package. A typical program generally includes:
- Applied behavior analysis (ABA) procedures, including positive behavior support (PBS)—or training and support of parents and school faculty in behavior management strategies to use in the home and school, and social skills training for more effective interpersonal interactions;
- Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions and to cut back on obsessive interests and repetitive routines;
- Medication for coexisting conditions such as major depressive disorder and anxiety disorders;
- Occupational or physical therapy to assist with poor sensory processing and motor coordination; and,
- Social communication intervention, which is specialized speech therapy to help with the pragmatics and give-and-take of normal conversation.
Of the many studies on behavior-based early intervention programs, most are case reports of up to five participants and typically examine a few problem behaviors such as self-injury, aggression, noncompliance, stereotypes, or spontaneous language; unintended side effects largely ignored.
Vocational training is important to teach job interview etiquette and workplace behavior to older children and adults with Asperger syndrome, and organization software and personal data assistants can improve the work and life management of people with AS.
Asperger syndrome Medication (???????? ???????? ?? ????)
No medications directly treat the core symptoms of AS. Although research into the efficacy of pharmaceutical intervention for AS is limited, it is essential to diagnose and treat comorbid conditions.
Medication can be effective in combination with behavioral interventions and environmental accommodations in treating comorbid symptoms such as:
- Anxiety disorders
- Major depressive disorder
- Inattention
- Aggression
The atypical antipsychotic medications:
- Risperidone
- Olanzapine
- Aripiprazole
Risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts, and impulsivity, and improve stereotypical patterns of behavior and social relatedness.
The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine, and sertraline have been effective in treating restricted and repetitive interests and behaviors, while stimulant medication, such as methylphenidate, can reduce inattention.
Care must be taken with medications, as side effects may be more common and harder to evaluate in individuals with AS, and tests of drugs’ effectiveness against comorbid conditions routinely exclude individuals from the autism spectrum.
Abnormalities in metabolism, cardiac conduction times, and an increased risk of type 2 diabetes have been raised as concerns with antipsychotic medications, along with serious long-term neurological side effects.
Weight gain and fatigue are commonly reported side effects of risperidone, which may also lead to increased risk for extrapyramidal symptoms such as restlessness and dystonia and increased serum prolactin levels.
Sedation and weight gain are more common with olanzapine, which has also been linked with diabetes.
Asperger syndrome Prognosis (???????? ???????? ??? ?? ?????)
There is some evidence that children with AS may see a lessening of symptoms; up to 20% of children may no longer meet the diagnostic criteria as adults, although social and communication difficulties may persist.
Individuals with Asperger syndrome appear to have a normal life expectancy but have an increased prevalence of comorbid psychiatric conditions, such as major depressive disorder and anxiety disorders that may significantly affect prognosis.
Although social impairment may be lifelong, the outcome is generally more positive than with individuals with lower-functioning autism spectrum disorders.
Although many attend regular education classes, some children with AS may utilize special education services because of their social and behavioral difficulties. Adolescents with AS may exhibit ongoing difficulty with self-care or organization, and disturbances in social and romantic relationships.
Despite the high cognitive potential, most young adults with AS remain at home, yet some do marry and work independently.
Depression is often the result of chronic frustration from repeated failure to engage others socially, and mood disorders requiring treatment may develop. Clinical experience suggests the rate of suicide may be higher among those with AS, but this has not been confirmed by systematic empirical studies.
Prognosis may be improved by diagnosis at a younger age that allows for early interventions, while interventions in adulthood are valuable but less beneficial.
Stem Cell Therapy & Asperger syndrome (????? ??? ?????? ?? ???????? ????????)
Asperger syndrome and Autism spectrum disorder is a neurodevelopmental disorder accompanied by a weak immune system and neuroinflammation. The use of human embryonic stem cell therapy may be a safe and effective treatment for patients. Please read and watch a video for detailed information.
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Reference: https://en.wikipedia.org/wiki/Asperger_syndrome
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