By Dr Ananya Mandal, MD
Asperger Syndrome is a development disorder that was first described by Viennese paediatrician, Hans Asperger, in the 1940’s. The disease however found a place in the official guidebook of all mental diseases called the Diagnostic and Statistical Manual of Mental Disorders DSM-IV (Fourth Edition) in 1994.
Asperger syndrome is part of the Autism Spectrum disorders (ASD) but is significantly different from typical autism by the fact that the children with this condition have normal or high IQ.
The exact cause of the condition is unknown but it seems to have a basis in genetics as well as neurological development.
Developmental disorders are classified into three broad categories:-
Development of social skills and relations
Use of language for communication
Behavioural and stylistic characteristics repetitive features or narrow range of interests
The defects in each of these categories may range from relatively mild to severe and ranges widely among the various disorders in the autism spectrum including Asperger syndrome.
Several authorities believe that Asperger syndrome is just a milder form of autism or that the conditions are linked by broad clinical similarities.
Asperger syndrome is characterized by normal or higher cognitive abilities and a relatively normal language function compared to other disorders in the Autism spectrum disorders.
Clinical features of Asperger syndrome
The hallmark features of Asperger syndrome include normal language development and normal or higher than normal IQ. The children with the condition tend to have a narrow range of interest.
The interest may be in specific intellectual areas with an obsessive intensity. There may be interest in math or in reading or science. The child may want to learn everything possible on the subject and want to dwell in the subject in all conversations and play time.
In fact when the first case was described in 1944, the interest was in modes of transport with the children described being fascinated with memorizing tram lines in Vienna.
There is also a definite lack of social skills. The difficulty is not in interacting with the others but in making effective interactions and conversations. The children with Asperger syndrome tend to fail in reading the other person’s needs and body language and thus fail to respond appropriately.
Children with Asperger syndrome may also fail to understand jokes and appreciate humour. This however is not universal among all children with Asperger syndrome and the mistaken belief that all children with autism and Asperger syndrome are humour-less is baseless.
Asperger syndrome with age
With age the symptoms may change but the overall problem remains in place. While some features increase or decrease in severity some like social and communication problems may remain.
In preschool aged child there is no single, uniform presenting picture of Asperger syndrome. The problems may be similar to typical autism with language delays and social difficulties.
However, with age the child catches up on language skills and IQ but fails to recover the social difficulties. Most children enter kindergarten without having been diagnosed. Those with other problems such as hyperactivity, inattention, aggression or frequent tantrums and outbursts may be detected earlier.
The problems of socialization and behavioural adjustment surface as the child grows into middle and high school.
As the Asperger children grow up they overcome most of the problems but fail to recover from their social and behavioural difficulties.
The defect is not clearly understood. However, with extensive brain imaging studies and neuroanatomical studies it is found that there is a defect in the connections between the amygdala – seat of human emotions, and the cerebral cortex that regulate response.
Exposure to toxins while still within the mother’s womb also acts as a major link to autism and Asperger syndrome.
Cerebellar dysfunction and dysfunction in the levels of serotonin in the brain are also cited as underlying pathologies behind autism in general. None of these are clearly proven.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)